Satisfaction with life in a sample of prelingually deaf cochlear implant users with a good command of spoken Polish as the primary language.

INTRODUCTION: This study investigated the level of satisfaction with life (SWL) in a group of cochlear implant (CI) users who had been prelingually deaf but were orally educated. They had received one or two CIs (as a child, adolescent, or adult) and were highly competent Polish speakers. This study looked at three factors that may affect SWL - psychosocial, deafness/hearing and communication related, and sociodemographic. METHODS: The participants were prelingually deaf CI users who had learned highly competent spoken Polish as their primary language. They had been educated in mainstream or integrated schools (not schools for the deaf), and had no other disability or severe illness. Measurements were done with 5 questionnaires: the Satisfaction With Life Scale (SWLS), the I-Others Questionnaire, the Patient Health Questionnaire (PHQ-9), the Deaf Identity Development Scale (DIDS), and the Nijmegen Cochlear Implant Questionnaire (NCIQ). RESULTS: The SWL level of the group was similar to that of the standard Polish population. SWL was positively related to positive self-perception, acceptance of oneself as a deaf person, and to perceiving the benefits of having a CI (as measured by three NCIQ domains: self-esteem, activity limitations, and social interactions). On the other hand, negative self-perception, marginal deaf identity, and depressive symptoms were negatively related to SWL. There was no relationship between SWL and knowledge of sign language. Lower depressive symptoms and greater hearing loss were both significant predictors of SWL, although those who used two CIs generally had a lower SWL. CONCLUSIONS: Prelingually deaf CI users with low SWL require psychological support in many spheres, including working through problems of deaf identity, self-acceptance, and depression. Additional research should involve diverse DHH CI users, including those with limited spoken Polish competency or sign language skills, as well as members of the Polish Deaf community.

Cognitive Assessment in Elderly Cochlear Implant Recipients: Long-Term Analysis.

OBJECTIVES: To examine long-term speech and cognition outcomes in older adult cochlear implant (CI) recipients. First, by evaluating if CI performance was maintained over an extended follow-up period regardless of preoperative cognitive status. Secondly, by evaluating if there was a difference in the rate of cognitive decline between preoperative mild and normal cognition following CI over an extended period of time. STUDY DESIGN AND SETTING: Retrospective cohort study. METHODS: CI recipients ≥65 years of age implanted between 2009 and 2014 with 4+ years follow up. Pre- and postoperative audiometric and speech outcome assessments were collected. Cognitive status was measured using the mini mental status examination (MMSE) at numerous time points. RESULTS: Fifty-three patients met inclusion. Patients were divided into two groups based on preoperative MMSE with scores considered normal (28-30) and those with mildly impaired cognition (MIC, scores 25-27). Audiometric and speech performance improved significantly at one-year post implantation and this was maintained without significant change at 4+ years, regardless of cognitive status. Mixed modeling analysis controlling for age demonstrated no significant difference in the rate of cognitive decline at 4+ years post implantation between the normal cognition cohort (1.74; 95%CI 0.89-2.6) and MIC (2.9; 95%1.91-3.88). CONCLUSION: Speech performance was significantly improved and sustained after CI in both normal cognition and MIC patients. The rate of cognitive decline in older adult CI patients appears to be similar regardless of preoperative cognitive status. Although results demonstrate rates of cognitive decline following CI did not differ between cognition groups over 4+ years, future studies will need to further investigate this over extended time periods with a more comprehensive cognitive testing battery. LEVEL OF EVIDENCE: 4 Laryngoscope, 133:2379-2387, 2023.

Parents' Perspectives on the Outcome of Cochlear Implantation for the Deaf Child and the Family in Saudi Arabia.

The researchers investigated parents' perspectives on the outcome of cochlear implantation on the deaf child and the family in Saudi Arabia with respect to linguistic, social, psychological, and educational aspects. They also explored potential factors influencing parents' perspectives on the outcome of a cochlear implant (CI). Seventy-seven parents completed the questionnaire, and multiple linear regression and descriptive statistics were used to answer the research questions. Most of the parents (88.5%) reported choosing a CI for their deaf child because they wanted their child to be part of the hearing world. About half of the parents (49.4%) expressed the belief that the CI would help their child find a better job in the future. The study also found that, overall, the model was not significant, and the independent variables explained little of the variance in parents' perspectives on the outcome of their child's cochlear implantation.

