scholarly journals Effects of Early Acoustic Hearing on Speech Perception and Language for Pediatric Cochlear Implant Recipients

2019 ◽  
Vol 62 (9) ◽  
pp. 3620-3637 ◽  
Author(s):  
Lisa S. Davidson ◽  
Ann E. Geers ◽  
Rosalie M. Uchanski ◽  
Jill B. Firszt
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Language Skills ◽  
Spoken Language ◽  
Receptive Language ◽  
Receptive Vocabulary ◽  
Residual Hearing ◽  
Regression Analyses ◽  
Optimal Duration ◽  
Spoken Language Skills

Purpose The overall goal of the current study was to identify an optimal level and duration of acoustic experience that facilitates language development for pediatric cochlear implant (CI) recipients—specifically, to determine whether there is an optimal duration of hearing aid (HA) use and unaided threshold levels that should be considered before proceeding to bilateral CIs. Method A total of 117 pediatric CI recipients (ages 5–9 years) were given speech perception and standardized tests of receptive vocabulary and language. The speech perception battery included tests of segmental perception (e.g., word recognition in quiet and noise, and vowels and consonants in quiet) and of suprasegmental perception (e.g., talker and stress discrimination, and emotion identification). Hierarchical regression analyses were used to determine the effects of speech perception on language scores, and the effects of residual hearing level (unaided pure-tone average [PTA]) and duration of HA use on speech perception. Results A continuum of residual hearing levels and the length of HA use were represented by calculating the unaided PTA of the ear with the longest duration of HA use for each child. All children wore 2 devices: Some wore bimodal devices, while others received their 2nd CI either simultaneously or sequentially, representing a wide range of HA use (0.03–9.05 years). Regression analyses indicate that suprasegmental perception contributes unique variance to receptive language scores and that both segmental and suprasegmental skills each contribute independently to receptive vocabulary scores. Also, analyses revealed an optimal duration of HA use for each of 3 ranges of hearing loss severity (with mean PTAs of 73, 92, and 111 dB HL) that maximizes suprasegmental perception. Conclusions For children with the most profound losses, early bilateral CIs provide the greatest opportunity for developing good spoken language skills. For those with moderate-to-severe losses, however, a prescribed period of bimodal use may be more advantageous for developing good spoken language skills.

Phonological Awareness and Phonemic Perception in 4-Year-Old Children With Delayed Expressive Phonology Skills

2003 ◽  
Vol 12 (4) ◽  
pp. 463-471 ◽  
Author(s):  
Susan Rvachew ◽  
Alyssa Ohberg ◽  
Meghann Grawburg ◽  
Joan Heyding
Keyword(s):  
Phonological Awareness ◽  
Early Literacy ◽  
Emergent Literacy ◽  
Language Skills ◽  
Receptive Language ◽  
Receptive Vocabulary ◽  
Vocabulary Skills ◽  
Literacy Knowledge ◽  
Age Appropriate ◽  
Expressive Phonology

The purpose of this study was to compare the phonological awareness abilities of 2 groups of 4-year-old children: one with normally developing speech and language skills and the other with moderately or severely delayed expressive phonological skills but age-appropriate receptive vocabulary skills. Each group received tests of articulation, receptive vocabulary, phonemic perception, early literacy, and phonological awareness skills. The groups were matched for receptive language skills, age, socioeconomic status, and emergent literacy knowledge. The children with expressive phonological delays demonstrated significantly poorer phonemic perception and phonological awareness skills than their normally developing peers. The results suggest that preschool children with delayed expressive phonological abilities should be screened for their phonological awareness skills even when their language skills are otherwise normally developing.

