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1.
Ear Hear ; 42(1): 20-28, 2020 12 22.
Artigo em Inglês | MEDLINE | ID: mdl-33369590

RESUMO

OBJECTIVES: The impact of social distancing on communication and psychosocial variables among individuals with hearing impairment during COVID-19 pandemic. It was our concern that patients who already found themselves socially isolated (Wie et al. 2010) as a result of their hearing loss would be perhaps more susceptible to changes in their communication habits resulting in further social isolation, anxiety, and depression. We wanted to better understand how forced social isolation (as part of COVID-19 mitigation) effected a group of individuals with hearing impairment from an auditory ecology and psychosocial perspective. We hypothesized that the listening environments would be different as a result of social isolation when comparing subject's responses regarding activities and participation before COVID-19 and during the COVID-19 pandemic. This change would lead to an increase in experienced and perceived social isolation, anxiety, and depression. DESIGN: A total of 48 adults with at least 12 months of cochlear implant (CI) experience reported their listening contexts and experiences pre-COVID and during-COVID using Ecological Momentary Assessment (EMA; methodology collecting a respondent's self-reports in their natural environments) through a smartphone-based app, and six paper and pencil questionnaires. The Smartphone app and paper-pencil questionnaires address topics related to their listening environment, social isolation, depression, anxiety, lifestyle and demand, loneliness, and satisfaction with amplification. Data from these two-time points were compared to better understand the effects of social distancing on the CI recipients' communication abilities. RESULTS: EMA demonstrated that during-COVID CI recipients were more likely to stay home or be outdoors. CI recipients reported that they were less likely to stay indoors outside of their home relative to the pre-COVID condition. Social distancing also had a significant effect on the overall signal-to-noise ratio of the environments indicating that the listening environments had better signal-to-noise ratios. CI recipients also reported better speech understanding, less listening effort, less activity limitation due to hearing loss, less social isolation due to hearing loss, and less anxiety due to hearing loss. Retrospective questionnaires indicated that social distancing had a significant effect on the social network size, participant's personal image of themselves, and overall loneliness. CONCLUSIONS: Overall, EMA provided us with a glimpse of the effect that forced social isolation has had on the listening environments and psychosocial perspectives of a select number of CI listeners. CI participants in this study reported that they were spending more time at home in a quieter environments during-COVID. Contrary to our hypothesis, CI recipients overall felt less socially isolated and reported less anxiety resulting from their hearing difficulties during-COVID in comparison to pre-COVID. This, perhaps, implies that having a more controlled environment with fewer speakers provided a more relaxing listening experience.


Assuntos
/prevenção & controle , Implante Coclear , Perda Auditiva/psicologia , Razão Sinal-Ruído , Percepção da Fala , Adulto , Idoso , Ansiedade/psicologia , Implantes Cocleares , Surdez/fisiopatologia , Surdez/psicologia , Surdez/reabilitação , Depressão/psicologia , Avaliação Momentânea Ecológica , Meio Ambiente , Feminino , Auxiliares de Audição , Perda Auditiva/fisiopatologia , Perda Auditiva/reabilitação , Perda Auditiva Bilateral/fisiopatologia , Perda Auditiva Bilateral/psicologia , Perda Auditiva Bilateral/reabilitação , Perda Auditiva Unilateral/fisiopatologia , Perda Auditiva Unilateral/psicologia , Perda Auditiva Unilateral/reabilitação , Humanos , Masculino , Pessoa de Meia-Idade , Ruído , Isolamento Social/psicologia
2.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32989084

RESUMO

BACKGROUND: Children who are deaf or hard of hearing (D/HH) have improved language outcomes when enrolled in early intervention (EI) before the age of 6 months. Little is understood about the long-term impact of EI on outcomes of kindergarten readiness (K-readiness). The study objective was to evaluate the impact of EI before the age of 6 months (early) versus after 6 months (later) on K-readiness in children who are D/HH. METHODS: In this study, we leveraged data from the Ohio Early Hearing Detection and Intervention Data Linkage Project, which linked records of 1746 infants identified with permanent hearing loss born from 2008 to 2014 across 3 Ohio state agencies; 417 had kindergarten records. The Kindergarten Readiness Assessment was used to identify children as ready for kindergarten; 385 had Kindergarten Readiness Assessment scores available. Multiple logistic regression was used to investigate the relationship between K-readiness and early EI entry while controlling for confounders (eg, hearing loss severity and disability status). RESULTS: Children who were D/HH and entered EI early (n = 222; 57.7% of the cohort) were more likely to demonstrate K-readiness compared with children who entered EI later (33.8% vs 20.9%; P = .005). Children who entered early had similar levels of K-readiness as all Ohio students (39.9%). After controlling for confounders, children who entered EI early were more likely to be ready for kindergarten compared with children who entered later (odds ratio: 2.02; 95% confidence interval 1.18-3.45). CONCLUSIONS: These findings support the sustained effects of early EI services on early educational outcomes among children who are D/HH. EI entry before the age of 6 months may establish healthy trajectories of early childhood development, reducing the risk for later academic struggles.


