Sound Localization and Speech Perception in Noise of Pediatric Cochlear Implant Recipients: Bimodal Fitting Versus Bilateral Cochlear Implants.

OBJECTIVES: The aim of this study was to compare binaural performance of auditory localization task and speech perception in babble measure between children who use a cochlear implant (CI) in one ear and a hearing aid (HA) in the other (bimodal fitting) and those who use bilateral CIs. DESIGN: Thirteen children (mean age ± SD = 10 ± 2.9 years) with bilateral CIs and 19 children with bimodal fitting were recruited to participate. Sound localization was assessed using a 13-loudspeaker array in a quiet sound-treated booth. Speakers were placed in an arc from -90° azimuth to +90° azimuth (15° interval) in horizontal plane. To assess the accuracy of sound location identification, we calculated the absolute error in degrees between the target speaker and the response speaker during each trial. The mean absolute error was computed by dividing the sum of absolute errors by the total number of trials. We also calculated the hemifield identification score to reflect the accuracy of right/left discrimination. Speech-in-babble perception was also measured in the sound field using target speech presented from the front speaker. Eight-talker babble was presented in the following four different listening conditions: from the front speaker (0°), from one of the two side speakers (+90° or -90°), from both side speakers (±90°). Speech, spatial, and quality questionnaire was administered. RESULTS: When the two groups of children were directly compared with each other, there was no significant difference in localization accuracy ability or hemifield identification score under binaural condition. Performance in speech perception test was also similar to each other under most babble conditions. However, when the babble was from the first device side (CI side for children with bimodal stimulation or first CI side for children with bilateral CIs), speech understanding in babble by bilateral CI users was significantly better than that by bimodal listeners. Speech, spatial, and quality scores were comparable with each other between the two groups. CONCLUSIONS: Overall, the binaural performance was similar to each other between children who are fit with two CIs (CI + CI) and those who use bimodal stimulation (HA + CI) in most conditions. However, the bilateral CI group showed better speech perception than the bimodal CI group when babble was from the first device side (first CI side for bilateral CI users or CI side for bimodal listeners). Therefore, if bimodal performance is significantly below the mean bilateral CI performance on speech perception in babble, these results suggest that a child should be considered to transit from bimodal stimulation to bilateral CIs.

Comparison of Speech Perception Performance According to Prosody Change Between People With Normal Hearing and Cochlear Implant Users.

Background and Objectives: : Cochlear implants (CIs) are well known to improve audibility and speech recognition in individuals with hearing loss, but some individuals still struggle with many aspects in communication, such as prosody. This study explores how prosodic elements are perceived by those with normal hearing (NH) and CIs. Subjects and Methods: : Thirteen individuals with NH and thirteen CI users participated in this study and completed speech perception, speech prosody perception, speech prosody production, pitch difference discrimination, and melodic contour perception testing. Results: : NH listeners performed significantly better than CI users on speech perception, speech prosody perception (except for words with neutral meaning and a negative prosody change and when words were repeated twice), pitch difference discrimination, and melodic contour perception testing. No statistical significance was observed for speech prosody production for both groups. Conclusions: : Compared to NH listeners, CI users had limited ability to recognize prosodic elements. The study findings highlight the necessity of an assessment tool and signal processing algorithm for CIs, specifically targeting prosodic elements in clinical settings.

The clinical significance of preoperative brain magnetic resonance imaging in pediatric cochlear implant recipients.

