The effect of age of cochlear implantation on vocal characteristics in children.

BACKGROUND: Early cochlear implantation aids auditory feedback and supports better communication and self-monitoring of the voice. The objective of this study was to determine whether the age of cochlear implantation has an impact on vocal development in children implanted before age 4. METHOD AND PROCEDURES: The study consisted of 19 participants in total. All implant recipients (experimental group) were 3-5 years post-implantation, including four prelingual (0-2 years) and five perilingual (2-4 years) implant recipients. The control group consisted of 10 children whose hearing was within normal limits between the ages 3-6 years and 10 months, which was compared to the experimental group. Established paediatric norms were used for additional comparison. A questionnaire was used to gather information from each of the participant's caregivers to determine whether other personal and contextual factors had an impact on voice production. An acoustic analysis was conducted for each participant using the Multi-Dimensional Voice Program of the Computerized Speech Lab. RESULTS: When the experimental group and the control group were compared, similar results were yielded for fundamental frequency and short-term perturbation (jitter and shimmer). More variability was noted in long-term frequency and amplitude measures, with significantly higher differences, and therefore further outside the norms, in the prelingual group when compared to the perilingual and control groups. CONCLUSION: In this study, age of implantation did not impact vocal characteristics. Further research should include larger sample sizes, with participants that are age and gender matched.

Profound childhood hearing loss in a South Africa cohort: risk profile, diagnosis and age of intervention.

OBJECTIVE: To describe profound childhood hearing loss in a South African population of pediatric cochlear implant recipients in terms of risk profile, and age of diagnosis and intervention. METHODS: A retrospective review of patient files for 264 pediatric cochlear implant recipients from five cochlear implant programs was conducted. Data was captured from 264 eligible subjects, of which all were implanted between 1996 and 2013 and PCEHL was confirmed under the age of 5 years old. Data collected included demographical information, risk factors from case histories, diagnostic test procedures conducted, diagnosis (type, onset and degree of hearing loss) and documented ages of caregiver suspicion, initial diagnosis and intervention. RESULTS: Risk factors for permanent childhood hearing loss were present in 51.1% of cases, with the most prevalent risks being NICU admittance (28.1%), family history of childhood hearing loss (19.6%) and prematurity (15.1%). An associated syndrome was diagnosed in 10% of children and 23.5% presented with at least one additional developmental condition. Hearing loss for most (77.6%) children was confirmed as congenital/early onset, while 20.3% presented with postnatal onset of hearing loss. ANSD was diagnosed in 5% of children, with admittance to NICU (80%) and hyperbilirubinemia (50%) being the most prevalent risk factors for these cases. Hearing loss was typically diagnosed late (15.3 months), resulting in delayed initial hearing aid fitting (18.8 months), enrollment in early intervention services (19.5 months) and eventual cochlear implantation (43.6 months). CONCLUSION: Most prevalent risk factors in profound childhood hearing loss were admittance to NICU, family history and prematurity. Diagnosis and intervention was typically delayed predisposing this population to poorer outcomes.