Assuntos
Correção de Deficiência Auditiva , Intervenção Médica Precoce/métodos , Transtornos da Audição , Desenvolvimento da Linguagem , Desempenho Acadêmico , Fatores Etários , Criança , Pré-Escolar , Surdez/reabilitação , Feminino , Humanos , Lactente , Masculino , Ohio
4.
Int J Pediatr Otorhinolaryngol ; 134: 110043, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32305661

RESUMO

INTRODUCTION: Congenital sensorineural hearing loss is a heterogeneous disorder; its etiological profile varies between populations. Pathogenic variants of GJB2 gene are the major cause of non-syndromic hearing loss. Congenital cytomegalovirus infection (cCMV) is the most important prenatal etiological factor causing hearing loss and other disorders. Perinatal events, syndromes, postnatal infections or traumas are less common. Causes of the remaining one third of hearing loss cases are unknown. OBJECTIVES: To determine the etiological profile of hearing loss in pediatric cochlear implant users in Lithuanian population. METHODS: The data of 122 children (70 male/52 female; aged 7.6 ± 3.3 years) cochlear implant users were analysed. Medical records of all children recruited in Santaros Clinics (Vilnius, Lithuania) were analysed to identify prenatal, perinatal, or postnatal risk factors based on the adapted list proposed by the Joint Committee of Infant Hearing. Genetic counselling and testing according to the scheme were performed to 101 children. DNA of 117 children was extracted from the DBS on Guthrie cards and CMV DNA detected using real time PCR. RESULTS: Non-syndromic hearing loss was diagnosed in 65 cases (53.3%), 58 of which were GJB2 gene-associated; syndromic hearing loss was diagnosed to 8 children (6.6%). Perinatal (prematurity, low birth weight, hypoxia, hyperbilirubinemia, sepsis, ototoxicity, and meningitis) and postnatal (meningitis) risk factors were associated with hearing loss in 16 (13.1%) and 4 (3.3%) study participants respectively. CMV DNA was detected in 12 samples (9.8%). The cause of hearing loss remained unknown only for 17 (13.9%) children. CONCLUSIONS: The major cause of HL in the current study was GJB2 gene alterations. Only 14% of the cohort had congenital hearing loss of unknown origin.


Assuntos
Implante Coclear , Conexinas/genética , Infecções por Citomegalovirus/complicações , Surdez/etiologia , Perda Auditiva Neurossensorial/etiologia , Adolescente , Criança , Pré-Escolar , Implantes Cocleares , Estudos de Coortes , Infecções por Citomegalovirus/congênito , Surdez/genética , Surdez/reabilitação , Feminino , Perda Auditiva Neurossensorial/genética , Perda Auditiva Neurossensorial/reabilitação , Humanos , Hiperbilirrubinemia Neonatal/complicações , Hipóxia/complicações , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido Prematuro , Lituânia , Masculino , Meningite/complicações , Sepse Neonatal/complicações
5.
Otolaryngol Head Neck Surg ; 162(6): 926-932, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32178574

