Graeme Clark Collection
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ItemThe development of speech perception in children using cochlear implants: effects of etiologic factors and delayed milestones( 2000)Hypothesis: Speech perception outcomes for cochlear implantation of children vary over a wide range, and it is hypothesized that central pathologic states associated with certain causes of hearing impairment account for a substantial part of the variance. Study Design: A retrospective analysis was carried out to ascertain the relationships between speech perception, etiologic factors, and central pathologic states as indicated by preoperative delayed motor milestones and/or cognitive delays. Setting: Data were obtained from the pre-and postoperative records of patients attending a hospital cochlear implant clinic. Patients: Results for 75 consecutive patients up to age 5 years who underwent implantation were included in the study. Intervention: Patients received a 22-electrode cochlear prosthesis and were seen by the clinic for regular tune-up and assessments. Home-and school-based habilitation was recommended by the clinic. Main Outcome Measures: Speech perception measures were classified on a five-point scale to allow for different evaluation procedures at different ages and developmental stages. Results: The incidence of motor and cognitive delays were fairly evenly spread across etiologic factors, except for cytomegalovirus, which had a much higher than average incidence. Children with motor and/or cognitive delays were significantly slower than other children in the development of speech perception skills after implantation. Etiologic factors did not have a statistically significant effect on speech perception outcome. Conclusions: It is likely that central pathologic states account for a substantial part of the variance among children using cochlear implants. Specific indicators of central pathologic states should be used to assess a child's prognosis in preference to less specific information based on etiologic factors alone.
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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.