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BACKGROUND: In order to optimise the support of children with cochlear implants (CI), it is very important to detect slow developmental processes as early as possible. Data from the LittlEARS® Auditory Questionnaire (LEAQ) from children with early bilateral CI are evaluated and presented in relation to age and hearing age and compared with language development data recorded later. MATERIALS AND METHODS: This retrospective multicentre study included data from a total of 554 children for whom at least one LEAQ was completed during the course of CI rehabilitation. Children without additional disabilities who received bilateral simultaneous or sequential CI treatment were included. RESULTS: As expected, there are high correlations between hearing age (HA) and the overall LEAQ total score. When analysed according to chronological age (CA), development runs roughly parallel to the development of children with normal hearing, albeit at a lower level. Children implanted early up to an age of ≤â¯12 months consistently achieve approximately 7-8 raw points more. Only the LEAQ results of the later test times (from the age of 18 months) correlate with some areas of the speech development test for children (SETK; areas 3-5). CONCLUSION: The earliest possible detection of critical developmental processes in children with CI is extremely important. In the case of very early CI fitting, the CA should be used as a reference measure in diagnostics. The LEAQ values determined for the group of children with CI are suitable to a limited extent as generally valid reference values for children with early bilateral CI. Further studies should continue to work out the correlations between early preverbal development and later speech development.
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PURPOSE: The aim of this study was to investigate whether the fitting data of children with Cochlear implants (CI) and severe additional disabilities (CAD) differ compared to children with CI but without additional disabilities (CnonAD). METHODS: In this retrospective analysis, 76 CI cases (fitted ears) from CAD were included and matched with 76 cases from CnonAD. The subjective set values, such as pulse width (PW), threshold (T) and most comfortable (MC) levels were recorded. Additionally, the response threshold values by means of aided soundfield threshold (AST), the values of the intracochlear electrode impedances, the eCAP thresholds and the daily wearing time by using data logging were recorded and analysed. RESULTS: The T and MC levels for the Medel implants were significantly lower in the sample than in the control group. A similar trend was evident for Cochlear® implants. The sample showed a positive correlation between the eCAP thresholds and the T level and MC level in case of the Cochlear implants. The CAD group showed a significantly higher aided soundfield threshold. In contrast to the CnonAD (0%), there was a total of 18% in the CAD with a reduced daily wearing time. When these were excluded, eCAP thresholds were significantly higher in the CAD group. In addition, there was a trend for eCAP thresholds to be higher if the contralateral ear was not also fitted with a CI. CONCLUSIONS: The significantly higher eCAPs in CAD may be explained by different neural survival but also by different fittings and MC levels. The audiuologist's subjectivity must be considered as a potential bias but also as potentially valuable input variable contributing to the variance in the fitting parameters and outcomes. Better fitting of T and MC levels focusing on behavioural and developmental responses may lead to a longer wearing time. To support the audiologist and the fitting process, it is necessary to interpret the response thresholds in the aided soundfield threshold against the background of the medical diagnosis and observations from everyday life should be considered. To ensure optimal development of CAD children according to their individual abilities, a multi-professional, family-centred intervention programme including videoanalyses should be implemented at an early stage, ideally from the decision process for a cochlear implant.
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BACKGROUND: Very early bilateral cochlear implant (CI) provision is today's established standard for children. Therefore, the assessment of preverbal and verbal performance in very early stages of development is becoming increasingly important. Performance data from cohorts of children were evaluated and presented based on diagnostic assessment using chronological age (CA) and hearing age (HA). METHODS: The present study, as part of a retrospective multicentre study, included 4 cohorts (Nâ¯= 72-233) of children with bilateral CI without additional disabilities. Their results in the German parent questionnaires Elternfragebögen zur Früherkennung von Risikokindern(ELFRA1 and ELFRA-2) subdivided for CA and HA were statistically analysed. The data were also analysed in terms of mono-/bilingualism and age at CI provision. RESULTS: Overall, verbal performance in relation to CA was lower than in relation to HA. Preverbal skills were largely CA appropriate. Children with bi-/multilingual language acquisition performed significantly lower. Verbal performance in ELFRA2 referenced to CA was negatively correlated with age at CI provision. CONCLUSION: In the case of early CI provision, CA should be the preferred reference mark in preverbal and verbal assessment in order to obtain exact individual performance levels and avoid bias in results. The percentiles determined are of limited use as generally valid reference values to which the individual performance of bilaterally implanted children could be compared. Further multicentre studies should be initiated.