RESUMO

OBJECTIVE: Default frequency filters of cochlear implant (CI) devices assign frequency information irrespective of intracochlear position, resulting in varying degrees of frequency-to-place mismatch. Substantial mismatch negatively influences speech recognition in postlingually deafened CI recipients, and acclimatization may be particularly challenging for older adults due to effects of aging on the auditory pathway. The present report investigated the influence of mismatch and age at implantation on speech recognition within the initial 6 months of CI use. STUDY DESIGN: Retrospective review. SETTING: Tertiary referral center. SUBJECTS AND METHODS: Forty-eight postlingually deafened adult CI recipients of lateral wall electrode arrays underwent postoperative computed tomography to determine angular insertion depth of each electrode contact. Frequency-to-place mismatch was determined by comparing spiral ganglion place frequencies to default frequency filters. Consonant-nucleus-consonant (CNC) scores in the CI-alone condition at 1, 3, and 6 months postactivation were compared to the degree of mismatch at 1500 Hz and age at implantation. RESULTS: Younger adult CI recipients experienced more rapid growth in speech recognition during the initial 6 months postactivation. Greater degrees of frequency-to-place mismatch were associated with poorer performance, yet older listeners were not particularly susceptible to this effect. CONCLUSIONS: While older adults are not necessarily more sensitive to detrimental effects of frequency-to-place mismatch, other factors appear to limit early benefit with a CI in this population. These results suggest that minimizing mismatch could optimize outcomes in adult CI recipients across the life span, which may be particularly beneficial in the elderly considering auditory processing deficits associated with advanced age.


Assuntos
Implante Coclear/métodos , Surdez/reabilitação , Percepção da Fala/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Surdez/diagnóstico , Surdez/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
8.
Acta Otolaryngol ; 139(12): 1090-1097, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31671009

RESUMO

Background: There are some debates regarding the benefit from cochlear implantation (CI) for prelingually deaf children with white matter changes.Objective: To assess the hearing and speech outcomes of prelingually deaf children with white matter changes (group A), and those with complete deafness (group B), at 2 years after CI.Material and Methods: Study 1 included 32 and 34 children in group A and B, respectively. The Categories of Auditory Performance (CAP) and Speech Intelligibility Rate (SIR) were used to assess the performance on hearing and speech. Study 2 included eight children with white matter changes and eight with complete deafness at 2 years post-CI, and nine normal-hearing peers. The mismatch response (MMR) to the stimulus pair 'ba'/'pa' was investigated.Results: There was no significant difference on CAP or SIR scores between the children in group A and B. All children with white matter changes showed MMRs to Mandarin consonants at 2 years post-CI. And there was no significant difference on the incidence, the latency or amplitude of MMR among three groups.Conclusions and significance: Most prelingually deaf children with white matter changes got good outcomes from CI. CI is not a contraindication for most individuals with white matter changes.


Assuntos
Implante Coclear/reabilitação , Surdez/cirurgia , Leucoencefalopatias/complicações , Audiometria da Fala , Criança , Pré-Escolar , Implante Coclear/psicologia , Surdez/complicações , Surdez/congênito , Surdez/reabilitação , Potenciais Evocados , Feminino , Seguimentos , Humanos , Lactente , Masculino , Inteligibilidade da Fala
9.
Audiol Neurootol ; 24(5): 264-269, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31661682

RESUMO

OBJECTIVE: Our aim was to determine the effect of acute changes in cochlear place of stimulation on cochlear implant (CI) sound quality. DESIGN: In Experiment 1, 5 single-sided deaf (SSD) listeners fitted with a long (28-mm) electrode array were tested. Basal shifts in place of stimulation were implemented by turning off the most apical electrodes and reassigning the filters to more basal electrodes. In Experiment 2, 2 SSD patients fitted with a shorter (16.5-mm) electrode array were tested. Both basal and apical shifts in place of stimulation were implemented. The apical shifts were accomplished by current steering and creating a virtual place of stimulation more apical that that of the most apical electrode. RESULTS: Listeners matched basal shifts by shifting, in the normal-hearing ear, the overall spectrum up in frequency and/or increasing voice pitch (F0). Listeners matched apical shifts by shifting down the overall frequency spectrum in the normal-hearing ear. CONCLUSION: One factor determining CI voice quality is the location of stimulation along the cochlear partition.


