Auditory and speech performance after unilateral cochlear implantation for cochlear nerve canal stenosis

To explore the correlation between the width of the bony cochlear nerve canal (CNC) and long-term auditory rehabilitation after unilateral cochlear implantation (CI) in pediatric patients with congenital deafness and bilateral cochlear nerve canal stenosis (CNCS). A retrospective review was performed on 10 patients with bilateral CNCS and bilateral congenital profound hearing loss who each underwent unilateral cochlear implantation. The width of the CNC was determined on computed tomography (CT) imaging and following CI, auditory and speech performance following CI were graded using categories of auditory performance (CAP), speech intelligibility rating (SIR), and the meaningful auditory integration scale (MAIS) at 24 months following implantation. No correlation was noted between CAP score and CNCS at 24 months post CI ( P > .05). A positive correlation was noted between SIR score and CNC width (ρ = .81, P < .05). Similarly, a positive correlation was noted between MAIS and CNC width (ρ = .71, P < .05). The width of the CNC in patients with CNCS is positively correlated with some long-term auditory and speech outcomes after CI.

Round window versus conventional bony cochleostomy technique in pediatric cochlear implantation; A Randomized controlled double blinded trial.

<p><strong>Background:</strong> Objective of the study was to investigate the outcomes of cochlear implantation when done via two different techniques namely, the round window or the bony cochleostomy.</p><p><strong>Methods:</strong> A single-center, double-blinded randomized controlled trial including forty prelingual, bilateral severe to profoundly deaf children less than six years from the year 2014 to 2016 in a tertiary referral center in India were randomly allocated to round window and bony cochleostomy group. Our primary outcome measures were intraoperative neural response telemetry levels, behavioral threshold (t) and comfortable (c) loudness levels. The secondary subjective outcomes were measured via the category of auditory performance (CAP) and the meaningful auditory integration scale (MAIS) score. The cases were followed up for 9 months.</p><p><strong>Results:</strong> Intra-operative, electrically evoked compound action potentials (ECAP) showed comparable mean thresholds for both the techniques except intermediate electrodes (p~0.04) showed lower values for the round window. Similarly, a lower threshold (p~0.03) and comfortable mean current levels (p~0.03) were noticed for the round window group at 6 months post-implantation. Secondary speech perception outcome scores measured via category of auditory performance (CAP) and MAIS score were comparable. </p><p><strong>Conclusions:</strong> The round window insertion technique has physiological benefit as compared to the bony cochleostomy as evidenced by better stimulation levels in the intermediate electrodes and lower mean threshold and comfortable levels in the round window with more beneficial peri-modiolar position of electrode arrays. However, comparable speech perception outcomes revealed no clinical benefit in the cochlear implant performance depending on the technique of electrode insertion. </p>

Relation Between the Screening Checklist for Auditory Processing in Adults and Diagnostic Auditory Processing Test Performance

Purpose The aim of the study was to evaluate the relationship between the Screening Checklist for Auditory Processing in Adults and the performance of older adults on a battery of diagnostic tests for auditory processing. This was done for two versions of the checklist, one answered by older individuals at risk for auditory processing disorder (APD) and the other by the family of the older adults. Method Forty-nine older adults and 34 of their family members were initially tested with the screening checklist, each being tested with the version developed for them. Approximately half of the older adults had normal pure-tone thresholds, while the others had mild–moderate hearing loss above 2 kHz. The older adults were administered tests of auditory separation/closure, auditory integration, temporal resolution, temporal patterning, and auditory memory and sequencing. Results Most of the older adults and their family members reported of the presence of auditory processing difficulties on the screening checklist. On the diagnostic test battery, many of the older adults, irrespective of their high-frequency hearing sensitivity, failed the tests measuring temporal resolution and auditory integration. The sensitivity and specificity of the checklist answered by the older individuals were 69.05% and 71.43%, respectively. On the other hand, for the checklist answered by the family members, it was 77.78% and 33.33%, respectively. The test–retest reliability of the two versions of the checklist was found to be good. Conclusions As the specificity of the checklist answered by the family members was considerably lower than that answered by the older adults, the use of the version for the latter group is recommended. However, the checklist answered by the caregivers could be used to complement information obtained from the older adults at risk for APD when the older adults are unable to give valid responses.

Directional biosonar beams allow echolocating harbour porpoises to actively discriminate and intercept closely-spaced targets

Echolocating toothed whales face the problem that high sound speeds in water mean that echoes from closely-spaced targets will arrive at time delays within their reported auditory integration time of some 264 µsec. Here we test the hypothesis that echolocating harbour porpoises cannot resolve and discriminate targets within a clutter interference zone given by their integration time. To do this, we trained two harbour porpoises (Phocoena phocoena) to actively approach and choose between two spherical targets at four varying inter-target distances (13.5, 27, 56 and 108 cm) in a two-alternative forced-choice task. The free-swimming, blindfolded porpoises were tagged with a sound and movement tag (DTAG4) to record their echoic scene and acoustic outputs. The known ranges between targets and the porpoise, combined with the sound levels received on target-mounted hydrophones revealed how they controlled their acoustic gaze. When targets were close together and the discrimination task was more difficult due to smaller echo time delays and lower echo level ratios between the targets, buzzes were longer and started from farther away, source levels were reduced at short ranges, and the porpoises clicked faster, scanned across the targets more, and delayed making their discrimination decision until closer to the target. We conclude that harbour porpoises can resolve and discriminate closely-spaced targets, suggesting a clutter rejection zone much shorter than their auditory integration time, and that such clutter rejection is greatly aided by spatial filtering with their directional biosonar beam.