Exploring Predictors of Expressive Grammar Across Different Assessment Tasks in Preschoolers With or Without DLD

2019 ◽  
Vol 42 (2) ◽  
pp. 111-121
Author(s):  
Marley Yarian ◽  
Karla N. Washington ◽  
Caroline E. Spencer ◽  
Jennifer Vannest ◽  
Kathryn Crowe
Keyword(s):  
Stepwise Regression ◽  
Expressive Language ◽  
Receptive Language ◽  
Receptive Vocabulary ◽  
Typically Developing ◽  
Regression Analyses ◽  
Assessment Tasks ◽  
Language Assessments ◽  
Parent Concern ◽  
Speech And Language Development

Predictors of expressive grammar were compared in formal and naturalistic assessment tasks for children with typically developing (TD) language and with Developmental Langauge Disorder (DLD). Standardized expressive language assessments were administered to 110 preschoolers. The parents of these children reported whether or not they were concerned about their child’s speech and language development. Stepwise regression analyses revealed receptive language as the only significant predictor of expressive grammar across assessment tasks. For TD preschoolers, receptive vocabulary and grammar accounted for expressive grammar performance in the formal task; however, only receptive grammar accounted for performance in the naturalistic task. For DLD preschoolers, only receptive vocabulary accounted for expressive grammar performance across both tasks. Nonverbal IQ and parent concern did not predict expressive grammar performance in either task. Implications for treatment of preschool DLD using relative strengths in vocabulary are discussed.

scholarly journals Longitudinal Development of Executive Functioning and Spoken Language Skills in Preschool-Aged Children With Cochlear Implants

2020 ◽  
Vol 63 (4) ◽  
pp. 1128-1147 ◽  
Author(s):  
William G. Kronenberger ◽  
Huiping Xu ◽  
David B. Pisoni
Keyword(s):  
Working Memory ◽  
Executive Functioning ◽  
Cochlear Implants ◽  
Language Skills ◽  
Verbal Working Memory ◽  
Spoken Language ◽  
Parent Report ◽  
Longitudinal Development ◽  
Spoken Language Skills ◽  
Over Time

Purpose Auditory deprivation has downstream effects on the development of language and executive functioning (EF) in prelingually deaf children with cochlear implants (CIs), but little is known about the very early development of EF during preschool ages in children with CIs. This study investigated the longitudinal development of EF and spoken language skills in samples of children with normal hearing (NH; N = 40) or CIs ( N = 41) during preschool ages. Method Participants were enrolled in the study between ages 3 and 6 years and evaluated annually up to the age of 7 years. Mixed-effects models were used to evaluate and predict growth of spoken language and EF skills over time. Results Children with CIs scored lower than NH peers on language measures but improved significantly over time. On performance-based neurocognitive measures of controlled attention, inhibition, and working memory, children with CIs scored more poorly than the sample of NH peers but comparable to norms, whereas on a parent report behavior checklist, children with CIs scored more poorly than both NH peers and norms on inhibition and working memory. Children with CIs had poorer EF than the sample of NH peers in most domains even after accounting for language effects, and language predicted only the verbal working memory domain of EF. In contrast, EF skills consistently predicted language skills at subsequent visits. Conclusions Findings demonstrate that, despite significant improvement over time, some domains of EF (particularly parent-reported EF) and language skills in children with CIs lag behind those of children with NH during preschool ages. Language delays do not fully explain differences in EF development between children with CIs and NH peers during preschool ages, but EF skills predict subsequent language development in children with CIs.

scholarly journals The Limitations of FDA Criteria: Inconsistencies with Clinical Practice, Findings, and Adult Criteria as a Barrier to Pediatric Implantation

2021 ◽  
Vol 42 (04) ◽  
pp. 373-380
Author(s):  
Lisa R. Park ◽  
Erika B. Gagnon ◽  
Kevin D. Brown
Keyword(s):  
Clinical Practice ◽  
Cochlear Implant ◽  
Cochlear Implants ◽  
Cochlear Implantation ◽  
Spoken Language ◽  
Evidence Based ◽  
Residual Hearing ◽  
Off Label ◽  
Single Side ◽  
Hearing Children

