Graeme Clark Collection
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ItemSpeech perception in children using cochlear implants: prediction of long-term outcomes.(Informa UK Limited, 2002-03)A group of 102 children using the Nucleus multichannel cochlear implant were assessed for open-set speech perception abilities at six-monthly intervals following implant surgery. The group included a wide range of ages, types of hearing loss, ages at onset of hearing loss, experience with implant use and communication modes. Multivariate analysis indicated that a shorter duration of profound hearing loss, later onset of profound hearing loss, exclusively oral/aural communication and greater experience with the implant were associated with better open-set speech perception. Developmental delay was associated with poorer speech perception and the SPEAK signal coding scheme was shown to provide better speech perception performance than previous signal processors. Results indicated that postoperative speech perception outcomes could be predicted with an accuracy that is clinically useful.
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ItemThe progress of children using the multichannel cochlear implant in Melbourne( 1995)Multi-channel cochlear implantation in children began in Australia in 1985 and there are now close to 4000 profoundly deaf children and adolescents using the Australian implant system around the world. The aim of the implant procedure is to provide adequate hearing for speech and language development through auditory input. This contrasts with the situation for adults with acquired deafness where the cochlear implant aims to restore hearing for someone with well-developed auditory processing and language skills. As with adults, results vary over a wide range for children using the Multi-channel implant. Many factors have been suggested that may contribute to differences in speech perception for implanted children. In an attempt to better understand these factors, the speech perception results for children implanted in Melbourne were reviewed and subjected to statistical analysis. This has indicated that the amount of experience with the implant and the length of sensory deprivation are strongly correlated with perceptual results. This means that younger children are likely to perform better with an implant and that a number of years of experience are required for children to reach their full potential. The results have also indicated that educational placement and management play a crucial role in children reaching their potential. Overall, 60% of the children and adolescents in the study have reached a level of open-set speech understanding using the cochlear implant without lipreading.
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ItemPotential and limitations of cochlear implants in children( 1995)Multiple-channel cochlear implants have been in use with children and adolescents for 8 years. The speech perception, speech production, and language of many of these children has been investigated in some detail.l-4 There have been many predictions about factors that may affect the performance of children with implants. For instance, it has been suggested that children with a congenital loss of hearing would not have the same potential to benefit from a cochlear implant as those with an acquired loss. Similarly, it has been suggested that younger children are likely to gain more benefit from a cochlear implant because of the effect of various critical ages for language learning.5 As more results have become available, it has been our observation that the performance of any particular child with a cochlear implant does not appear to follow well-defined rules, and that generalizations about the potential of certain groups of children are likely to encounter many exceptions. We now have a large quantity of results for children using cochlear implants, and it may be possible to determine some of the factors that have a significant effect on performance. This paper will attempt to identify some of these factors by reviewing speech perception results for 100 children implanted with the Nucleus 22-channel cochlear prosthesis in Australia and speech perception results for adult patients. This analysis will use an "information processing" model of a child using a cochlear implant. That is, we will assume that a child will benefit from a cochlear implant in terms of speech perception, production, and language development, if he or she receives a maximal amount of auditory information from the environment, and is able to process this information successfully. This model divides potential limiting or predictive factors into those that affect the information presented to the auditory system (eg, implant technology, surviving auditory neurons) and those that affect the processing of this information (eg, development of central auditory pathways, amount and consistency of auditory input).