Assuntos
Percepção Auditiva/fisiologia , Cóclea/cirurgia , Implante Coclear , Implantes Cocleares , Surdez/reabilitação , Estimulação Acústica , Feminino , Testes Auditivos , Humanos , Masculino , Pessoa de Meia-Idade
10.
Audiol Neurootol ; 24(6): 279-284, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31665723

RESUMO

BACKGROUND: Cochlear implantation (CI) is an effective treatment option for patients with severe-to-profound hearing loss. When CI first started, it was recommended to wait until at least 4 weeks after the CI surgery for the initial activation because of possible complications. Advances in the surgical techniques and experiences in fitting have made initial activation possible within 24 h. OBJECTIVES: To compare the complaints and complications after early activation between behind-the-ear (BTE) and off-the-ear (OTE) sound processors and to show the impact of early activation on the electrode impedance values. METHOD: CI surgeries performed between March 2013 and July 2018 were retrospectively analyzed from the database. In total, 294 CI users were included in the present study. The impedance measurements were analyzed postoperatively at the initial activation prior to the stimulation, and 4 weeks after the initial activation in the first-month follow-up visit. A customized questionnaire was administered in the first-month follow-up fitting session to caregivers and/or patients who were using CI at least for 6 months. Medical records were also reviewed to identify any postoperative complications. RESULTS: In the early activation group, impedance values were significantly lower than in the control group (p < 0.05) at first fitting. At the first-month follow-up, no significant difference was found between the groups (p > 0.05). The most common side effects were reported to be edema (6.1%) and pain (5.7%) in the early activation group. In patients with OTE sound processors, the rate of side effects such as skin infection, wound swelling, skin hyperemia, and pain was higher than in patients with BTE sound processors; however, a statistical significance was only observed in wound swelling (p = 0.005). Selecting the appropriate magnet was defined as a problem for the OTE sound processors during the initial activation. CONCLUSION: This study revealed that early activation of CI was clinically safe and feasible in patients with BTE sound processors. When using OTE sound processors, the audiologists should be careful during the activation period and inform patients of possible side effects. The first fitting should be delayed for 4 weeks after CI for OTE sound processors. This current study is the first to report this finding with 5 years of experience in a large cohort.


Assuntos
Implante Coclear/métodos , Implantes Cocleares , Surdez/reabilitação , Ajuste de Prótese/métodos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Edema/epidemiologia , Feminino , Humanos , Hiperemia/epidemiologia , Lactente , Masculino , Pessoa de Meia-Idade , Ruído , Dor Pós-Operatória/epidemiologia , Complicações Pós-Operatórias , Estudos Retrospectivos , Processamento de Sinais Assistido por Computador , Percepção da Fala , Infecção da Ferida Cirúrgica , Inquéritos e Questionários , Adulto Jovem
11.
J Speech Lang Hear Res ; 62(11): 4196-4230, 2019 11 22.
Artigo em Inglês | MEDLINE | ID: mdl-31652408

RESUMO

Purpose The purpose of this systematic review is to identify and evaluate the available scientific evidence on the effectiveness of rehabilitation approaches proposed to children with severe-to-profound prelinguistic deafness on the hearing, speech, and language skills development. Method Databases (PubMed, CINHAL, PsycInfo, Cochrane, ERIC, and EMBASE) were searched with relevant key words (children, deafness, rehabilitation approach, auditory, speech, and language). Studies published between 2000 and 2017 were included. The methodological quality of the studies was evaluated with the Quality Assessment Tool for Quantitative Studies, and the level of evidence was evaluated with the Oxford Centre for Evidence-Based Medicine Levels of Evidence. Every step of the selection and analysis was made by 2 independent judges. Results Of 1,739 articles listed in different databases, 38 met the inclusion criteria and were selected for analysis. The majority of included articles present a relatively low level of evidence. Rehabilitation approaches that do not include signs appear more frequently associated with a better auditory, speech, and language development, except for receptive language, than approaches that included any form of signs. Conclusion More robust studies are needed to decide on the approach to prioritize with severe-to-profound deaf children.


Assuntos
Linguagem Infantil , Surdez/reabilitação , Audição , Fala , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Índice de Gravidade de Doença , Resultado do Tratamento
12.
Trends Hear ; 23: 2331216519866029, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31533581

