Faculty Bibliography

OBJECTIVE: The development of oral language in children with a cochlear implant is dependent on numerous factors. Although baseline achievements have been established, ceiling attainment levels have yet to be explored. One indicator of a higher capability level is the ability of children with implants to learn to communicate orally using a second language. The purpose of this research was to explore 1) the feasibility of children with cochlear implants developing oral fluency in a second language and 2) the factors that affect the development. STUDY DESIGN: Retrospective study of children fulfilling the criteria. SETTING: University medical center. PATIENTS: Eighteen profoundly hearing-impaired children who were reported to be bilingual. INTERVENTION: Cochlear implantation at age 5 or younger. MAIN OUTCOME MEASURES: The subjects were evaluated using standard speech perception and receptive and expressive language measures. RESULTS: The data revealed the ability of some pediatric cochlear implant recipients to develop competency in a second spoken language in addition to their primary language. Equally as important is the fact that the majority showed age-appropriate receptive and/or expressive language abilities in their primary language commensurate with normal-hearing children. CONCLUSION: High levels of achievement including the learning of a second spoken language are possible after implantation in the pediatric population. Variables include speech perception postimplantation, the linguistic environment, type of intervention, and educational placement

OBJECTIVE: Since 1987, when the use of multichannel cochlear implants was initiated in children, candidacy has expanded; many thousands of children have received these devices, and results have revealed a wide range of performance. However, few long-term studies exist on a large population of these children. There have been concerns expressed that cochlear implant function might degrade over time, that devices and electrodes might migrate and extrude in the growing child, or that there might even be a deleterious effect of long-term stimulation of the cochlear nerve. The purpose of this study was to explore the long-term effects of implantation as a function of performance over time, reimplantation, and educational factors. STUDY DESIGN AND SETTING: We studied 81 children who received implants at a major academic medical center and were followed for 5 to 13 years. RESULTS: Results revealed significant gains in speech perception, use of oral language, and ability to function in a mainstream environment. There was no decrease in performance over time and no significant incidence of device or electrode migration or extrusion, and device failure did not cause a deterioration in long-term outcome. CONCLUSIONS: Multichannel cochlear implants in children provide perception, linguistic, and educational advantages, which are not adversely affected by long-term electrical stimulation

OBJECTIVE: To assess and document the development of open-set speech recognition in congenitally deaf children implanted with the Nucleus multichannel cochlear prosthesis at < 5 years of age. STUDY DESIGN: The study group consisted of 38 consecutively chosen children in whom the decision to proceed with implantation had already been made. PATIENTS AND SETTING: Congenitally profoundly deaf children were implanted with the Nucleus multichannel cochlear implant at < 5 years of age and followed at NYU Medical Center for a period of 1-5 years. MAIN OUTCOME MEASURES: Open-set speech perception was evaluated preoperatively and postoperatively using the following: the Glendonald Auditory Screening Procedure (GASP) word subset, the GASP sentence subtest, Phonetically Balanced Kindergarten monosyllabic word lists, Common Phrases test, Multisyllabic Lexical Neighborhood test, and Lexical Neighborhood test. RESULTS: Correlation coefficients were calculated between scores at each interval and age at implantation; one-way analyses of variance were performed independently. Results showed that all subjects had significant open-set speech recognition at the time of the last postoperative evaluation. Thirty-seven of the children use oral language as their sole means of communication. CONCLUSIONS: Multichannel cochlear implants provide significant and usable open-set speech perception in congenitally deaf children given implants at < 5 years of age