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BACKGROUND: Due to the COVID-19 pandemic, all essential treatment must adhere to strict health and hygiene protocols. New measures have been introduced in CI treatment centres in order to safely accommodate families and continue to provide effective follow-up CI therapy for children implanted with CIs. OBJECTIVES: The aim of this study was to document, over the course of the pandemic, how patients' parents viewed the likelihood and danger of infection and how necessary they thought the newly implemented protocols were. MATERIALS AND METHODS: All parents of children implanted with CIs who participated in therapy at the CIC treatment centre between August and November 2020 (Nâ¯= 255) were requested to fill out a questionnaire anonymously following their stay. RESULTS: 255 questionnaires were distributed, 83 (32.5%) of which were filled out. During the course of the study, there was an increase in the parents' perceived risk of infection. Simultaneously, fewer parents felt well protected at the CIC. According to parents, the new hygiene protocols at the CIC did not negatively affect treatment. However, many parents noted that their interactions with other patient families had been better prior to introduction of the hygiene protocols. CONCLUSIONS: The CIC`s hygiene protocols were well received. However, data analysis over the course of the study suggests that hygiene protocols were not sufficient to prevent fear of infection in light of increasing rate of infection.
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COVID-19 , COVID-19/prevención & control , Niño , Humanos , Higiene , Pacientes Internos , Pandemias , Padres , Encuestas y CuestionariosRESUMEN
OBJECTIVES: To document musical listening and enjoyment in recipients of Advanced Bionics cochlear implants (CIs) and to compare musical perception in those using early coding strategies with subjects using the newer HiRes and HiRes 120 strategies. METHODS: A questionnaire was completed by 136 adult subjects, including questions on the ability to identify specific musical features. The subjects were in three groups: those using early coding strategies (n = 29), HiRes (n = 59), and HiRes 120 (n = 48), and results were compared with a group of 84 normally hearing (NH) subjects. RESULTS: Of the CI users, 79% reported listening to music. The NH group rated listening frequency and enjoyment higher than the CI users. Thirty-five users reported that they sang and this group had significantly higher overall performance. There were no significant differences in overall perception of specific musical features among the strategy groups, though some individual questions showed significantly higher performance in the HiRes 120 users. DISCUSSION: Users of current CI technology show a high level of musical appreciation, though still significantly less than NH subjects. Frequency of listening and enjoyment were significantly correlated and active participation in musical activities, specifically singing, resulted in significantly higher overall performance scores.
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Percepción Auditiva/fisiología , Implantes Cocleares , Sordera/psicología , Sordera/terapia , Música , Adolescente , Adulto , Estudios de Casos y Controles , Implantación Coclear , Sordera/fisiopatología , Diseño de Equipo , Femenino , Hábitos , Felicidad , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVE: To assess if speech perception improves after the upgrade from the TEMPO+ to the OPUS 2 processor. METHOD: In this retrospective study, 45 subjects (54 ears) implanted with a cochlear implant were upgraded from the TEMPO+ (continuous interleaved sampling + coding strategy) to the OPUS 2 processor (fine structure processing). Before the upgrade, patients were tested with the Freiburg monosyllable (FM) and the Hochmair-Schulz-Moser (HSM) sentence test in quiet and in noise. Four weeks after the upgrade, subjects were again assessed with the same tests. RESULTS: In quiet, mean FM results improved from 62.0% (±21.3%) to 77.8% (±15.2%) and HSM sentences from 69.9% (±26.1%) to 77.9% (±22.1%). In noise, mean FM results improved from 27.3% (±17.1%) to 52.1% (±18.6%) and HSM sentences from 40.4% (±29.1%) to 58.0% (±26.1%). The upgrade to the OPUS 2 was statistically very significant for all speech perception tests (p < 0.001). Additionally, subjects stated that the OPUS 2 initially sounded 'awkward' but that quality and speech perception improved after a certain adaptation time. CONCLUSION: Speech understanding in quiet and noise significantly improved with the OPUS 2 in all speech perception tests.