RESUMO

Cochlear implantation in subjects with single-sided deafness (SSD) offers a unique opportunity to directly compare the percepts evoked by a cochlear implant (CI) with those evoked acoustically. Here, nine SSD-CI users performed a forced-choice task evaluating the similarity of speech processed by their CI with speech processed by several vocoders presented to their healthy ear. In each trial, subjects heard two intervals: their CI followed by a certain vocoder in Interval 1 and their CI followed by a different vocoder in Interval 2. The vocoders differed either (i) in carrier type-(sinusoidal [SINE], bandfiltered noise [NOISE], and pulse-spreading harmonic complex) or (ii) in frequency mismatch between the analysis and synthesis frequency ranges-(no mismatch, and two frequency-mismatched conditions of 2 and 4 equivalent rectangular bandwidths [ERBs]). Subjects had to state in which of the two intervals the CI and vocoder sounds were more similar. Despite a large intersubject variability, the PSHC vocoder was judged significantly more similar to the CI than SINE or NOISE vocoders. Furthermore, the No-mismatch and 2-ERB mismatch vocoders were judged significantly more similar to the CI than the 4-ERB mismatch vocoder. The mismatch data were also interpreted by comparing spiral ganglion characteristic frequencies with electrode contact positions determined from postoperative computed tomography scans. Only one subject demonstrated a pattern of preference consistent with adaptation to the CI sound processor frequency-to-electrode allocation table and two subjects showed possible partial adaptation. Those subjects with adaptation patterns presented overall small and consistent frequency mismatches across their electrode arrays.


Assuntos
Implante Coclear/métodos , Implantes Cocleares/normas , Perda Auditiva Unilateral/reabilitação , Adulto , Surdez/reabilitação , Feminino , Humanos , Masculino , Som , Fala , Percepção da Fala/fisiologia , Gânglio Espiral da Cóclea
13.
Acta Otolaryngol ; 139(12): 1098-1103, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31560244

RESUMO

Background: Few studies had assessed the auditory and preverbal skills of very young cochlear implant (CI) children with additional disabilities (AD) over a long period, especially in China.Aims/Objectives: The aim of this study was to compare the early auditory and preverbal developmental trajectories in CI children with and without AD.Material and Methods: The LittlEARS® Auditory Questionnaire (LEAQ) was employed. 29 typically developing (TD) children and 17 with AD were involved (age at implantation less than 2 years).Results: All children showed significant improvement in total LEAQ scores with CI use. Children with cerebral palsy (CP), developmental delay (DD) and white matter lesions (WML) scored lower than TD children since 3 months of CI use; a decreasing trend was observed from 24, 18 and 18 months of CI use, respectively. Children with higher nonverbal developmental quotients exhibited superior early auditory and preverbal skills.Conclusions and significance: The development of early auditory and preverbal skills among CI-using children progressed more slowly in those with AD (CP, DD or WML) than in TD children, but the differences between the two groups gradually diminished over time. Nonverbal cognitive status has a positive effect on early auditory and preverbal abilities.


Assuntos
Paralisia Cerebral/complicações , Implantes Cocleares , Surdez/reabilitação , Deficiências do Desenvolvimento/complicações , Desenvolvimento da Linguagem , Grupo com Ancestrais do Continente Asiático , Paralisia Cerebral/psicologia , Pré-Escolar , Surdez/complicações , Surdez/psicologia , Surdez/cirurgia , Deficiências do Desenvolvimento/psicologia , Feminino , Seguimentos , Humanos , Lactente , Masculino
14.
Am J Speech Lang Pathol ; 28(4): 1673-1691, 2019 11 19.
Artigo em Inglês | MEDLINE | ID: mdl-31513745

RESUMO

Purpose The increasing prevalence of pediatric cochlear implantation over the past 25 years has left little doubt that resulting improvements in hearing offer significant benefits to language development for many deaf children. Furthermore, given the documented importance of access to language from birth, there has been strong support for providing congenitally deaf children with implants as early as possible. Earliest implantation, in many ways, has become the "gold standard" in pediatric cochlear implantation, on the assumption that it is the key to language development similar to that of hearing children. Empirical evidence to support this assumption, however, appears more equivocal than generally is believed. This article reviews recent research aimed at assessing the impact of age at implantation on vocabulary and grammatical development among young implant users. Method Articles published between 2003 and 2018 that included age at implantation as a variable of interest and in which it was subjected to statistical analysis were considered. Effect sizes were calculated whenever possible; we conducted a multivariate meta-analysis to compare outcomes in different language domains. Results Taken together, findings from 49 studies suggest that age at implantation is just one of a host of variables that influence vocabulary and grammatical development, its impact varying with several factors including whether age at implantation is treated as a dichotomous or continuous variable. Results from a meta-analysis showed significant differences across language domains. Conclusion The pattern of results obtained indicates the importance of considering various child, family, and environmental characteristics in future research aimed at determining how early "early implantation" needs to be and the extent to which age at implantation, duration of implant use, and other factors influence language and language-related outcomes. Supplemental Material https://doi.org/10.23641/asha.9789041.


