The effect of cross-over frequency on binaural hearing performance of adults using electric-acoustic stimulation.

Objective: To investigate the effect of varying cross-over frequency (CF) settings for electric-acoustic (EA) stimulation in one ear combined with acoustic (A) hearing in the opposite ear on binaural speech perception, localization and functional performance in real life. Methods: Performance with three different CF settings set according to audiometric-based criterion were compared, following a four week familiarisation period with each, in ten adult cochlear implant recipients with residual hearing in both ears. On completion of all trials participants selected their preferred CF setting. Results: On average, CF settings did not have a significant effect on performance scores. However, higher ratings on device usage were associated with the preferred CF settings. Conclusion: Individuals who use EA + A stimulation may benefit from access to different CF settings to achieve maximal device usage.

Factors influencing parents' decisions about communication choices during early education of their child with hearing loss: a qualitative study.

OBJECTIVE: To explore the factors influencing parents' choice of communication mode during early education of their child with hearing loss. DESIGN: Qualitative descriptive analysis of semi-structured interviews of parents of children with hearing loss. STUDY SAMPLE: Fourteen parents of children who participated in the Longitudinal Outcomes of Children with Hearing Impairment study. RESULTS: Four themes emerged from thematic analysis of the interview data: (1) parents draw on a variety of experiences and information to make decisions; (2) parents' preferred outcomes for their children drive their choices; (3) child's preference and proficiency drive parental choice; and (4) parents' fears and worries influence decisions. Parents required unbiased, descriptive information as well as evaluative information from professionals, so that they could consider all options in making a decision that met their needs. They required continual support for implementation of their choices as they adjusted to their children's changing needs. CONCLUSIONS: Decisions around communication mode are rarely made in isolation, but occur within a larger decision-making matrix that include device choices, early intervention agency choices and "future-proofing" the child's future communication options.

Spoken language and everyday functioning in 5-year-old children using hearing aids or cochlear implants.

OBJECTIVE: This study investigated the factors influencing 5-year language, speech and everyday functioning of children with congenital hearing loss. DESIGN: Standardised tests including PLS-4, PPVT-4 and DEAP were directly administered to children. Parent reports on language (CDI) and everyday functioning (PEACH) were collected. Regression analyses were conducted to examine the influence of a range of demographic variables on outcomes. STUDY SAMPLE: Participants were 339 children enrolled in the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study. RESULTS: Children's average receptive and expressive language scores were approximately 1 SD below the mean of typically developing children, and scores on speech production and everyday functioning were more than 1 SD below. Regression models accounted for 70-23% of variance in scores across different tests. Earlier CI switch-on and higher non-verbal ability were associated with better outcomes in most domains. Earlier HA fitting and use of oral communication were associated with better outcomes on directly administered language assessments. Severity of hearing loss and maternal education influenced outcomes of children with HAs. The presence of additional disabilities affected outcomes of children with CIs. CONCLUSIONS: The findings provide strong evidence for the benefits of early HA fitting and early CI for improving children's outcomes.

Factors influencing speech perception in noise for 5-year-old children using hearing aids or cochlear implants.

OBJECTIVE: We investigated the factors influencing speech perception in babble for 5-year-old children with hearing loss who were using hearing aids (HAs) or cochlear implants (CIs). DESIGN: Speech reception thresholds (SRTs) for 50% correct identification were measured in two conditions - speech collocated with babble, and speech with spatially separated babble. The difference in SRTs between the two conditions give a measure of binaural unmasking, commonly known as spatial release from masking (SRM). Multiple linear regression analyses were conducted to examine the influence of a range of demographic factors on outcomes. STUDY SAMPLE: Participants were 252 children enrolled in the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study. RESULTS: Children using HAs or CIs required a better signal-to-noise ratio to achieve the same level of performance as their normal-hearing peers but demonstrated SRM of a similar magnitude. For children using HAs, speech perception was significantly influenced by cognitive and language abilities. For children using CIs, age at CI activation and language ability were significant predictors of speech perception outcomes. CONCLUSIONS: Speech perception in children with hearing loss can be enhanced by improving their language abilities. Early age at cochlear implantation was also associated with better outcomes.

Multilingual children with hearing loss: Factors contributing to language use at home and in early education.

Understanding the relationship between children's cultural and linguistic diversity and child, caregiver, and environmental characteristics is important to ensure appropriate educational expectations and provisions. As part of the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study, children's caregivers and educators completed questionnaires on demographic characteristics, including the communication mode (oral, manual, or mixed) and languages used in home and early educational environments. This article reports an exploratory analysis to examine factors associated with language use and communication mode of children at 3 years of age. A Chi Square Automatic Interaction Detector (CHAID) analysis was performed on data from 406 children to examine factors influencing communication mode and oral language use. The factor that most influenced children's communication mode at home was the communication mode used by their female caregiver. Children's communication mode in their early education environment was most related to the communication mode they used at home, and then related to the presence of additional needs in the children, female caregivers' level of education and the male caregivers' use of languages other than English (LOTEs). A second exploratory CHAID analysis of data for children from multilingual families (n = 106) indicated that female caregivers' use of English at home significantly influenced whether children used a LOTE at home. Finally, the use of a LOTE at home was associated with the use of a LOTE in the early education environment. These findings serve as an initial description of the factors that were associated with the communication mode and language use of children with hearing loss.