Facial and Auditory Recognition Abilities of Implanted Primary Schoolers.

OBJECTIVE: Emotions are often conveyed via visual and together with the auditory mode in social interaction. We aimed to investigate the ability to recognize facial and/or auditory emotions in school-aged children with cochlear implantation and healthy controls. METHODS: All participants were asked to respond to facial emotions of Ekman and Friesen's pictures, then auditory emotions, and last, they were asked to respond to video-based dynamic synchronous facial and auditory emotions. RESULTS: The mean accuracy rates in recognizing anger (p = 0.025), surprise (p = 0.029), and neutral (p = 0.029) faces were significantly worse in children with cochlear implants (CIs) than in healthy controls. They were significantly worse than healthy controls in recognizing all auditory emotions except auditory emotion of fear (p = 0.067). The mean accuracy rates in recognizing video-based auditory/facial emotions of surprise (p = 0.031) and neutral (p = 0.029) emotions were significantly worse in children with CIs. CONCLUSION: The children with hearing loss were poorer in recognizing surprise, anger, and neutral facial emotions than healthy children; they had similar performance in recognizing anger emotions when both stimuli were given synchronously which may have a positive effect on social behaviors. It seems beneficial that emotion recognition training should be included in rehabilitation programs.

Age-Related Changes in Voice Emotion Recognition by Postlingually Deafened Listeners With Cochlear Implants.

OBJECTIVES: Identification of emotional prosody in speech declines with age in normally hearing (NH) adults. Cochlear implant (CI) users have deficits in the perception of prosody, but the effects of age on vocal emotion recognition by adult postlingually deaf CI users are not known. The objective of the present study was to examine age-related changes in CI users' and NH listeners' emotion recognition. DESIGN: Participants included 18 CI users (29.6 to 74.5 years) and 43 NH adults (25.8 to 74.8 years). Participants listened to emotion-neutral sentences spoken by a male and female talker in five emotions (happy, sad, scared, angry, neutral). NH adults heard them in four conditions: unprocessed (full spectrum) speech, 16-channel, 8-channel, and 4-channel noise-band vocoded speech. The adult CI users only listened to unprocessed (full spectrum) speech. Sensitivity (d') to emotions and Reaction Times were obtained using a single-interval, five-alternative, forced-choice paradigm. RESULTS: For NH participants, results indicated age-related declines in Accuracy and d', and age-related increases in Reaction Time in all conditions. Results indicated an overall deficit, as well as age-related declines in overall d' for CI users, but Reaction Times were elevated compared with NH listeners and did not show age-related changes. Analysis of Accuracy scores (hit rates) were generally consistent with d' data. CONCLUSIONS: Both CI users and NH listeners showed age-related deficits in emotion identification. The CI users' overall deficit in emotion perception, and their slower response times, suggest impaired social communication which may in turn impact overall well-being, particularly so for older CI users, as lower vocal emotion recognition scores have been associated with poorer subjective quality of life in CI patients.

Implicit learning of non-verbal regularities by deaf children with cochlear implants: An investigation with a dynamic temporal prediction task.

Some deaf children continue to show difficulties in spoken language learning after cochlear implantation. Part of this variability has been attributed to poor implicit learning skills. However, the involvement of other processes (e.g. verbal rehearsal) has been underestimated in studies that show implicit learning deficits in the deaf population. In this study, we investigated the relationship between auditory deprivation and implicit learning of temporal regularities with a novel task specifically designed to limit the load on working memory, the amount of information processing, and the visual-motor integration skills required. Seventeen deaf children with cochlear implants and eighteen typically hearing children aged 5 to 11 years participated. Our results revealed comparable implicit learning skills between the two groups, suggesting that implicit learning might be resilient to a lack of early auditory stimulation. No significant correlation was found between implicit learning and language tasks. However, deaf children's performance suggests some weaknesses in inhibitory control.

