Comparisons of electrophysiological and psychophysical fitting methods for cochlear implants

Purpose Fundamental frequency (F0) is the primary acoustic cue for lexical tone perception in tonal languages but is processed in a limited way in cochlear implant (CI) systems. The aim of this study was to evaluate the importance of F0 contours in sentence recognition in Mandarin-speaking children with CIs and find out whether it is similar to/different from that in age-matched normal-hearing (NH) peers. Method Age-appropriate sentences, with F0 contours manipulated to be either natural or flattened, were randomly presented to preschool children with CIs and their age-matched peers with NH under three test conditions: in quiet, in white noise, and with competing sentences at 0 dB signal-to-noise ratio. Results The neutralization of F0 contours resulted in a significant reduction in sentence recognition. While this was seen only in noise conditions among NH children, it was observed throughout all test conditions among children with CIs. Moreover, the F0 contour-induced accuracy reduction ratios (i.e., the reduction in sentence recognition resulting from the neutralization of F0 contours compared to the normal F0 condition) were significantly greater in children with CIs than in NH children in all test conditions. Conclusions F0 contours play a major role in sentence recognition in both quiet and noise among pediatric implantees, and the contribution of the F0 contour is even more salient than that in age-matched NH children. These results also suggest that there may be differences between children with CIs and NH children in how F0 contours are processed.

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Age at Full-Time Use Predicts Language Outcomes Better Than Age of Surgery in Children Who Use Cochlear Implants

American Journal of Audiology ◽

10.1044/2019_aja-19-0073 ◽

2019 ◽

Vol 28 (4) ◽

pp. 986-992 ◽

Cited By ~ 2

Author(s):

Lisa R. Park ◽

Erika B. Gagnon ◽

Erin Thompson ◽

Kevin D. Brown

Keyword(s):

Cochlear Implants ◽

Time Use ◽

Expressive Language ◽

Normal Hearing ◽

Full Time ◽

Language Outcomes ◽

Age At Surgery ◽

Device Placement ◽

Device Use ◽

Better Than

Purpose The aims of this study were to (a) determine a metric for describing full-time use (FTU), (b) establish whether age at FTU in children with cochlear implants (CIs) predicts language at 3 years of age better than age at surgery, and (c) describe the extent of FTU and length of time it took to establish FTU in this population. Method This retrospective analysis examined receptive and expressive language outcomes at 3 years of age for 40 children with CIs. Multiple linear regression analyses were run with age at surgery and age at FTU as predictor variables. FTU definitions included 8 hr of device use and 80% of average waking hours for a typically developing child. Descriptive statistics were used to describe the establishment and degree of FTU. Results Although 8 hr of daily wear is typically considered FTU in the literature, the 80% hearing hours percentage metric accounts for more variability in outcomes. For both receptive and expressive language, age at FTU was found to be a better predictor of outcomes than age at surgery. It took an average of 17 months for children in this cohort to establish FTU, and only 52.5% reached this milestone by the time they were 3 years old. Conclusions Children with normal hearing can access spoken language whenever they are awake, and the amount of time young children are awake increases with age. A metric that incorporates the percentage of time that children with CIs have access to sound as compared to their same-aged peers with normal hearing accounts for more variability in outcomes than using an arbitrary number of hours. Although early FTU is not possible without surgery occurring at a young age, device placement does not guarantee use and does not predict language outcomes as well as age at FTU.

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A Systematic Review of Emergent Literacy Interventions for Preschool-Age Children With Cochlear Implants

Contemporary Issues in Communication Science and Disorders ◽

10.1044/cicsd_43_s_64 ◽

2016 ◽

Vol 43 (Spring) ◽

pp. 64-76

Author(s):

Lavin K. Entwisle ◽

Kyle Brouwer ◽

Elizabeth Hanson ◽

Jessica Messersmith

Keyword(s):

Systematic Review ◽

Emergent Literacy ◽

Cochlear Implants ◽

Preschool Age ◽

Literacy Interventions ◽

Preschool Age Children

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Overview of Current Approaches to Aural Rehabilitation for Adults With Cochlear Implants

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-20-00078 ◽

2020 ◽

Vol 5 (5) ◽

pp. 1175-1187

Author(s):

Rachel Glade ◽

Erin Taylor ◽

Deborah S. Culbertson ◽

Christin Ray

Keyword(s):

Health Care ◽

Clinical Practice ◽

Cochlear Implants ◽

Practice Patterns ◽

The United States ◽

Care Providers ◽

Aural Rehabilitation ◽

Starting Point ◽

Clinical Models ◽

Hearing Health

Purpose This clinical focus article provides an overview of clinical models currently being used for the provision of comprehensive aural rehabilitation (AR) for adults with cochlear implants (CIs) in the Unites States. Method Clinical AR models utilized by hearing health care providers from nine clinics across the United States were discussed with regard to interprofessional AR practice patterns in the adult CI population. The clinical models were presented in the context of existing knowledge and gaps in the literature. Future directions were proposed for optimizing the provision of AR for the adult CI patient population. Findings/Conclusions There is a general agreement that AR is an integral part of hearing health care for adults with CIs. While the provision of AR is feasible in different clinical practice settings, service delivery models are variable across hearing health care professionals and settings. AR may include interprofessional collaboration among surgeons, audiologists, and speech-language pathologists with varying roles based on the characteristics of a particular setting. Despite various existing barriers, the clinical practice patterns identified here provide a starting point toward a more standard approach to comprehensive AR for adults with CIs.

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Fitting the Second Speech Processor in Sequential Bilateral Cochlear Implants: Achieving Optimal Performance

Perspectives on Hearing and Hearing Disorders in Childhood ◽

10.1044/hhdc15.2.9 ◽

2005 ◽

Vol 15 (2) ◽

pp. 9-11

Author(s):

Stacy L. Payne ◽

Annelle V. Hodges

Keyword(s):

Cochlear Implants ◽

Optimal Performance ◽

Speech Processor ◽

Bilateral Cochlear Implants

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Selecting the Optimal FM System for Children With Cochlear Implants

Perspectives on Hearing and Hearing Disorders in Childhood ◽

10.1044/hhdc18.1.19 ◽

2008 ◽

Vol 18 (1) ◽

pp. 19-24

Author(s):

Erin C. Schafer

Keyword(s):

Speech Recognition ◽

Cochlear Implants ◽

Empirical Research ◽

Background Noise ◽

Signal To Noise Ratio ◽

Evidence Based ◽

Signal To Noise ◽

Speech Processor ◽

System Input ◽

Optimal Type

Children who use cochlear implants experience significant difficulty hearing speech in the presence of background noise, such as in the classroom. To address these difficulties, audiologists often recommend frequency-modulated (FM) systems for children with cochlear implants. The purpose of this article is to examine current empirical research in the area of FM systems and cochlear implants. Discussion topics will include selecting the optimal type of FM receiver, benefits of binaural FM-system input, importance of DAI receiver-gain settings, and effects of speech-processor programming on speech recognition. FM systems significantly improve the signal-to-noise ratio at the child's ear through the use of three types of FM receivers: mounted speakers, desktop speakers, or direct-audio input (DAI). This discussion will aid audiologists in making evidence-based recommendations for children using cochlear implants and FM systems.

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