Assuntos
Implantes Cocleares , Surdez/psicologia , Surdez/reabilitação , Desenvolvimento da Linguagem , Fala , Vocabulário , Fatores Etários , Implante Coclear , Surdez/cirurgia , Humanos
15.
Rev. logop. foniatr. audiol. (Ed. impr.) ; 39(3): 115-128, jul.-sept. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-185830

RESUMO

Introduction: children with severe to profound sensorineural hearing loss and prelingual onset of deafness exhibit less linguistic skills and poorer academic achievements when compared with their hearing peers. Recent studies show that cochlear implants may promote language development in this paediatric population, although phonological development does not always follow the patterns attested for typically developing children. Aim and method: the present study aims at describing the phonetic properties of segments and the phonological processes produced by 18 deaf Portuguese children with more than 2.0 years of implant use, divided into two groups according of their hearing age (A=2.10-4.04 and B=5.04-7.03) For this purpose, we used a formal articulation test validated for the Portuguese population. Results: results show that Group B, with a higher hearing age, exhibit a consonant repertoire more complete than Group A, whose hearing age was lower. Syllable and segmental difficulties tend to persist over a long period of time, even after 4 years of implant experience (i.e. hearing age). Discussion: the children's consonant repertoire of plosives and fricatives seems to take longer to establish in deaf children with cochlear implants than in their Portuguese hearing peer; other phonological patterns found in the data show an immature phonological development (e.g. syllable omission and onset deletion); these results match the ones reported for other languages in other studies on cochlear implanted children


Introducción: los niños con un nivel de hipoacusia neurosensitiva entre intensa y profunda, y en fases iniciales de sordera prelocutiva presentan conocimientos lingüísticos y resultados académicos inferiores en relación con otros niños de su misma edad con un cuadro auditivo normal. Estudios recientes muestran que los implantes cocleares pueden promover el desarrollo lingüístico de este segmento pediátrico, aun cuando el desarrollo fonológico no siempre siga la progresión estándar que se observa en niños con una evolución prototípica. Objetivo y metodología: este estudio tiene como objetivo describir las propiedades de los segmentos fonéticos y de las pautas fonológicas producidos por 18 niños sordos portugueses con más de 2 años de experiencia con el implante coclear, divididos en dos cohortes en función del tiempo que han utilizado este tipo de implantes (A = 2.10-4.04 y B = 5.04-7.03). Con este propósito nos hemos servido de una prueba de articulación formal validada para hablantes portugueses. Resultados: los resultados muestran que el grupo B, con mayor edad auditiva, presenta un repertorio de consonantes más completo que el grupo A. Las dificultades en la producción de sílabas y segmentos suelen persistir durante un largo período de tiempo, incluso después de los 4 años de experiencia con el implante, es decir, con 4 años de edad auditiva. Discusión: al parecer, el repertorio de consonantes obstruyentes (oclusivas y fricativas) tarda más tiempo en establecerse en niños sordos con implantes cocleares que en niños con audición normal. Los datos obtenidos revelan, además, pautas propias de un desarrollo fonológico inmaduro (p. ej., omisión total de sílabas y omisión de ataques silábicos); los resultados coinciden así con los que arrojan varios estudios sobre niños de otras lenguas que llevan también implante coclear


Assuntos
Humanos , Surdez/complicações , Transtorno Fonológico/fisiopatologia , Implantes Cocleares/estatística & dados numéricos , Transtornos do Desenvolvimento da Linguagem/reabilitação , Portugal , Transtorno Fonológico/reabilitação , Surdez/reabilitação , Crianças com Deficiência
16.
J Speech Lang Hear Res ; 62(9): 3493-3499, 2019 09 20.
Artigo em Inglês | MEDLINE | ID: mdl-31415186