Parents' Perspectives on Cochlear Implantation Results for Deaf Children or Children With Hearing Loss in Saudi Arabia.

The purpose of the research was to understand the quality of life of children from Saudi Arabia with cochlear implants (CIs) from the parental perspective in terms of communication abilities, social skills, academic achievement, being well adapted for future life, rehabilitation knowledge, and stress due to hearing loss. A quantitative approach was used, in which a questionnaire was administered to 103 children with CIs. The results showed high levels of expectations with respect to communication abilities, social skills, academic achievement, being well adapted for future life, and rehabilitation knowledge. The parents were observed to be highly stressed by their children's disability. Pearson's correlation and linear regression analysis were used to test the association of the characteristics of the implanted children on factors of quality of life.

Remote Assessment of Verbal Memory in Youth With Cochlear Implants During the COVID-19 Pandemic.

Purpose Youth with cochlear implants (CIs) are at risk for delays in verbal short-term memory (STM)/working memory (WM), which adversely affect language, neurocognitive, and behavioral outcomes. Assessment of verbal STM/WM is critical for identifying and addressing these delays, but standard assessment procedures require face-to-face (FTF) administration. The purpose of this study was to determine the feasibility and validity of remote testing methods (teleassessment) of verbal STM/WM in youth with CIs as a method of addressing COVID-19-related restrictions on FTF test administration. Method Tests of verbal STM/WM for nonwords, digit spans, letter-number sequences, sentences, and stories were individually administered by speech-language pathologists over a teleassessment platform to 28 youth (aged 9-22 years) with CIs and 36 same-aged normal-hearing peers. Examiners, parents, and participants completed quality and satisfaction ratings with the teleassessment procedure. Teleassessment scores were compared to results of tests obtained at FTF visits an average of 1.6 years earlier. Results Quality and satisfaction ratings for teleassessment were high and in almost all cases did not differ between the CI and normal-hearing samples. Youth with CIs scored lower than normal-hearing peers on measures of verbal STM/WM, and scores for digit span and letter-number sequencing did not differbetween teleassessment and FTF methods. Correlations across teleassessment and FTF visits were strong for digit span, letter-number sequencing, and sentence memory, but were more modest for nonword repetition. Conclusion With some caveats, teleassessment of verbal STM/WM was feasible and valid for youth with CIs.

Exposure to Spoken Communication in Children With Cochlear Implants During the COVID-19 Lockdown.

Importance: The coronavirus disease 2019 (COVID-19) lockdowns in Ontario, Canada in the spring of 2020 created unprecedented changes in the lives of all children, including children with hearing loss. Objective: To quantify how these lockdowns changed the spoken communication environments of children with cochlear implants by comparing the sounds they were exposed to before the Ontario provincial state of emergency in March 2020 and during the resulting closures of schools and nonessential businesses. Design, Setting, and Participants: This experimental cohort study comprised children with hearing loss who used cochlear implants to hear. These children were chosen because (1) their devices monitor and catalog levels and types of sounds during hourly use per day (datalogs), and (2) this group is particularly vulnerable to reduced sound exposure. Children were recruited from the Cochlear Implant Program at a tertiary pediatric hospital in Ontario, Canada. Children whose cochlear implant datalogs were captured between February 1 and March 16, 2020, shortly before lockdown (pre-COVID-19), were identified. Repeated measures were collected in 45 children during initial easing of lockdown restrictions (stages 1-2 of the provincial recovery plan); resulting datalogs encompassed the lockdown period (peri-COVID-19). Main Outcomes and Measures: Hours of sound captured by the Cochlear Nucleus datalogging system (Cochlear Corporation) in 6 categories of input levels (<40, 40-49, 50-59, 60-69, 70-79, ≥80 A-weighted dB sound pressure levels [dBA]) and 6 auditory scene categories (quiet, speech, speech-in-noise, music, noise, and other). Mixed-model regression analyses revealed main effects with post hoc adjustment of confidence intervals using the Satterthwaite method. Results: A total of 45 children (mean [SD] age, 7.7 [5.0] years; 23 girls [51.1%]) participated in this cohort study. Results showed similar daily use of cochlear implants during the pre- and peri-COVID-19 periods (9.80 mean hours pre-COVID-19 and 9.34 mean hours peri-COVID-19). Despite consistent device use, these children experienced significant quieting of input sound levels peri-COVID-19 by 0.49 hour (95% CI, 0.21-0.80 hour) at 60 to 69 dBA and 1.70 hours (95% CI, 1.42-1.99 hours) at 70 to 79 dBA with clear reductions in speech exposure by 0.98 hour (95% CI, 0.49-1.47 hours). This outcome translated into a reduction of speech:quiet from 1.6:1.0 pre-COVID-19 to 0.9:1.0 during lockdowns. The greatest reductions in percentage of daily speech occurred in school-aged children (elementary, 12.32% [95% CI, 7.15%-17.49%]; middle school, 11.76% [95% CI, 5.00%-18.52%]; and high school, 9.60% [95% CI, 3.27%-15.93%]). Increased daily percentage of quiet (7.00% [95% CI, 4.27%-9.74%]) was most prevalent for children who had fewer numbers of people in their household (estimate [SE] = -1.12% [0.50%] per person; Cohen f = 0.31). Conclusions and Relevance: The findings of this cohort study indicate a clear association of COVID-19 lockdowns with a reduction in children's access to spoken communication.