Although central nervous system abnormalities are incidentally detected in preoperative brain magnetic resonance imaging (MRI) studies in pediatric cochlear implant (CI) candidates, the clinical significance of the abnormalities remains unclear. We aimed to assess post-implantation auditory and speech performance in patients with brain lesions seen on MRI. Pediatric CI recipients (n = 177) who underwent preoperative MRI scans of the brain between January 2002 and June 2009 were included in this study. Patients with brain lesions on MRI were reviewed and categorized into the following groups: brain parenchymal lesions (focal vs. diffuse), ventriculomegaly, and extra-axial lesion. The main communication mode as well as progress in auditory perception and speech production were evaluated preoperatively and at 3, 6, 12, and 24 months postoperatively. Performance in patients with brain lesions was compared with the age- and sex-matched control group. Various brain lesions were found in 27 out of 177 patients. Children with brain lesions who received CIs showed gradual progress in auditory and speech outcomes for 2 years, though performance was reduced compared with the control group. In addition, there was a significant difference in the main communication mode between the two groups at 2 years following cochlear implantation. This difference was especially significant in patients with diffuse brain parenchymal lesions after further stratification of the brain lesion group. Preoperative brain MRI may have a role in improving the prediction of adverse outcomes in pediatric CI recipients. In particular, children with diffuse brain parenchymal lesions should be counseled regarding the poor prognosis preoperatively, and followed up with special attention.

The influence of various factors on the performance of repetition tests in adults with cochlear implants.

A variety of internal and external factors influence speech perception performance following cochlear implantation (CI) in adult deaf patients. The aim of this study was to evaluate the speech perception performance during repetition testing according to various factors and to identify the predictive factors associated with postoperative speech perception. The performances on speech perception under audio-only conditions were examined over time in 61 adult patients with CI. Mono- and bi-syllable and sentence repetition testing, using both the Korean version of the Central Institute for the Deaf (K-CID) and the K-Western Aphasia Battery test (K-WAB), were performed preoperatively and at 3, 6 and 12 months postoperatively. To elucidate the effect that the etiology of deafness has on postoperative outcome, patients were divided into the following four groups: Prelingual hearing loss (HL) (n = 9), Meningitis (n = 6), Progressive HL (n = 31) and Sudden HL groups (n = 15). Moreover, the duration of HL and deafness was defined as follows: (1) "age of deafness onset: AoD", (2) "number of years between the onset of profound deafness and CI: DoD" and (3) "percentage of the patient's life with moderate-to-profound hearing loss before CI: PoL". DoD and PoL were significantly different between the four groups. Although AoD appeared to be associated with performance on the sentence repetition test before standardizing for education level and age (P = 0.015), there was no association after adjusting for these factors (P = 0.719). Only PoL showed a good correlation with performance on repetition testing after CI after adjusting for AoD and DoD. However, DoD was associated with speech perception performance on the sentence repetition test only. In addition, speech perception performance results in the Progressive and Sudden HL groups were improved over the Prelingual HL and Meningitis groups. The Meningitis group showed the poorest speech perception performance among postlingually deaf adults. Consideration of age, education level, etiology and overall time with hearing loss may be necessary for predicting speech perception outcomes in CI recipients.

Experiences With the University Admission Process and Educational Support Among Students With Cochlear Implants in South Korea.

OBJECTIVES: The aim of this study was to investigate the current university admission rate and experiences of educational support among students with cochlear implants (CIs) in South Korea. METHODS: A prospective online survey was conducted to examine the university admission process and academic support for students with CIs. Thirty individuals who took the college entrance exams at least 3 years after CI surgery were invited to participate, although two did not respond. The survey consisted of three topics (demographics, university admission process, and academic support) and 25 items regarding laws and policies related to university admission and support for students with hearing disabilities in Korea. RESULTS: The university matriculation rate for students with CI was 85.7% (24/28), of whom 50% were admitted through the special admission process for students with disabilities. Most universities provided teaching and learning support and rental services for assistive devices for students with disabilities to help them better adapt to school life. However, only a small percentage of the students benefited from accommodation services, and 62.5% and 12.5% of the students received teaching and learning support and used assistive devices, respectively. CONCLUSION: To the best of our knowledge, this is the first study to investigate the university admission process and university disability services for students with CIs in South Korea. The results of this study will be helpful for young CI recipients and their parents as they prepare for university entrance.

Effect of Cochlear Implant Electrode Array Design on Electrophysiological and Psychophysical Measures: Lateral Wall versus Perimodiolar Types.