Translation in Ukrainian and adaptation of the English questionnaires: scales of meaningful auditory integration (MAIS) and scales of meaningful language use (MUSS) scales for assessing language development in children with deafness after cochlear implantation

Introduction: The world community is concerned with the assessment of the speech and hearing development of children with sensorineural deafness after cochlear implantation, since the most important result of rehabilitation is the success of social integration of such children. In most countries of the world, the Meaningful Auditory Integration Scale (MAIS) and the Meaningful Use of Language Scale (MUSS) are used to assess the auditory and language integration of children with sensorineural hearing loss after cochlear implantation (CI). Unfortunately, in Ukraine there are still no Ukrainian questionnaires for assessing the auditory development of children with sensorineural hearing loss after cochlear implantation. The aim of our study was to translate MAIS and MUSS manuals into Ukrainian, to adapt and validate them culturally. Materials and methods: Materials for translation and cultural adaptation were English-language versions of the Meaningful Auditory Integration Scale (MAIS) and Meaningful Use of Language Scale (MUSS), developed by the Nottingham Group of Cochlear Implantation, which are recognized and recommended for use by all cochlear implant manufacturers. Results obtained: The evaluation consisted of the following stages: preparatory stage – collection and analysis of literature; translation of original texts from English into Ukrainian; reversed translation by an independent translator of Ukrainian text into English; collation of the translation and comparison with the original questionnaire by an independent linguist; Cognitive analysis; field-testing of textbooks translated into Ukrainian with a small group of children after the CI; corrections, final revision of translations to identify and correct any grammatical, orthographic and other errors. The Ukrainian version of the questionnaire demonstrated a high level of internal compliance, testability and validity. Conclusions: Given the considerable relevance and demand ability of the materials, the tests can be recognized as valid and recommended for use in cochlear implant rehabilitation process.

Modification and verification of the Infant–Toddler Meaningful Auditory Integration Scale: a psychometric analysis combining item response theory with classical test theory

Background Early prelingual auditory development (EPLAD) is a fundamental and important process in the speech and language development of infants and toddlers. The Infant–Toddler Meaningful Auditory Integration Scale (ITMAIS) is a widely used measurement tool for EPLAD, however it has not yet undergone a comprehensive psychometric analysis. The aim of this research was to modify and verify the psychometric properties of ITMAIS using a combination of Item Response Theory (IRT) and Classical Test Theory (CTT). Methods Stage 1—1730 children were retrospectively recruited to enable the application of an IRT model, specifically the graded response model, to modify the ITMAIS. Stage 2—another 450 infants and toddlers with normal hearing or permanent hearing loss before auditory intervention were recruited to verify the psychometric properties of the modified ITMAIS (ITMAIS-m) using the CTT method. Results Using the metric of the graded response model, by removing item 2 from the ITMAIS, ITMAIS-m demonstrated discrimination parameters ranging from 3.947 to 5.431, difficulty parameters from − 1.146 to 1.150, item information distributed between 4.798 and 9.259 and a test information score of 48.061. None of the items showed differential item functioning. ITMAIS-m was further verified in Stage 2, showing Cronbach’s α of 0.919 and item-total correlations ranging from 0.693 to 0.851. There was good convergent validity of ITMAIS-m with other auditory outcome measure (r = 0.932) and pure tone average thresholds (r ranging from − 0.670 to − 0.909), as well as a high ability to discriminate between different hearing grades (Cohen d ranging from 0.41 to 5.83). Conclusions The ITMAIS-m is a reliable and valid tool for evaluating EPLAD in infants and toddlers, which can be efficiently and precisely applied in clinical practice. The combined use of IRT and CTT provides a powerful means to modify psychometrically robust scales aimed at childhood auditory outcome measurements.

Can Evidence Inform Intervention? Reporting on Research into Auditory Processing Disorders in Children with ASD- Considering Whether Research Into Auditory Integration Training and Filtered Sound Training Has Relevance

Since the 1980’s there has been an acceleration of interest by neuroscientists in the Auditory Problems of Children with Autism Spectrum Disorder (ASD). The focus of study has largely shifted from attempting a differential diagnosis between the symptoms of ASD and of Auditory Processing Disorder (APD), towards an improved understanding of APD and its impact on the lives and wellness of people with this disorder. A large amount of research data has accumulated, and sheds light on the manner in which auditory brain potentials of children with ASD differ from those of the neurotypical learner. This article will offer a summarised overview of this data, and will discuss how this body of evidence is informing and directing our intervention strategies, both clinical and educational. The author will further summarise the most recently published research papers on the impact of Auditory Integration Training (AIT)– the Bérard Method (also named Filtered Sound Training - FST), The statistical significance and implications of this data for the planning of intervention programmes to remediate auditory problems of children with ASD will be discussed. In conclusion some new insights into the breadth of the impact of auditory processing problems on the social, emotional, learning, language and well-being of children with ASD will be mentioned.