RESUMO

Purpose Our aim was to make audible for normal-hearing listeners the Mickey Mouse™ sound quality of cochlear implants (CIs) often found following device activation. Method The listeners were 3 single-sided deaf patients fit with a CI and who had 6 months or less of CI experience. Computed tomography imaging established the location of each electrode contact in the cochlea and allowed an estimate of the place frequency of the tissue nearest each electrode. For the most apical electrodes, this estimate ranged from 650 to 780 Hz. To determine CI sound quality, a clean signal (a sentence) was presented to the CI ear via a direct connect cable and candidate, and CI-like signals were presented to the ear with normal hearing via an insert receiver. The listeners rated the similarity of the candidate signals to the sound of the CI on a 1- to 10-point scale, with 10 being a complete match. Results To make the match to CI sound quality, all 3 patients need an upshift in formant frequencies (300-800 Hz) and a metallic sound quality. Two of the 3 patients also needed an upshift in voice pitch (10-80 Hz) and a muffling of sound quality. Similarity scores ranged from 8 to 9.7. Conclusion The formant frequency upshifts, fundamental frequency upshifts, and metallic sound quality experienced by the listeners can be linked to the relatively basal locations of the electrode contacts and short duration experience with their devices. The perceptual consequence was not the voice quality of Mickey Mouse™ but rather that of Munchkins in The Wizard of Oz for whom both formant frequencies and voice pitch were upshifted. Supplemental Material https://doi.org/10.23641/asha.9341651.


Assuntos
Percepção Auditiva , Implantes Cocleares , Surdez/fisiopatologia , Surdez/reabilitação , Som , Adulto , Feminino , Humanos , Pessoa de Meia-Idade
17.
HNO ; 67(10): 778-785, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31468082

RESUMO

BACKGROUND: Hearing rehabilitation of patients with severe hearing loss by cochlear implant (CI) enhances their opportunities for communication immensely with regard to their normal-hearing social environment. The degree of participation depends decisively on speech discrimination. This study examines whether speech discrimination can be improved by equipping patients with next-generation speech processors (SP). METHODS: The changes in speech discrimination of 420 CI patients upon receiving a newer SP from 2003-2012 were retrospectively analyzed. Audiometry comprised the Freiburg number and monosyllable tests and the Oldenburg sentence test in quiet and noise, with a presentation volume of 70 dB. RESULTS: In all audiometric tests, the newer SP showed a significant improvement compared to the preceding SP. This improvement was attainable for the majority of patients and was independent of age. CONCLUSION: Upgrade of the SP results in improved speech discrimination. This holds true for several test settings. We therefore recommend earlier upgrades and that the costs for new SP be met.


Assuntos
Implante Coclear , Implantes Cocleares , Surdez , Percepção da Fala , Compreensão , Surdez/reabilitação , Humanos , Estudos Retrospectivos , Fala
18.
Int J Pediatr Otorhinolaryngol ; 126: 109631, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31445481

RESUMO

OBJECTIVE: Although various studies have depicted the importance of language intervention programs in facilitating language acquisition in cochlear implanted children, to this date rarely has a specific language intervention approach been recommended as better than the other and no best practice has been introduced in terms of language acquisition outcomes. Thus, the therapists remain uncertain as to which approach to follow and how to apply evidence to practice. Hence, the main goal of this study was to take a step in this regard by comparing the communication development of pediatric cochlear implant users who enrolled in two different language intervention approaches: the routine auditory-verbal approach, and the routine auditory-verbal approach plus a new intervention protocol specifically designed to enhance receptive vocabulary development in cochlear implanted children. METHOD AND MATERIALS: This prospective experimental study compared the receptive and expressive communication developmental scores of 26 cochlear implanted 20-24 months old children who received both a routine auditory-verbal intervention and a new cognitive based intervention protocol specifically designed to enhance receptive vocabulary development, with that of a group of 25 participants whose intervention program was only auditory-verbal. The children were recruited from Fars cochlear implant center situated in the city of Shiraz in Iran, and were assigned randomly to the two groups. The communication development of both groups was evaluated by the Bayley scales of Infant and Toddler Development- Third Edition, and statistical analysis was performed using the Statistical Package for Social Sciences-version 21(SPSS-21). RESULTS: The two groups were not significantly different in terms of age, sex and parents' educational level. Both the receptive and expressive communication outcomes of the children who received auditory-verbal as well as the new specifically-designed cognitive-based intervention protocol focusing on receptive vocabulary enhancement, were significantly higher than the control group (p < 0.001). CONCLUSION: The new specifically-designed cognitive-based language intervention protocol focusing on receptive vocabulary enhancement was significantly more effective in promoting and enhancing the communication development of cochlear implanted children than the routine auditory-verbal intervention.


