Establishing a mental lexicon with cochlear implants: an ERP study with young children.
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ABSTRACT:
SUBMITTER: Vavatzanidis NK
PROVIDER: S-EPMC5772553 | biostudies-literature | 2018 Jan
REPOSITORIES: biostudies-literature
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Establishing a mental lexicon with cochlear implants: an ERP study with young children.
Vavatzanidis Niki K NK Mürbe Dirk D Friederici Angela D AD Hahne Anja A
Scientific reports 20180117 1
In the present study we explore the implications of acquiring language when relying mainly or exclusively on input from a cochlear implant (CI), a device providing auditory input to otherwise deaf individuals. We focus on the time course of semantic learning in children within the second year of implant use; a period that equals the auditory age of normal hearing children during which vocabulary emerges and extends dramatically. 32 young bilaterally implanted children saw pictures paired with ei ...[more]
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Project description:Background and objectives: More and more children with severe-to-profound hearing loss are receiving cochlear implants (CIs) at an early age to improve their hearing and listening abilities, speech recognition, speech intelligibility, and other aspects of spoken language development. Despite this, the rehabilitation outcomes can be very heterogeneous in this population, not only because of issues related to surgery and fitting or the specific characteristics of the child with his/her additional disabilities but also because of huge differences in the quality of the support and rehabilitation offered by the therapist and the family. These quality standards for the rehabilitation of young deaf children receiving CIs are developed within the European KA202 Erasmus+ project "VOICE"-vocational education and training for speech and language therapists and parents for the rehabilitation of children with CIs, Ref. No.: 2020-1-RO01-KA202-080059. Material and methods: To develop these quality standards, we used the input from the face-to-face interviews of 11 local rehabilitation experts in CIs from the four partner countries of the project and the outcomes of the bibliographic analysis of 848 publications retrieved from six databases: Pub Med, Psych Info, CINAHL, Scopus, Eric, and Cochrane. Based on all this information, we created a first set of 32 quality standards over four domains: general, fitting, rehabilitation, and for professionals. Further on, the Delphi method was used by 18 international rehabilitation experts to discuss and agree on these standards. Results: The results from the literature analysis and the interviews show us that more than 90% of the consulted international experts agreed on 29 quality standards. They focus on different aspects of rehabilitation: the multidisciplinary team, their expertise and knowledge, important rehabilitation topics to focus on, and programming issues related to rehabilitation. Conclusions: These quality standards aim to optimize the activity of speech rehabilitation specialists so that they reach the optimal level of expertise. Also presented is the necessary equipment for the IC team to carry out the rehabilitation sessions in good conditions. This set of quality standards can be useful to ensure the appropriate postoperative care of these children. As a result, the rehabilitation process will be more relaxed, and therapists will have the opportunity to focus more on the specific needs of each child, with the provision of quality services, which will result in better results. This theme is particularly complex and dependent on multifactorial aspects of medicine, education, speech therapy, social work, and psychology that are very intricate and interdependent.
| S-EPMC10386159 | biostudies-literature
Project description:Early bilateral cochlear implants (CIs) may enhance attention to speech, and reduce cognitive load in noisy environments. However, it is sometimes difficult to measure speech perception and listening effort, especially in very young children. Behavioral measures cannot always be obtained in young/uncooperative children, whereas objective measures are either difficult to assess or do not reliably correlate with behavioral measures. Recent studies have thus explored pupillometry as a possible objective measure. Here, pupillometry is introduced to assess attention to speech and music in noise in very young children with bilateral CIs (N = 14, age: 17-47 months), and in the age-matched group of normally-hearing (NH) children (N = 14, age: 22-48 months). The results show that the response to speech was affected by the presence of background noise only in children with CIs, but not NH children. Conversely, the presence of background noise altered pupil response to music only in in NH children. We conclude that whereas speech and music may receive comparable attention in comparable listening conditions, in young children with CIs, controlling for background noise affects attention to speech and speech processing more than in NH children. Potential implementations of the results for rehabilitation procedures are discussed.
