Faculty Bibliography

On the basis of the good predictions for phonemes correct, we conclude that closed-set feature identification may successfully predict phoneme identification in an open-set word recognition task. For word recognition, however, the PCM model underpredicted observed performance, and the addition of a mental lexicon (ie, the SPAMR model) was needed for a good match to data averaged across 7 adults with CIs. The predictions for words correct improved with the addition of a lexicon, providing support for the hypothesis that lexical information is used in open-set spoken word recognition by CI users. The perception of words more complex than CNCs is also likely to require lexical knowledge (Frisch et al, this supplement, pp 60-62) In the future, we will use the performance off individual CI users on psychophysical tasks to generate predicted vowel and consonant confusion matrices to be used to predict open-set spoken word recognition. $$:

This study considers the validity of the Words and Gestures and Words and Sentences portions of the MacArthur Communicative Development Inventories (MCDI) for pediatric cochlear implant users who exceed the age ranges for which these inventories were normed. In Experiment 1, scores on the Words and Gestures measures were compared with scores on behavioral receptive and expressive vocabulary and language measures at preimplantation and again at 6 months postimplantation. Children ranged in age from 17 to 72 months, and results revealed significant correlations (r-values:.38-.80), with the strongest correlations resulting between MCDI measures and raw scores derived using the Reynell Developmental Language Scales (RDLS). Correlations also obtained between the number of words produced reported on the MCDI Words and Gestures inventory and the Peabody Picture Vocabulary Test-Third Edition (PPVT-III). Experiment 2 compared scores on the Words and Sentences measures with the same behavioral receptive and expressive vocabulary and language measures at 12 and 18 months postimplantation. Children ranged in age from 38 months to 67 months, and significant correlations obtained between behavioral measures and Words and Sentences measures assessing word production as well as grammatical ability (r-values:.60-.90). The strong validity findings motivated Experiment 3, in which predictive formulas were developed to predict scores on the RDLS based on scores from the MCDI. These models will allow researchers and clinicians to use a single index to assess the language abilities of a broad range of ages and performance abilities within the pediatric cochlear implant population. $$:

OBJECTIVE: To measure the impact of tonsillectomy and adenoidectomy (T&A) on children's behavioral and emotional problems using a standardized assessment. DESIGN: Prospective study. SETTING: Tertiary care children's hospital. PATIENTS: Thirty-six children, aged 2 through 18 years, with symptoms of nighttime snoring, observed apneas, and daytime mouth breathing and physical examination results demonstrating 3+ or 4+ tonsils scheduled for T&A. INTERVENTION: Parents completed a standard survey of their children's symptoms of sleep apnea and a standardized measure of children's competencies and problems, the Child Behavior Checklist for ages 2 through 3 years or 4 through 18 years, before T&A and 3 months postoperatively. MAIN OUTCOME MEASURE: The Child Behavior Checklist total problem score. RESULTS: The preoperative Child Behavior Checklist total problem score was consistent with abnormal behavior for 10 children (28%). After T&A (n = 15), only 2 scores were abnormal, but the change was not statistically significant. In contrast, the mean total problem score was 7.5 points lower after surgery (95% confidence interval, 5.1-9.7), indicating a significant decrease (P<.001, matched t test). CONCLUSIONS: This pilot study demonstrates a high prevalence (28%) of abnormal behavior in children undergoing T&A for chronic upper airway obstruction. Scores on a standardized measure of behavior improve following T&A, but larger studies with increased statistical power are needed to clarify the degree of improvement and its clinical importance

Although laryngotracheoesophageal clefts are often found in association with other well-described anomalies, we know of no previous reported association with eosinophilic gastroenteritis, a disorder of unknown etiology characterized by eosinophilic infiltration of the gastrointestinal tract. We treated 2 children who had laryngeal clefts and eosinophilic gastroenteritis. Since the esophageal inflammatory changes found in eosinophilic gastroenteritis may persist despite aggressive therapy, management of the laryngotracheoesophageal clefts is more complicated. The diagnosis of eosinophilic gastroenteritis should not be overlooked in patients with laryngotracheoesophageal clefts and warrants prompt referral to a pediatric gastroenterologist