The influence of the bimodal stimulation on the auditory ability of temporal ordering

ABSTRACT Objective: to analyze temporal ordering auditory ability in unilateral cochlear implant users with bimodal stimulation. Methods: the study included 15 unilateral cochlear implant users, six with bimodal stimulation and nine with exclusive cochlear implant and a control group consisting of 15 hearing individuals. Both groups underwent the standard duration and the standard frequency tests for temporal ordering auditory ability analysis. In the inferential analysis of the data, the nonparametric statistical tests Mann-Whitney and Kruskal-Wallis were used (p<0,05). Results: there was a significant difference in the performance of the standard frequency test, and subjects with bimodal stimulation presented a better performance than those with exclusive cochlear implants. The standard frequency test was associated with education and speech therapy. On the other hand, in the standard duration test, there was a relation with the implanted ear. The most frequent errors were discrimination for both temporal tests. Conclusion: bimodal stimulation, education and speech therapy influenced the performance of the frequency pattern test, while the implanted side influenced the performance of the duration pattern test.

Development of Phonological, Lexical, and Syntactic Abilities in Children With Cochlear Implants Across the Elementary Grades

Purpose This study assessed phonological, lexical, and morphosyntactic abilities at 6th grade for a group of children previously tested at 2nd grade to address 4 questions: (a) Do children with cochlear implants (CIs) demonstrate deficits at 6th grade? (b) Are those deficits greater, the same, or lesser in magnitude than those observed at 2nd grade? (c) How do the measured skills relate to each other? and (d) How do treatment variables affect outcome measures? Participants Sixty-two 6th graders (29 with normal hearing, 33 with CIs) participated, all of whom had their language assessed at 2nd grade. Method Data are reported for 12 measures obtained at 6th grade, assessing phonological, lexical, and morphosyntactic abilities. Between-groups analyses were conducted on 6th-grade measures and the magnitude of observed effects compared with those observed at 2nd grade. Correlational analyses were performed among the measures at 6th grade. Cross-lagged analyses were performed on specific 2nd- and 6th-grade measures of phonological awareness, vocabulary, and literacy to assess factors promoting phonological and lexical development. Treatment effects of age of 1st CI, preimplant thresholds, and bimodal experience were evaluated. Results Deficits remained fairly consistent in type and magnitude across elementary school. The largest deficits were found for phonological skills and the least for morphosyntactic skills, with lexical skills intermediate. Phonological and morphosyntactic skills were largely independent of each other; lexical skills were moderately related to phonological skills but not morphosyntactic skills. Literacy acquisition strongly promoted both phonological and lexical development. Of the treatment variables, only bimodal experience affected outcomes and did so positively. Conclusions Congenital hearing loss puts children at continued risk of language deficits, especially for phonologically based skills. Two interventions that appear to ameliorate that risk are providing a period of bimodal stimulation and strong literacy instruction.