BACKGROUND AND OBJECTIVES: The present study aims to investigate whether the cochlear implant electrode array design affects the electrophysiological and psychophysical measures. SUBJECTS AND METHODS: Eighty five ears were used as data in this retrospective study. They were divided into two groups by the electrode array design: lateral wall type (LW) and perimodiolar type (PM). The electrode site was divided into three regions (basal, medial, apical). The evoked compound action potential (ECAP) threshold, T level, C level, dynamic range (DR), and aided air conduction threshold were measured. RESULTS: The ECAP threshold was lower for the PM than for the LW, and decreased as the electrode site was closer to the apical region. The T level was lower for the PM than for the LW, and was lower on the apical region than on the other regions. The C level on the basal region was lower for the PM than for the LW whereas the C level was lower on the apical region than on the other regions. The DRs on the apical region was greater for the PM than for the LW whereas the DR was narrower on the apical region than on the other regions. The aided air conduction threshold was not different for the electrode design and frequency. CONCLUSIONS: The current study would support the advantages of the PM over the LW in that the PM had the lower current level and greater DR, which could result in more localized neural stimulation and reduced power consumption.

Benefit and predictive factors for speech perception outcomes in pediatric bilateral cochlear implant recipients.

INTRODUCTION: Despite recent advancement in the prediction of cochlear implant outcome, the benefit of bilateral procedures compared to bimodal stimulation and how we predict speech perception outcomes of sequential bilateral cochlear implant based on bimodal auditory performance in children remain unclear. OBJECTIVES: This investigation was performed: (1) to determine the benefit of sequential bilateral cochlear implant and (2) to identify the associated factors for the outcome of sequential bilateral cochlear implant. METHODS: Observational and retrospective study. We retrospectively analyzed 29 patients with sequential cochlear implant following bimodal-fitting condition. Audiological evaluations were performed; the categories of auditory performance scores, speech perception with monosyllable and disyllables words, and the Korean version of Ling. Audiological evaluations were performed before sequential cochlear implant with the bimodal fitting condition (CI1+HA) and one year after the sequential cochlear implant with bilateral cochlear implant condition (CI1+CI2). The good performance group (GP) was defined as follows; 90% or higher in monosyllable and bisyllable tests with auditory-only condition or 20% or higher improvement of the scores with CI1+CI2. Age at first implantation, inter-implant interval, categories of auditory performance score, and various comorbidities were analyzed by logistic regression analysis. RESULTS: Compared to the CI1+HA, CI1+CI2 provided significant benefit in categories of auditory performance, speech perception, and Korean version of Ling results. Preoperative categories of auditory performance scores were the only associated factor for being GP (odds ratio=4.38, 95% confidence interval - 95%=1.07-17.93, p=0.04). CONCLUSIONS: The children with limited language development in bimodal condition should be considered as the sequential bilateral cochlear implant and preoperative categories of auditory performance score could be used as the predictor in speech perception after sequential cochlear implant.

Can young adolescents with cochlear implants perceive different timbral cues?

OBJECTIVE: This study aimed to compare the timbre recognition and preferences of young adolescents with cochlear implants (CIs) to that of adolescents with normal hearing (NH). METHODS: Nine Korean adolescents with CIs and 25 adolescents with NH participated in this study. After listening to each of four Western instruments and five traditional Korean instruments, participants were asked to identify presented instruments and rate how much they liked the timbres. RESULTS: The results showed that the CI group recognized instruments significantly less often than the NH group. They also tended to show a relatively higher recognition of the instruments bearing a rapid and strong attack time. With regard to timbre preferences, no significant differences were found between the groups. DISCUSSION: Young adolescents with CIs show potential for detecting salient features in sound information, especially instrumental timbre. This study indicates what can be considered to incorporate more sounds with varying origins and tone qualities into music perception and education for this population.

Social skills and developmental delay: importance in predicting the auditory and speech outcomes after cochlear implantation in children.

