RESUMEN
OBJECTIVE: The objective of the study was to investigate the functions of the vestibular, tactile, visual, and proprioceptive modalities in children with prelinguistic hearing loss. Specifically, the study sought to examine evidence for the compensation hypothesis (auditory deprivation leads to enhancements in functions of other sensory systems) versus the deficiency hypothesis (functions of the spared senses are compromised as a result of auditory deprivation). METHODS: Twelve children between the ages of 5 years, 1 month and 8 years, 11 months with bilateral severe-profound hearing loss participated in the study. All children used bilateral cochlear implants. Subtests of two norm-referenced instruments, the Sensory Integration and Praxis Test and the Beery-Buktenica Developmental Test of Visual-Motor Integration, were administered to all of the children. Mean subtest scores for children with hearing loss were compared with the mean scores for the normative group. RESULTS: As expected, a majority of children demonstrated vestibular dysfunction. Assessment of other modalities revealed significantly below average performance on two tasks by children with hearing loss when compared to the normative group. Both tasks involved temporal processing of tactile or proprioceptive signals. Conversely, children with hearing loss showed significantly better performance compared to the normative group for a spatial task that involved localization of a tactile stimulus. No group differences were found for any of the visual tasks. CONCLUSIONS: Results supported both the compensation and the deficiency hypotheses. The findings have implications for both assessment and intervention of young children with hearing loss. Further investigations are necessary to replicate these findings with a more comprehensive set of measures on a larger cohort of children with prelinguistic, severe-profound hearing loss.
Asunto(s)
Adaptación Fisiológica , Implantación Coclear/métodos , Pérdida Auditiva Bilateral/cirugía , Propiocepción/fisiología , Desempeño Psicomotor/fisiología , Privación Sensorial/fisiología , Factores de Edad , Niño , Preescolar , Implantes Cocleares , Femenino , Estudios de Seguimiento , Pérdida Auditiva Bilateral/diagnóstico , Humanos , Lactante , Masculino , Medición de Riesgo , Índice de Severidad de la Enfermedad , Análisis y Desempeño de Tareas , Factores de Tiempo , Enfermedades Vestibulares/fisiopatología , Percepción Visual/fisiologíaRESUMEN
We examined sensory-processing disorder (SPD) in children with cochlear implants and explored the relationship between SPD and duration of hearing loss or duration of cochlear implant use. Caregivers of 30 children completed the Sensory Profile Questionnaire (SPQ). Seventy percent of the children showed "at-risk" or "different" behaviors in one or more of five categories of the SPQ: auditory, visual, vestibular, tactile, and oral processing. No noteworthy relationships surfaced between duration of deafness or duration of cochlear implant use and the atypical behaviors identified. To validate these findings further, postrotary nystagmus (PRN) testing and Miller's Assessment for Preschoolers (MAP) were administered to a subset of children. PRN was atypical in all 6 children tested. MAP findings revealed atypical sensory processing in 4 of the 6 children. Findings suggested that children with cochlear implants may be at risk for SPD. The findings are discussed in light of clinician and teacher referral for occupational therapy evaluations.