| S-EPMC8956090 | biostudies-literature
Project description:ImportanceChildren who receive a cochlear implant (CI) for early severe to profound sensorineural hearing loss may achieve age-appropriate spoken language skills not possible before implantation. Despite these advances, reduced access to auditory experience may have downstream effects on fundamental neurocognitive processes for some children with CIs.ObjectiveTo determine the relative risk (RR) of clinically significant executive functioning deficits in children with CIs compared with children with normal hearing (NH).Design, setting, and participantsIn this prospective, cross-sectional study, 73 children at a hospital-based clinic who received their CIs before 7 years of age and 78 children with NH, with average to above average mean nonverbal IQ scores, were recruited in 2 age groups: preschool age (age range, 3-5 years) and school age (age range, 7-17 years). No children presented with other developmental, cognitive, or neurologic diagnoses.InterventionsParent-reported checklist measures of executive functioning were completed during psychological testing sessions.Main outcomes and measuresEstimates of the RR of clinically significant deficits in executive functioning (≥1 SDs above the mean) for children with CIs compared with children with NH were obtained based on 2 parent-reported child behavior checklists of everyday problems with executive functioning.ResultsIn most domains of executive functioning, children with CIs were at 2 to 5 times greater risk of clinically significant deficits compared with children with NH. The RRs for preschoolers and school-aged children, respectively, were greatest in the areas of comprehension and conceptual learning (RR [95% CI], 3.56 [1.71-7.43] and 6.25 [2.64-14.77]), factual memory ( 4.88 [1.58-15.07] and 5.47 [2.03-14.77]), attention (3.38 [1.03-11.04] and 3.13 [1.56-6.26]), sequential processing (11.25 [1.55-81.54] and 2.44 [1.24-4.76]), working memory (4.13 [1.30-13.06] and 3.64 [1.61-8.25] for one checklist and 1.77 [0.82-3.83] and 2.78 [1.18-6.51] for another checklist), and novel problem-solving (3.93 [1.50-10.34] and 3.13 [1.46-6.67]). No difference between the CI and NH samples was found for visual-spatial organization (2.63 [0.76-9.03] and 1.04 [0.45-2.40] on one checklist and 2.86 [0.98-8.39] for school-aged children on the other checklist).Conclusions and relevanceA large proportion of children with CIs are at risk for clinically significant deficits across multiple domains of executive functioning, a rate averaging 2 to 5 times that of children with NH for most domains. Screening for risk of executive functioning deficits should be a routine part of the clinical evaluation of all children with deafness and CIs.
| S-EPMC5701781 | biostudies-literature
Project description:Congenital cytomegalovirus (cCMV) infection is the most common cause of progressive hearing impairment. In our previous study around 90% of children with a cCMV infection and CI had severely damaged balance functions (Karltorp et al., 2014). Around 20% had vision impairment, 15% were diagnosed with Autism-Spectrum-Disorder, and 20% with ADHD. One clinical observation was that children with cCMV infection had problems with executive functioning (EF), while controls with a genetic cause of deafness (Connexin 26 mutations; Cx26) did not have similar difficulties. A follow-up study was therefore initiated with the main objective to examine EF and pragmatic skills in relation to mental health in children with a cCMV infection and to draw a comparison with matched controls with Cx26 mutations (age, sex, hearing, non-verbal cognitive ability, vocabulary, and socioeconomic status level). Ten children with a cCMV infection and CI (4.8-12:9 years) and seven children with CI (4:8-12:8 years) participated in the study, which had a multidisciplinary approach. Executive functioning was assessed both with formal tests targeting working memory and attention, parent and teacher questionnaires, and a systematic observation by a blinded psychologist during one test situation. Pragmatics and mental health were investigated with parent and teacher reports. In addition, the early language outcome was considered in non-parametric correlation analyses examining the possible relationships between later EF skills, pragmatics, and mental health. Children with cCMV had a statistically significant worse pragmatic outcome and phonological working memory than controls despite their groups having similar non-verbal cognitive ability and vocabulary. However, there were no statistical differences between the groups regarding their EF skills in everyday settings and mental health. There were associations between early language outcomes and later EF skills and pragmatics in the whole sample. Conclusion: Children with a cCMV infection are at risk of developing learning difficulties in school due to difficulties with phonological working memory and pragmatic skills in social interactions.