Phone Speech Recognition Improvement in Noisy Environment: Use of a Bluetooth Accessory.

OBJECTIVE: To evaluate speech understanding in noise and patient satisfaction using the new Cochlear Wireless Phone Clip device. MATERIAL AND METHODS: Twenty-nine experienced cochlear implant (CI) users (>6 months usage) were situated in a soundproof room where a 65 dB SPL Spanish cocktail noise was generated continuously from 4 loudspeakers. Lists of disyllabic words were presented through the clinic landline telephone to the patients. Patients were tested first holding the phone and then with the Cochlear Phone Clip© paired to the CP910 using various mixing ratios (2:1, 4:1, and Phone Clip© only). RESULTS: Statistically significant (P < .001) improvement of speech recognition performance was found in cell phone usage by wireless transmission and also when using this new device. Kepler questionnaire results showed that before using Phone Clip in everyday life, 55.2% of patients described themselves highly or greatly affected by their deafness for telephone use and 80% moderately to greatly affected. Kim questionnaire results showed statistically significant differences (P < .001) in the subjective satisfaction of the Bluetooth-implemented CI compared to the conventional mode for sound quality, noise interference, and sound accuracy. CONCLUSIONS: The wireless Phone Clip© device helps implanted people to improve subjective and objective speech recognition performance through the phone in noisy environments.

The Devil in the Details Can Be Hard to Spot: Malapropisms and Children With Hearing Loss.

Purpose Better auditory prostheses and earlier interventions have led to remarkable improvements in spoken language abilities for children with hearing loss (HL), but these children often still struggle academically. This study tested a hypothesis for why this may be, proposing that the language of school becomes increasingly disconnected from everyday discourse, requiring greater reliance on bottom-up phonological structure, and children with HL have difficulty recovering that structure from the speech signal. Participants One hundred nineteen fourth graders participated: 48 with normal hearing (NH), 19 with moderate losses who used hearing aids (HAs), and 52 with severe-to-profound losses who used cochlear implants (CIs). Method Three analyses were conducted. #1: Sentences with malapropisms were created, and children's abilities to recognize them were assessed. #2: Factors contributing to those abilities were evaluated, including phonological awareness, phonological processing, vocabulary, verbal working memory, and oral narratives. #3: Teachers' ratings of students' academic competence were obtained, and factors accounting for those ratings were evaluated, including the five listed above, along with word reading and reading comprehension. Results #1: Children with HAs and CIs performed more poorly on malapropism recognition than children with NH, but similarly to each other. #2: All children with HL demonstrated large phonological deficits, but they were especially large for children with CIs. Phonological awareness explained the most variance in malapropism recognition for children with CIs. Vocabulary knowledge explained malapropism recognition for children with NH or HAs, but other factors also contributed. #3: Teachers rated academic competence for children with CIs more poorly than for children with NH or HAs, and variance in those ratings for children with CIs were primarily explained by malapropism scores. Conclusion Children with HL have difficulty recognizing acoustic-phonetic detail in the speech signal, and that constrains their abilities to follow conversations in academic settings, especially if HL is severe enough to require CIs. Supplemental Material https://doi.org/10.23641/asha.13133018.