AbstractChildren require greater access to sound than adults as they are learning to communicate using hearing and spoken language. Yet when it comes to cochlear implant candidacy, currently approved Food and Drug Administration (FDA) criteria for adults are much less restrictive than those for children, allowing for greater levels of residual hearing and aided speech recognition in adults. Cochlear implant guidelines for children have changed very little in the 30 years since cochlear implants have been approved for pediatrics, and this lack of change has proven to be a barrier to implantation. Using evidence-based practice, centers have been providing off-label implantation for children who fall outside of current FDA criteria, including children with more residual hearing, children with single-side deafness younger than 5 years, and infants with bilateral profound loss younger than 9 months. The purpose of this article is to outline how these restrictions impede access to implants for children and describe the evidence supporting cochlear implantation in children who fall outside of current criteria.

scholarly journals Segmental and Suprasegmental Perception in Children Using Hearing Aids

2017 ◽  
Vol 28 (10) ◽  
pp. 901-912 ◽  
Author(s):  
Kaitlyn A. Wenrich ◽  
Lisa S. Davidson ◽  
Rosalie M. Uchanski
Keyword(s):  
Speech Perception ◽  
Outcome Measures ◽  
Hearing Aids ◽  
Low Frequency ◽  
Receptive Language ◽  
Acoustic Properties ◽  
Frequency Resolution ◽  
Residual Hearing ◽  
Hearing Thresholds ◽  
Hearing Device

Background: Suprasegmental perception (perception of stress, intonation, “how something is said” and “who says it”) and segmental speech perception (perception of individual phonemes or perception of “what is said”) are perceptual abilities that provide the foundation for the development of spoken language and effective communication. While there are numerous studies examining segmental perception in children with hearing aids (HAs), there are far fewer studies examining suprasegmental perception, especially for children with greater degrees of residual hearing. Examining the relation between acoustic hearing thresholds, and both segmental and suprasegmental perception for children with HAs, may ultimately enable better device recommendations (bilateral HAs, bimodal devices [one CI and one HA in opposite ears], bilateral CIs) for a particular degree of residual hearing. Examining both types of speech perception is important because segmental and suprasegmental cues are affected differentially by the type of hearing device(s) used (i.e., cochlear implant [CI] and/or HA). Additionally, suprathreshold measures, such as frequency resolution ability, may partially predict benefit from amplification and may assist audiologists in making hearing device recommendations. Purpose: The purpose of this study is to explore the relationship between audibility (via hearing thresholds and speech intelligibility indices), and segmental and suprasegmental speech perception for children with HAs. A secondary goal is to explore the relationships among frequency resolution ability (via spectral modulation detection [SMD] measures), segmental and suprasegmental speech perception, and receptive language in these same children. Research Design: A prospective cross-sectional design. Study Sample: Twenty-three children, ages 4 yr 11 mo to 11 yr 11 mo, participated in the study. Participants were recruited from pediatric clinic populations, oral schools for the deaf, and mainstream schools. Data Collection and Analysis: Audiological history and hearing device information were collected from participants and their families. Segmental and suprasegmental speech perception, SMD, and receptive vocabulary skills were assessed. Correlations were calculated to examine the significance (p < 0.05) of relations between audibility and outcome measures. Results: Measures of audibility and segmental speech perception are not significantly correlated, while low-frequency pure-tone average (unaided) is significantly correlated with suprasegmental speech perception. SMD is significantly correlated with all measures (measures of audibility, segmental and suprasegmental perception and vocabulary). Lastly, although age is not significantly correlated with measures of audibility, it is significantly correlated with all other outcome measures. Conclusions: The absence of a significant correlation between audibility and segmental speech perception might be attributed to overall audibility being maximized through well-fit HAs. The significant correlation between low-frequency unaided audibility and suprasegmental measures is likely due to the strong, predominantly low-frequency nature of suprasegmental acoustic properties. Frequency resolution ability, via SMD performance, is significantly correlated with all outcomes and requires further investigation; its significant correlation with vocabulary suggests that linguistic ability may be partially related to frequency resolution ability. Last, all of the outcome measures are significantly correlated with age, suggestive of developmental effects.

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