CONCLUSION: Preoperative evaluation of social interaction and global development levels using the Vineland Social Maturity Scale (VSMS) and Bayley Scales of Infant Development-2nd edition (BSID-II) may be beneficial in predicting the postoperative outcome in pediatric cochlear implant recipients. In particular, cautious preoperative counseling regarding the poor postoperative prognosis may be necessary in children with low social skills and developmental status. OBJECTIVE: To determine the clinical benefit of preoperative evaluation of social interaction and global development levels using VSMS and BSID-II in predicting the postoperative outcome in pediatric cochlear implant recipients. PATIENTS: A total of 65 deaf children who underwent cochlear implantation (CI) were included in this study. Age at the time of implantation ranged from 12 to 76 months. All of the children underwent a comprehensive preimplant psychological assessment by a clinical psychologist. The VSMS and BSID-II were used for evaluating social skills and a child's development preoperatively. A social quotient (SQ) was calculated by using the VSMS for each subject using the following formula: (social age/chronological age) × 100. The auditory perception and speech production abilities were evaluated using the Categories of Auditory Performance (CAP) scale and the Korean version of the Ling's stage (K-Ling), respectively, at 1 year after CI. The associations between the preoperative SQ/developmental levels and the postoperative auditory/speech outcomes were evaluated. RESULTS: The mean SQ was significantly decreased in the enrolled children (90.6 ± 26.1). The improvement in CAP score at 1 year after CI was correlated with preoperative SQ. The improvements in phonemic and phonologic levels of K-Ling were correlated with preoperative VSMS and BSID-II scores.

Benefit and predictive factors for speech perception outcomes in pediatric bilateral cochlear implant recipients / Benefícios e fatores preditivos para os resultados de percepção da fala em pacientes pediátricos com implantes cocleares bilaterais

Abstract Introduction: Despite recent advancement in the prediction of cochlear implant outcome, the benefit of bilateral procedures compared to bimodal stimulation and how we predict speech perception outcomes of sequential bilateral cochlear implant based on bimodal auditory performance in children remain unclear. Objectives: This investigation was performed: (1) to determine the benefit of sequential bilateral cochlear implant and (2) to identify the associated factors for the outcome of sequential bilateral cochlear implant. Methods: Observational and retrospective study. We retrospectively analyzed 29 patients with sequential cochlear implant following bimodal-fitting condition. Audiological evaluations were performed; the categories of auditory performance scores, speech perception with monosyllable and disyllables words, and the Korean version of Ling. Audiological evaluations were performed before sequential cochlear implant with the bimodal fitting condition (CI1 + HA) and one year after the sequential cochlear implant with bilateral cochlear implant condition (CI1 + CI2). The good performance group (GP) was defined as follows; 90% or higher in monosyllable and bisyllable tests with auditory-only condition or 20% or higher improvement of the scores with CI1 + CI2. Age at first implantation, inter-implant interval, categories of auditory performance score, and various comorbidities were analyzed by logistic regression analysis. Results: Compared to the CI1 + HA, CI1 + CI2 provided significant benefit in categories of auditory performance, speech perception, and Korean version of Ling results. Preoperative categories of auditory performance scores were the only associated factor for being GP (odds ratio = 4.38, 95% confidence interval - 95% = 1.07-17.93, p = 0.04). Conclusions: The children with limited language development in bimodal condition should be considered as the sequential bilateral cochlear implant and preoperative categories of auditory performance score could be used as the predictor in speech perception after sequential cochlear implant.