Validation and inter-rater reliability testing of the Arabic version of speech intelligibility rating among children with cochlear implant.

OBJECTIVES: To validate and assess the reliability of the new version of an Arabic speech intelligibility rating among di erent raters. METHODS: This cross-sectional analysis was carried out between December 2018 and January 2019. Thirty cochlear-implant (CI) children (study group) and 30 subjects (control group) were enrolled. Study candidates' speech skills were evaluated using the translated Arabic SIR by parents and original SIR by professions such as speech-language pathologists (SLPs). Inter-rater agreement, test-retest reliability, pre- and post-intervention score (responsiveness test), patient versus control score comparison (discriminant validity), and cross-validation of Arabic SIR have all been assessed. RESULTS: There was a good sense of agreement between the post-operative SIR parents' assessments and the professional SLPs' assessments (r=0.920, p less than 0.001). The mean of study subjects pre- and post-implantation score of Arabic SIR showed a statistically significant difference (p less than 0.001). CONCLUSION: The Arabic SIR demonstrated excellent reliability with strong consistency. It showed its clinical ability in distinguishing healthy subjects from patients along with follow up of speech development skills over time. The Arabic SIR can be used by parents to evaluate post-CI progress of their children.

Benefits of Cochlear Implantation in Middle-Aged and Older Adults.

INTRODUCTION: Nowadays cochlear implantation (CI) is the treatment of choice in adults in case conventional hearing devices fail. Besides speech perception, an improvement in quality of life and in cognitive performance has been reported. Thereby, the study focused on the impact of age. PARTICIPANTS AND METHODS: Thirty middle-aged (MA) between 50 and 64 years and 41 older subjects (OA) aged 65 and older with bilateral severe hearing loss performed a comprehensive computer-based neurocognitive test battery (ALAcog) pre- and 12 months post-implantation. Besides, monosyllabic speech perception in quiet (Freiburg monosyllabic speech test), health-related quality of life (HR-QoL, Nijmegen Cochlear Implant Questionnaire) and depressive symptoms (GDS-15) have been assessed. RESULTS: Both age groups significantly improved in all three categories after 12 months. No differences were evaluated between MA and OA regarding speech perception and HR-QoL pre- and post-operatively. In contrast, cognitive performance differed between the age groups: pre-operatively OA performed worse in most neurocognitive subdomains like working memory (p=0.04), inhibition (p=0.004), processing speed (p=0.003) and mental flexibility (p=0.01), post-operatively MA outperformed OA only in inhibition (p=0.01). Age only slightly influenced cognitive performance in MA, whereas in OA age per se tremendously impacted on working memory (p=0.04), inhibition (p=0.02), memory (p=0.04) and mental flexibility (p=0.01). Educational level also affected processing speed, mental flexibility (p=0.01) and working memory (p=0.01). This was more pronounced in OA. In both age groups, hearing status had a strong effect on attentional tasks (p=0.01). In MA, depressive symptoms were more influential on cognitive functioning and on HR-QoL than in OA. Improvement in quality of life (p=0.0002) and working memory (p=0.001) was greater for those with a higher pre-operative depression score. CONCLUSION: Speech perception and HR-QoL improved in hearing impaired, independently of age. Pre-operative differences in cognitive performance between OA and MA clearly attenuated 12 months after CI. Impact of comorbidities differed between age groups.

Quality of life (QoL) evaluation of children using cochlear implants: agreement between pediatric and parent proxy-QoL reports.