Assuntos
Implantes Cocleares , Surdez/reabilitação , Terapia da Linguagem , Fonoterapia , Vocabulário , Pré-Escolar , Correção de Deficiência Auditiva/métodos , Surdez/cirurgia , Feminino , Humanos , Lactente , Desenvolvimento da Linguagem , Masculino , Estudos Prospectivos
19.
Am J Audiol ; 28(3): 686-696, 2019 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-31430174

RESUMO

Purpose There is a growing body of literature that suggests a linkage between impaired auditory function, increased listening effort, and fatigue in children and adults with hearing loss. Research suggests this linkage may be associated with hearing loss-related variations in diurnal cortisol levels. Here, we examine variations in cortisol profiles between young adults with and without severe sensorineural hearing loss and examine associations between cortisol and subjective measures of listening effort and fatigue. Method This study used a repeated-measures, matched-pair design. Two groups (n = 8 per group) of adults enrolled in audiology programs participated, 1 group of adults with hearing loss (AHL) and 1 matched control group without hearing loss. Salivary cortisol samples were collected at 7 time points over a 2-week period and used to quantify physiological stress. Subjective measures of listening effort, stress, and fatigue were also collected to investigate relationships between cortisol levels, perceived stress, and fatigue. Results Subjective ratings revealed that AHL required significantly more effort and concentration on typical auditory tasks than the control group. Likewise, complaints of listening-related fatigue were more frequent and more of a problem in everyday life for AHL compared to the control group. There was a significant association between subjective ratings of listening effort and listening-related fatigue for our AHL, but not for the control group. In contrast, there was no significant difference in cortisol measures between groups, nor were there significant associations between cortisol and any subjective measure. Conclusions Young AHL experience more effortful listening than their normal hearing peers. This increased effort is associated with increased reports of listening-related fatigue. However, diurnal cortisol profiles were not significantly different between groups nor were they associated with these perceived differences.


Assuntos
Ritmo Circadiano , Surdez/reabilitação , Fadiga/metabolismo , Hidrocortisona/metabolismo , Estresse Psicológico/metabolismo , Adulto , Estudos de Casos e Controles , Implantes Cocleares , Fadiga/psicologia , Feminino , Humanos , Masculino , Projetos Piloto , Estresse Psicológico/psicologia , Adulto Jovem
20.
Res Dev Disabil ; 93: 103453, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31421305

RESUMO

BACKGROUND AND AIM: It remains unclear how recognition of segmental and suprasegmental phonemes contributes to sentence-level language processing skills in Mandarin-speaking children with cochlear implants (CIs). Our study examined the influence of implantation age on the recognition of consonants, lexical tones and sentences respectively, and more importantly, the contribution of phonological skills to sentence repetition accuracy in Mandarin-speaking children with CIs. METHODS: The participants were three groups of prelingually deaf children who received cochlear implants at various ages and their age-matched controls with normal hearing. Three tasks were administered to assess their consonant perception, lexical tone recognition and language skills in open-set sentence repetition. RESULTS: Children with CIs lagged behind NH peers in all the three tests, and performances on segmental, suprasegmental and sentence-level processing were differentially modulated by implantation age. Furthermore, performances on recognition of consonants and lexical tones were significant predictors of sentence repetition accuracy in the children with CIs. CONCLUSION: Overall, segmental and suprasegmental perception as well as sentence-level processing is impaired in Mandarin-speaking children with CIs compared with age-matched children with NH. In children with CIs recognition of segmental and suprasegmental phonemes at the lower level predicts sentence repetition accuracy at the higher level. More importantly, implantation age plays an important role in the development of phonological skills and higher-order language skills, suggesting that age-appropriate aural rehabilitation and speech intervention programs need to be developed in order to better help CI users who receive CIs at different ages.


Assuntos
Grupo com Ancestrais do Continente Asiático , Percepção Auditiva , Linguagem Infantil , Implantes Cocleares , Correção de Deficiência Auditiva , Surdez , Fatores Etários , Criança , Pré-Escolar , Implante Coclear/instrumentação , Implante Coclear/métodos , Correção de Deficiência Auditiva/métodos , Correção de Deficiência Auditiva/psicologia , Surdez/psicologia , Surdez/reabilitação , Surdez/cirurgia , Crianças com Deficiência/psicologia , Crianças com Deficiência/reabilitação , Feminino , Humanos , Masculino , Medida da Produção da Fala/métodos
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