| S-EPMC6965306 | biostudies-literature
Project description:Phonological awareness is a critical component of phonological processing that predicts children's literacy outcomes. Phonological awareness skills enable children to think about the sound structure of words and facilitates decoding and the analysis of words during spelling. Past research has shown that children's vocabulary knowledge and working memory capacity are associated with their phonological awareness skills. Linguistic characteristics of words, such as phonological neighborhood density and orthography congruency have also been found to influence children's performance in phonological awareness tasks. Literacy is a difficult area for deaf and hard of hearing children, who have poor phonological awareness skills. Although cochlear implantation (CI) has been found to improve these children's speech and language outcomes, limited research has investigated phonological awareness in children with CI. Rhyme awareness is the first level of phonological awareness to develop in children with normal hearing (NH). The current study investigates whether rhyme awareness in children with NH (n = 15, median age = 5; 5, IQR = 11 ms) and a small group of children with CI (n = 6, median age = 6; 11.5, IQR = 3.75 ms) is associated with individual differences in vocabulary and working memory. Using a rhyme oddity task, well-controlled for perceptual similarity, we also explored whether children's performance was associated with linguistic characteristics of the task items (e.g., rhyme neighborhood density, orthographic congruency). Results indicate that there is an association between vocabulary and working memory and performance in a rhyme awareness task in NH children. Only working memory was correlated with rhyme awareness performance in CI children. Linguistic characteristics of the task items, on the other hand, were not found to be associated with success. Implications of the results and future directions are discussed.
| S-EPMC6751305 | biostudies-literature
Project description:The purpose of this study was to determine whether children with cochlear implants (CIs) are sensitive to statistical characteristics of words in the ambient spoken language, whether that sensitivity changes in expected ways as their spoken lexicon grows, and whether that sensitivity varies with unilateral or bilateral implantation.We analyzed archival data collected from the parents of 36 children who received cochlear implantation (20 unilateral, 16 bilateral) before 24 months of age. The parents reported their children's word productions 12 months after implantation using the MacArthur Communicative Development Inventories: Words and Sentences (Fenson et al., 1993). We computed the number of words, out of 292 possible monosyllabic nouns, verbs, and adjectives, that each child was reported to say and calculated the average phonotactic probability, neighborhood density, and word frequency of the reported words.Spoken vocabulary size positively correlated with average phonotactic probability and negatively correlated with average neighborhood density, but only in children with bilateral CIs.At 12 months postimplantation, children with bilateral CIs demonstrate sensitivity to statistical characteristics of words in the ambient spoken language akin to that reported for children with normal hearing during the early stages of lexical development. Children with unilateral CIs do not.
| S-EPMC4490103 | biostudies-literature
Project description:UnlabelledThe electrical stimulation generated by the Cochlear Implant (CI) may improve the neural synchrony and hence contribute to the development of auditory skills in patients with Auditory Neuropathy/Auditory Dyssynchrony (AN/AD).AimProspective cohort cross-sectional study to evaluate the auditory performance and the characteristics of the electrically evoked compound action potential (ECAP) in 18 children with AN/AD and cochlear implants.Material and methodsThe auditory perception was evaluated by sound field thresholds and speech perception tests. To evaluate ECAP's characteristics, the threshold and amplitude of neural response were evaluated at 80 Hz and 35 Hz.ResultsNo significant statistical difference was found concerning the development of auditory skills. The ECAP's characteristics differences at 80 and 35 Hz stimulation rate were also not statistically significant.ConclusionsThe CI was seen as an efficient resource to develop auditory skills in 94% of the AN/AD patients studied. The auditory perception benefits and the possibility to measure ECAP showed that the electrical stimulation could compensate for the neural dyssynchrony caused by the AN/AD. However, a unique clinical procedure cannot be proposed at this point. Therefore, a careful and complete evaluation of each AN/AD patient before recommending a Cochlear Implant is advised. Clinical Trials: NCT01023932.