Objectives: Cochlear implants are known to significantly improve the quality of life (QoL) of implanted children. However, variability exists between self-reported outcomes and parental-reported QoL questionnaires. We evaluated the QoL agreement between children and their parents following cochlear implantation and determined which factors lead to increased agreement. Methods: A cross-sectional study was performed including pediatric cochlear implant recipients and their parents. We evaluated postoperative QoL using The Pediatric Quality of Life Inventory (PedsQL). To assess agreement between pediatric and parental QoL perception, PedsQL intra-class correlations (ICCs) were calculated. Results: Thirty-five children and their parents completed QoL questionnaires. Children who were evaluated between 8-12 years of age reported highest absolute total and subscale PedsQL scores. Highest agreement was found amongst parents and children when: (1) children were between 8-12 years at QoL assessment (ICC: between 0.917[95%CI: 0.676-0.981] and 0.972[95%CI: 0.882-0.994]), and (2) when evaluating the physical health QoL domain (ICC: 0.964[95%CI: 0.849-0.992]). Conclusions: This study demonstrates high agreement (ICC > 0.8) between pediatric and parental QoL report in children aged between 8-12 years at QoL assessment. Therefore, results confirm that: (1) QoL agreement between pediatric self-report and parent proxy-report is high in chronically ill children and (2) children using cochlear implants can reliably report QoL between 8-12 years.

Translation and validation of parental perspective questionnaire for children with cochlear implant in persian language.

Objective: Parental views about the outcomes of implantation on the child's quality of life are valuable sources of information for implantation specialists. The aim at this study was to validate the "Parental Perspectives" questionnaire in Persian language.Design: The original questionnaire was translated from English to Persian language; the final Persian version of questionnaire was prepared and evaluated for validity and reliability. The internal consistency of the questionnaire and test-retest reliability were respectively evaluated by Cronbach's alpha and ICC index. Factor analysis was used to determine the construct validity.Study Sample: The participants of this study were 370 parents of CI children.Results: Sampling adequacy for executing of factor analysis was confirmed by the results of Kaiser-Meyer-Olkin (=0.84) and Bartlett test (p < .05). Three factors were extracted from exploratory factor analysis. Confirmatory factor analysis confirmed the accuracy of the three-dimensional structures. Principal component analysis revealed the structural validity of three factors. Correlation between questionnaire items was good (r = 0.76). Reliability coefficient was calculated as 0.93.Conclusions: The Persian version of the questionnaire has good validity and reliability and can be used to examine the perspectives of the parents about CI.

The influence of age and language on developmental trajectory of theory of mind in children with cochlear implants.

OBJECTIVE: The present study investigates if children with cochlear implants (CI) are associated with delayed development of Theory of Mind (ToM) and the differences in gain of ToM ability with respect to age, language and other aspects of CI. METHODS: One-hundred-eleven children with participation of their hearing parents, aged between 36 months and 132 months, who had congenital profound bilateral deafness and were unilateral CI users; plus 99 healthy children underwent 'Peabody Picture Vocabulary' and 'Sally-Anne' tests. A total of 77 children with CI (mean age: 76.51 months, 31 girls and 46 boys) and 82 healthy children (mean age: 72.41 months, 47 girls and 35 boys) were included in the analyses. Analytic comparisons were created between the controls and children with CI and between subgroups of CI users by univariate and multivariate analysis. The effects of age of hearing aid use, age of CI surgery, duration of CI use, language scores and the presence of risk factors, early rehabilitation with hearing aid and CI on the ToM development were analyzed. RESULTS: The Sally-Anne test success rates of 67.1% were significantly higher in controls than that of children with CI (49.4%) (p < 0.05). The mean age difference of the children, who were successful in Sally-Anne test was 5.33 months in favor of healthy controls. The ToM task success rates were 57.1% (24/42) and 40% (14/35) in children with early CI and late CI respectively. The children, who were good at language, were also better in Sally-Anne tests, but the mean Peabody Picture Vocabulary test scores were indifferent in the same age group with respect to the presence of CI use (p > 0.05). However, multivariate analysis presented the higher language scores as the only significant independent variable that has impact on the success in Sally-Anne test (p < 0.05). CONCLUSION: The results revealed that among all children, who did better in ToM were older in age and better in language skills. Children with CI also performed better in false-belief test depending on their language scores. Early CI surgery, older age, and hence longer CI use can provide a well-developed ToM for children with CI.