Resumo Introdução: Apesar dos avanços recentes na predição do resultado do implante coclear, ainda não está claro o benefício do procedimento bilateral em comparação com a estimulação bimodal e como podemos prever resultados de percepção da fala com implante coclear bilateral sequencial com base no desempenho auditivo bimodal em crianças. Objetivos: Este estudo foi realizado para: 1) Determinar o benefício do implante coclear bilateral sequencial e 2) Identificar os fatores associados com o resultado do implante bilateral sequencial. Método: Estudo observacional e retrospectivo. Analisamos retrospectivamente 29 pacientes com implantes sequenciais após a adaptação bimodal. Avaliações audiológicas foram realizadas; os escores das categorias de desempenho auditivo, a percepção da fala com palavras monossílabas e dissílabas e a versão coreana de Ling. As avaliações audiológicas foram realizadas antes do implante sequencial com o ajuste bimodal (IC1 + AH) e um ano após o implante coclear sequencial com implante bilateral (IC1 + IC2). O grupo com bom desempenho (BD) foi definido da seguinte forma: 90% ou mais em testes com monossílabos e dissílabos com condição apenas auditiva ou melhoria de 20% ou mais dos escores com IC1 + IC2. A idade no primeiro implante, o intervalo interimplante, o escore categorias de desempenho auditivo e as diversas comorbidades foram analisadas através de análise de regressão logística. Resultados: Em comparação com o IC1 + AA, IC1 + IC2 demonstraram benefícios significativos nos escores categorias de desempenho auditivo, percepção da fala e a versão coreana de Ling. Os escores de categorias de desempenho auditivo pré-operatórios foram o único fator associado para ser do grupo BD (odds ratio - OR = 4,38, intervalo de confiança de 95% - IC 95% = 1,07-17,93, p = 0,04). Conclusões: As crianças com desenvolvimento limitado de linguagem em condição bimodal devem ser consideradas, pois o implante coclear bilateral sequencial e o escore pré-operatório das categorias de desempenho auditivo poderiam ser usados como preditores na percepção da fala após implante sequencial.

The auditory and speech performance of children with intellectual disability after cochlear implantation.

CONCLUSION: The results revealed that children with intellectual disability (ID) who underwent cochlear implantation (CI) showed gradual progress in their auditory perception and speech development. ID in children should not be considered a contraindication for CI, because they are able to obtain a chance to develop oral communication skills following CI. OBJECTIVE: The purpose of this study was to assess the auditory and speech performance of 14 young deaf children with ID after CI. METHODS: Fourteen children with ID who underwent CI between December 2002 and February 2010 were included. Improvement in auditory perception and speech production over time was evaluated longitudinally with the Categories of Auditory Performance (CAP) score and Korean version of Ling's stages (K-Ling). The results were compared with those of age- and gender-matched implanted controls without additional disabilities. All tests were performed four times in each patient: before implantation and at 3, 6, and 12 months after implantation. Preoperative and postoperative communication modes were also assessed and compared between the two groups. RESULTS: Auditory perception and speech production of deaf children with an ID improved consistently after CI. In addition, the communication mode also took a favorable turn from nonverbal to vocalizations or oral communication or from vocalizations to oral communication.

Auditory and speech performance in deaf children with deaf parents after cochlear implant.

OBJECTIVE: To evaluate the auditory and speech outcome in deaf children with deaf parents (CDP) after cochlear implantation (CI), emphasizing both the presence of additional caregiver and patients' main communication mode. STUDY DESIGN: Retrospective case review. SETTING: Cochlear implant center at a tertiary referral hospital. PATIENTS: Fourteen CDP and 14 age- and sex-matched deaf children with normal-hearing parents (CNH). MAIN OUTCOME MEASURE(S): The Korean version of Ling's stage (K-Ling) and Category of Auditory Perception (CAP) were administered to the children to assess the speech production and auditory perception abilities, preoperatively and 3, 6, 12, and 24 months after CI. To elucidate the effects of the additional caregiver and main communication mode of the implanted child, the patients were divided into the following groups: with additional caregiver(s) who have normal hearing (n = 11) versus without additional caregiver (n = 3); sign language plus oral communication (S+O) group (n = 9) versus oral communication only (O) group (n = 5). RESULTS: CAP scores and K-Ling stages improved remarkably in both CDP and CNH, and no significant differences were found between the 2 groups. Within the CDP group, CAP scores and K-Ling stages improved significantly in CDP with an additional caregiver than those without. Auditory perception and speech production performances in the S+O group were similar to those in the O group. CONCLUSION: CDP can develop similarly to CNH in auditory perception and speech production, if an additional caregiver with normal hearing provides sufficient support and speech input. In addition, using sign language in addition to oral language might not be harmful, and these children can be a communication bridge between their deaf parents and society.

