The Role of Music in Families of Children With Hearing Loss and Normal Hearing in Australia, Finland, and the UK.

The primary aim of this current study was to compare the role, importance and value placed on music by families with normally hearing (NH) children, to those who had a child with a hearing loss (HL) who wore either hearing aids and/or cochlear implants. A secondary aim was to see whether this differed between the countries. Parents of children aged 2-6 years living in Australia, Finland, and the United Kingdom were invited to complete the Role of Music in Families Questionnaire (RMFQ). Two groups of participants were recruited from each country: (i) parents of NH children, and (ii) parents of children with a HL. The RMFQ had seven subsections covering topics such as music participation, attitudes to music, importance of music in the family, and future perspectives on music. Three hundred and twenty-two families of NH children, and 56 families of children with HL completed the questionnaire (Australia: 50 NH, 25 HL; Finland: 242 NH, 21 HL; United Kingdom: 30 NH, 10 HL). Analyses compared between NH and HL groups within each country, and between the three countries for the NH group, and the HL group, independently. Overall, there were few significant differences between the participation levels, role, or importance of music in families with NH children compared to those with a child who had a HL, regardless of whether the families lived in Australia, Finland or the United Kingdom. Children first started to respond to music at similar ages, and overall music participation frequency, and music enjoyment were relatively similar. The importance of music in the family was also similar between the NH and HL groups. In comparing between the countries, Finnish children had a tendency to have higher participation rates in musical activities, with few other differences noted. Overall, the results of this study indicate that children, regardless of hearing levels or country of residence, have similar levels of music engagement and enjoyment, and HL is not seen as a contraindication to music participation and involvement by the parents involved in this study.

A qualitative review of parents' perspectives on the value of CAEP recording in influencing their acceptance of hearing devices for their child.

Objective: To obtain a parental perspective on how audiological tests, including recording cortical auditory-evoked potentials (CAEP) to speech sounds, influenced their uptake of hearing devices for their infant. Design: A focus group was established by parents of hearing-impaired children. A facilitator explored how audiology tests influenced their understanding and management of hearing loss in their child and their acceptance of hearing aids or cochlear implant referral. The views were transcribed and thematic analysis was used to understand key topics. Study samples: Eight sets of parents participated. Their children had been enrolled in an audiology pathway that included CAEP testing. The sample included six children who were aided, one child who was going through the implant assessment and one child who was implanted. Results: Parents reported that it was important for them to understand the test results because this influenced acceptance of hearing aids and cochlear implant assessments. Seven sets of parents had not understood ABR results, while six reported that CAEPs had helped them to understand their child's hearing and need for intervention. Conclusion: Compliance with early hearing aid use and referral for cochlear implant depends upon parents' understanding of their infant's hearing loss by including CAEPs in the audiology pathway.

Expert opinion: Assessing cochlear implant candidacy and progress for people with English as an additional language.

Special considerations relating to cochlear implants (CIs) are necessary for deaf people for whom English is an additional language (EAL). The audiological and pre-linguistic skills criteria for CI candidacy are the same for children with EAL as for children from English-speaking families. However, thorough assessment is not straightforward, for example, requiring employment of experienced interpreters. To ensure family engagement and thus appropriate support in the home, clear understanding of the family's social and cultural framework and of their needs and requirements is essential. Equally, the family must be enabled to understand the implications of CI. Additional training of staff in CI teams may be needed. This article will address these and other issues for children and also consider the situation for adults.

Bilateral sequential cochlear implantation in the congenitally deaf child: evidence to support the concept of a 'critical age' after which the second ear is less likely to provide an adequate level of speech perception on its own.

This study attempts to answer the question of whether there is a 'critical age' after which a second contralateral cochlear implant is less likely to provide enough speech perception to be of practical use. The study was not designed to predict factors that determine successful binaural implant use, but to see if there was evidence to help determine the latest age at which the second ear can usefully be implanted, should the first side fail and become unusable.Outcome data, in the form of speech perception test results, were collected from 11 cochlear implant programmes in the UK and one centre in Australia. Forty-seven congenitally bilaterally deaf subjects who received bilateral sequential implants were recruited to the study. The study also included four subjects with congenital unilateral profound deafness who had lost all hearing in their only hearing ear and received a cochlear implant in their unilaterally congenitally deaf ear. Of those 34 subjects for whom complete sets of data were available, the majority (72%) of those receiving their second (or unilateral) implant up to the age of 13 years scored 60 per cent or above in the Bamford Kowal Bench (BKB) sentence test, or equivalent. In contrast, of those nine receiving their second or unilateral implant at the age of 15 or above, none achieved adequate levels of speech perception on formal testing: two scored 29 per cent and 30 per cent, respectively, and the rest seven per cent or less.A discriminant function analysis performed on the data suggests that it is unlikely that a second contralateral implant received after the age of 16 to 18 years will, on its own, provide adequate levels of speech perception. As more children receive sequential bilateral cochlear implants and the pool of data enlarges the situation is likely to become clearer.The results provide support for the concept of a 'critical age' for implanting the second ear in successful congenitally deaf unilateral cochlear implant users. This would argue against 'preserving' the second ear beyond a certain age, in order to use newer models of cochlear implant or for the purpose of hair cell regeneration and similar procedures in the future. The results suggest a new and more absolute reason for bilateral implantation of congenitally deaf children at an early age.

Conversion of scores between Bamford, Kowal and Bench (BKB) sentences and Arthur Boothroyd (AB) words in quiet for cochlear implant patients.

This paper describes the relationship between the scores obtained in the Bamford, Kowal and Bench (BKB) sentence test and the Arthur Boothroyd (AB) word test in quiet for a group of 71 cochlear implant users. Each subject was tested at the same appointment and in the same environment during routine clinical appointments at the South of England Cochlear Implant Centre.Using rationalised arcsine transformation and a linear regression calculation, conversion tables were produced from BKB to AB and from AB to BKB scores. The relationship between scores obtained from the two tests was highly significant.These conversion tables may be of use in cochlear implant centres and by audiology clinics.