Calidad de vida relacionada con la salud (CVRS) en niños de educación primaria de Islas Canarias que usan dispositivos auditivos / Health-Related Quality of Life (HRQoL) in children in Primary Education in the Canary Islands with cochlear implants or hearing aids

INTRODUCCIÓN: Los objetivos del estudio fueron: primero, evaluar la calidad de vida relacionada con la salud (CVRS) de niños y niñas con implantes cocleares (nIC) o audífonos (nAU) de educación primaria de Islas Canarias. Segundo, analizar las percepciones que los progenitores (padres o madres) tenían de la CVRS de los nIC o nAU y finalmente, explorar la homogeneidad de resultados entre los autoinformes de los nIC y nAU y los informes de sus progenitores sobre la CVRS. MATERIAL Y MÉTODOS: Se obtuvieron datos de 89 nIC y 63 nAU y sus 152 progenitores. Se utilizaron 2 instrumentos estandarizados: el Kid-KINDLR_children_7-13, el Kid_Kiddo-KINDLR_Parents_7-17 y un cuestionario con variables demográficas y audiológicas que respondieron nIC y nAU y sus progenitores. Mediante la prueba «t» de Student, ANOVA de una vía, análisis post hoc y 3 coeficientes de correlación de concordancia (CCC) se analizaron los 3 objetivos. RESULTADOS Y DISCUSIÓN: Los nIC mostraron una percepción de mejor CVRS en comparación con los nAU. Los nIC y nAU y sus padres fueron significativamente distintos en las provincias de Tenerife y Gran Canaria. Los nIC y nAU de Gran Canaria obtuvieron mejores resultados en las dimensiones bienestar emocional y familiar, mientras que los nIC y nAU de Tenerife destacaron en autoestima o amigos. Los progenitores de los niños con IC (pIC) tuvieron una puntuación promedio más alta en la percepción de la CVRS total y por dimensiones referida a sus hijos frente a los progenitores de los nAU. El acuerdo entre niños y sus progenitores fue bajo, excepto en la dimensión autoestima. Los nIC y sus progenitores percibieron mejor CVRS que los nAU y sus progenitores. Las autopercepciones de los nIC y nAU de la CVRS fueron inferiores a las informadas por sus progenitores. CONCLUSIONES: Los hallazgos sugieren que los nIC y nAU de educación primaria de las Islas Canarias han mantenido percepciones discrepantes de su CVRS, autopercibiendo los nIC mejor CVRS que los nAU. Los pIC han alcanzado una puntuación promedio más alta de la CVRS de sus hijos que la expresada por los progenitores de nAU por razones de pertenencia a una provincia. Los profesionales que trabajan con los nIC y nAU deben optimizar las dimensiones de la CVRS de los nIC y nAU

INTRODUCTION: The objectives of the study were first, to evaluate the health-related quality of life (HRQoL) of primary school children from the Canary Islands with cochlear implants (CIs) and hearing aids (HAs). And second, to analyse parents' perceptions of their children with CIs and HAs regarding HRQoL, and finally, to explore the agreement between the children's self-reports and their parents' reports concerning HRQoL. MATERIAL AND METHODS: Data consisted of 89 children with CIs and 63 children with HAs and their 152 parents. Two standardised instruments were used: Kid-KINDLR_children_7-13, Kid_Kiddo-KINDLR_Parents_ 7-17 and a demographic and audiological survey, which were answered by the children and their parents. Student's t-test, one-way ANOVA, post hoc analysis and 3 concordance correlation coefficients (CCC) were used to address the 3 objectives. RESULTS AND DISCUSSION: The children with CIs exhibited a perception of better HRQoL in comparison with the children with HAs. The children with CIs and HAs and their parents were significantly distinct in the provinces of Tenerife and Gran Canaria. The cchildren with CIs and HAs from Gran Canaria were better on Emotional well-being and Family, while the children with CIs and HAs from Tenerife emphasised Self-esteem or Friends. The parents of the children with CIs had a higher average score in the perception of the total HRQoL and per dimension related to their children compared to the parents of the children with HAs. The agreement between children and parents was low except in the Self-esteem dimension. The children with CIs and their parents demonstrated a perception of better HRQoL than the children with HAs and their parents. The children with CIs and HAs had lower self-perception of the HRQoL than their parents' reports. CONCLUSIONS: The findings suggest that the children with CIs and HAs in Primary Education in the Canary Islands have discrepant perceptions of their HRQoL; the children with CIs self-perceive better HRQoL than the children with HAs. The parents of the children with CIs achieved a higher average score of their children's HRQoL than the parents of the children with HAs due to their belonging to a province. Professionals working with CI and HA recipients need to be sensitive to psychological issues to optimise HRQoL dimensions in children with CIs and HAs

Adults' cochlear implant journeys through care: a qualitative study.