Performance after timely cochlear implantation in prelingually deaf children with cerebral palsy.

OBJECTIVES: To investigate auditory perception, speech production, and language ability of prelingually deaf toddlers with cerebral palsy (CP) who were implanted within a sensitive period and who received proper speech therapy. Comparison of their outcomes with age- and sex-matched CI recipients without additional disabilities was also performed. METHODS: We retrospectively reviewed a cohort of pediatric CI in Samsung Medical Center. Eight CP subjects who received CI before 3 years of age and age-sex matched control recipients who had no additional disabilities except idiopathic sensorineural hearing loss (SNHL) were included for the analysis. Preoperative evaluation included the Categories of Auditory Performance (CAP) score, Korean Version of the Ling's Stage (K-Ling), Sequenced Language Scale for Infants (SELSI), Bailey Scales of Infant Development II assessment, Social Maturity Scale test, and grading of CP severity using severity level and Gross Motor Function Classification System for CP (GMFCS). To measure the outcome, the CAP scores, K-Ling, and SELSI were performed at 3, 6, 12, and 24 months after implantation. RESULTS: Four CP children with outstanding performances showed comparable achievement with matched control recipients. These patients had less severe motor disabilities (mild-moderate severity, GMFCS level 1-3), better social quotient, and better cognitive abilities. Although the others showed poor language abilities and hardly produced meaningful speech, their CAP scores reached 1 or 2 in 24 months after implantation. CONCLUSIONS: Deaf children with CP could have various ranges of benefits up to the levels of normal peers whose only disability was hearing loss, when CI was performed within a critical period. Especially, children with mild or moderate CP had a favorable outcome after CI, equivalent to that of normal peers.

The Efficacy and Safety of Ablative Fractional Resurfacing Using a 2,940-Nm Er:YAG Laser for Traumatic Scars in the Early Posttraumatic Period.

BACKGROUND: Skin injuries, such as lacerations due to trauma, are relatively common, and patients are very concerned about the resulting scars. Recently, the use of ablative and non-ablative lasers based on the fractional approach has been used to treat scars. In this study, the authors demonstrated the efficacy and safety of ablative fractional resurfacing (AFR) for traumatic scars using a 2,940-nm erbium: yttrium-aluminum-garnet (Er:YAG) laser for traumatic scars after primary repair during the early posttraumatic period. METHODS: Twelve patients with fifteen scars were enrolled. All had a history of facial laceration and primary repair by suturing on the day of trauma. Laser therapy was initiated at least 4 weeks after the primary repair. Each patient was treated four times at 1-month intervals with a fractional ablative 2,940-nm Er:YAG laser using the same parameters. Post-treatment evaluations were performed 1 month after the fourth treatment session. RESULTS: All 12 patients completed the study. After ablative fractional laser treatment, all treated portions of the scars showed improvements, as demonstrated by the Vancouver Scar Scale and the overall cosmetic scale as evaluated by 10 independent physicians, 10 independent non-physicians, and the patients themselves. CONCLUSIONS: This study shows that ablative fractional Er:YAG laser treatment of scars reduces scars fairly according to both objective results and patient satisfaction rates. The authors suggest that early scar treatment using AFR can be one adjuvant scar management method for improving the quality of life of patients with traumatic scars.

Characteristics of nasal resonance and perceptual rating in prelingual hearing impaired adults.