| S-EPMC9450761 | biostudies-literature
Project description:Background and objectivesInfants with profound hearing loss are typically considered for cochlear implantation. Many insurance providers deny implantation to children with developmental impairments because they have limited potential to acquire verbal communication. We took advantage of differing insurance coverage restrictions to compare outcomes after cochlear implantation or continued hearing aid use.MethodsYoung children with deafness were identified prospectively from 2 different states, Texas and California, and followed longitudinally for an average of 2 years. Children in cohort 1 (n = 138) had normal cognition and adaptive behavior and underwent cochlear implantation. Children in cohorts 2 (n = 37) and 3 (n = 29) had low cognition and low adaptive behavior. Those in cohort 2 underwent cochlear implantation, whereas those in cohort 3 were treated with hearing aids.ResultsCohorts did not substantially differ in demographic characteristics. Using cohort 2 as the reference, children in cohort 1 showed more rapid gains in cognitive, adaptive function, language, and auditory skills (estimated coefficients, 0.166 to 0.403; P ≤ .001), whereas children in cohort 3 showed slower gains (-0.119 to -0.243; P ≤ .04). Children in cohort 3 also had greater increases in stress within the parent-child system (1.328; P = .02), whereas cohorts 1 and 2 were not different.ConclusionsCochlear implantation benefits children with deafness and developmental delays. This finding has health policy implications not only for private insurers but also for large, statewide, publicly administered programs. Cognitive and adaptive skills should not be used as a "litmus test" for pediatric cochlear implantation.
| S-EPMC9648123 | biostudies-literature
Project description:PurposeWe sought to evaluate the development of grammatical accuracy in English-speaking children with cochlear implants (CIs) over a 3-year span.MethodTen children who received CIs before age 30 months participated in this study at 3, 4, and 5 years postimplantation. For the purpose of comparison, 10 children each at ages 3, 4, and 5 years with typical hearing were included as well. All children participated in a story-retell task. We computed percent grammatical communication units (PGCU) in the task.ResultsChildren with CIs showed significant improvement in PGCU over the 3-year span. However, they produced lower PGCU than children with typical hearing who had matched hearing age at 4 and 5 years postimplantation. At the individual level, some children with CIs were able to produce PGCU comparable to children with typical hearing as early as 3 years after implantation. Better speech-perception skills at earlier time points were associated with higher PGCU at later time points. Moreover, children with and without CIs showed similar rankings in the types of grammatical errors.ConclusionDespite having auditory-perceptual and information-processing constraints, children who received CIs before age 30 months were able to produce grammatical sentences, albeit with a delayed pattern.
| S-EPMC5548077 | biostudies-literature
Project description:BackgroundVisual cross-modal re-organization is a neurophysiological process that occurs in deafness. The intact sensory modality of vision recruits cortical areas from the deprived sensory modality of audition. Such compensatory plasticity is documented in deaf adults and animals, and is related to deficits in speech perception performance in cochlear-implanted adults. However, it is unclear whether visual cross-modal re-organization takes place in cochlear-implanted children and whether it may be a source of variability contributing to speech and language outcomes. Thus, the aim of this study was to determine if visual cross-modal re-organization occurs in cochlear-implanted children, and whether it is related to deficits in speech perception performance.MethodsVisual evoked potentials (VEPs) were recorded via high-density EEG in 41 normal hearing children and 14 cochlear-implanted children, aged 5-15 years, in response to apparent motion and form change. Comparisons of VEP amplitude and latency, as well as source localization results, were conducted between the groups in order to view evidence of visual cross-modal re-organization. Finally, speech perception in background noise performance was correlated to the visual response in the implanted children.ResultsDistinct VEP morphological patterns were observed in both the normal hearing and cochlear-implanted children. However, the cochlear-implanted children demonstrated larger VEP amplitudes and earlier latency, concurrent with activation of right temporal cortex including auditory regions, suggestive of visual cross-modal re-organization. The VEP N1 latency was negatively related to speech perception in background noise for children with cochlear implants.ConclusionOur results are among the first to describe cross modal re-organization of auditory cortex by the visual modality in deaf children fitted with cochlear implants. Our findings suggest that, as a group, children with cochlear implants show evidence of visual cross-modal recruitment, which may be a contributing source of variability in speech perception outcomes with their implant.
| S-EPMC4726603 | biostudies-literature