BACKGROUND: Cochlear implants (CIs) can provide a sound sensation for those with severe sensorineural hearing loss (SNHL), benefitting speech understanding and quality of life. Nevertheless, rates of implantation remain low, and limited research investigates journeys from traditional hearing aids to implantable devices. METHOD: Fifty-five adults (≥ 50 years), hearing aid users and/or CI users, General Practitioners, and Australian and United Kingdom audiologists took part in a multi-methods study. Focus groups, interviews, and surveys were thematically analysed. RESULTS: One hundred forty-three data-capture events disclosed 2 themes: 1) "The burden of hearing loss and the impact of Cochlear Implants", and 2) "Professional Support and Practice, and HCPs Roles and Responsibilities". CONCLUSIONS: Care experience can include convoluted, complex journeys towards cochlear implantation. The significant impact of this, as hearing loss progresses, motivates people to consider implants, but they and healthcare professionals need clear supported with defined referral pathways, and less system complexity.

What can we learn from adult cochlear implant recipients with single-sided deafness who became elective non-users?

Objective: This retrospective study investigates the incidence of elective cochlear implant (CI) non-use amongst a cohort of adult CI recipients with single-sided deafness (SSD), identifies the causes that led to non-use, and assesses how non-use could be prevented. Methods: All adults with SSD who received a CI between 2008 and 2018 and who became elective CI non-users were included. Elective non-users were defined as CI recipients who decided to stop using their CI or, if explantation was necessary, refused reimplantation. Results: 5/114 (4.4%) adults with SSD who received a CI became elective non-users. The 5 non-users were a mean 44.2 years old (range 33-70 years) at implantation, had a mean duration of deafness of 7.1 years (range 0.5-20 years) at implantation, and used their CI for a mean 11.5 months (range 1.5-60 months) before (fully) discontinuing use. The primary cause of elective non-use was postoperative discouragement due to unrealistic expectations (4 participants) regarding sound perception with the CI or about the greater than expected level of commitment necessary for rehabilitation. Conclusions: Elective non-use among adult CI recipients with single-sided deafness was very rare and could be further prevented by comprehensive counselling to ensure that candidates have realistic expectations about the rehabilitation requirements and the outcomes with the CI.

The Relationship Between the Onset of Canonical Syllables and Speech Perception Skills in Children With Cochlear Implants.

Purpose The study sought to determine whether the onset of canonical vocalizations in children with cochlear implants (CIs) is related to speech perception skills and spoken vocabulary size at 24 months postactivation. Method The vocal development in 13 young CI recipients (implanted by their third birthdays; mean age at activation = 20.62 months, SD = 8.92 months) was examined at every 3-month interval during the first 2 years of CI use. All children were enrolled in auditory-oral intervention programs. Families of these children used spoken English only. To determine the onset of canonical syllables, the first 50 utterances from 20-min adult-child interactions were analyzed during each session. The onset timing was determined when at least 20% of utterances included canonical syllables. As children's outcomes, we examined their Lexical Neighborhood Test scores and vocabulary size at 24 months postactivation. Results Pearson correlation analysis showed that the onset timing of canonical syllables is significantly correlated with phonemic recognition skills and spoken vocabulary size at 24 months postactivation. Regression analyses also indicated that the onset timing of canonical syllables predicted phonemic recognition skills and spoken vocabulary size at 24 months postactivation. Conclusion Monitoring vocal advancement during the earliest periods following cochlear implantation could be valuable as an early indicator of auditory-driven language development in young children with CIs. It remains to be studied which factors improve vocal development for young CI recipients.