OBJECTIVES: Resonance problems in hearing impaired (HI) individuals have been described as aspects of nasality. However, there are limitations in being able to explain the range of resonance problems. Therefore, this study suggests a perceptual rating that will effectively explain the characteristics of resonance problems in HI individuals. METHODS: Nasalance scores were obtained from 32 subjects in each of HI and normal hearing (NH) groups using a nasometer. The subjects were categorized into groups based on normal and abnormal nasalance ranges. The abnormal nasalance range group was further divided into hyper-, hypo-, and mixed-nasal groups. Nasalance scores were based the individuals performance in a series of passage and syllable tasks. The perceptual rating was evaluated using a newly introduced tool, 'vertical focus of resonance' (VFR), which focuses on the resonance energy in the frontal, throat, pharyngeal and nasal locations. RESULTS: The NH group demonstrated a significantly lower nasalance score in the oral coupling and passage tasks than the HI group. Based on the results of nasalance correlation analysis, the HI group showed highly significant correlations between syllable and passage tasks, as contrasted with the NH group. There were significant differences in VFR between the nasalance types in both the NH and the HI groups. CONCLUSION: The HI hyper-nasal group showed tendencies of velopharyngeal opening, as opposed to the HI hypo-nasal group which showed tendencies of velopharyngeal closure. The HI mixed-nasal group showed inappropriate coordination of velopharyngeal function. In the HI group, the results of VFR showed that the air flow and the resonance energy were not released from the cavity of resonance. The suggested VFR tool explains the focusing characteristics of resonance energy within a continuation of speech sound regardless of the phonetic environment. Therefore, VFR may be a useful tool in explaining the deviant resonance patterns of HI individuals.

A new measurement tool for speech development based on Ling's stages of speech acquisition in pediatric cochlear implant recipients.

OBJECTIVES: With the rapid increase of pediatric cochlear implantation (CI), there exists a need for a standardized assessment tool regarding speech and communication skills in children with CI. However, the current testing tools are not appropriate for the longitudinal evaluation of young children after CI. The aims of this study were to describe a progressive testing tool developed for the evaluation of speech acquisition and production in young children who have undergone CI and to examine its validity. METHODS: Sixty children younger than six years of age with CI participated in this study. A Korean version of Ling's stages (K-Ling) was developed based on the Ling speech teaching model to longitudinally assess phonologic and phonetic developments in young children after CI. The K-Ling, the Categories of Auditory Performance (CAP), and the Sequenced Language Scale for Infants (SELSI) were performed in the children with CI preoperatively and three, six, and 12 months postoperatively. Correlations among these three testing tools were analyzed. RESULTS: Auditory, language, and speech skills assessed using the CAP, SELSI, and K-Ling improved continuously for 12 months in young children following CI. Strong correlations were obtained among K-Ling's level, CAP scores, and the equivalent age of SELSI; correlation indices ranged from 0.540 to 0.800. CONCLUSIONS: The K-Ling was a valid evaluation tool regarding speech development in young children who are using CI and who are in the early stages of speech development. Longitudinal assessments of phonetic and phonologic developments may be attainable in young children using the K-Ling.

Clinical assessment of music perception in Korean cochlear implant listeners.

CONCLUSION: The Korean version of the Clinical Assessment of Music Perception (K-CAMP) test is an efficient, self-administrable test for discrimination of a wide range of music perception ability in adult Korean cochlear implant (CI) users. OBJECTIVES: The aims of the study were the development of a clinically practical test of music perception for adult Korean CI lisetners and evaluation of its effectiveness. METHODS: Twelve adult post-lingually deafened patients and 12 normal-hearing (NH) controls were tested with the K-CAMP test, comprising pitch direction discrimination, melody identification, and timbre identification tests. RESULTS: Pitch discrimination, melody identification, and timbre identification in CI users showed a wide range of perceptual abilities. The mean pitch change discrimination difference limen (DL) for the base frequency of 262 Hz (middle C) was 2.7 +/- 1.7 semitones: 4.4 +/- 4.2 semitones for 330 Hz (E4) and 8.1 +/- 3.0 semitones for 391 Hz (G4) in CI listeners. The DL widened as the base frequency increased. The melody identification test produced 21.1 +/- 21.7% correct answers, and the timbre identification test recorded 25.7 +/- 8.5% correct answers in CI listeners. Pitched percussion instruments (piano, guitar) were better for timbre identification. Speech performance scores had a positive correlation with the pitch discrimination DL (p < 0.05).