Graeme Clark Collection
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ItemPredicting speech perception results for children using multichannel cochlear implants [Abstract]( 2002)It is most helpful in counselling families considering cochlear implantation to have some ability to predict outcomes for individual hearing-impaired children. Speech perception results for open-set words and sentences have been collected for all children implanted with the Nucleus device in Melbourne. Assessments are available at approximately six month intervals following implantation, Data was collected for each child regarding type of hearing loss, duration and age at onset of profound hearing loss, age at implantation, pre and post-implant communication mode, developmental delay, speech coding scheme and implant experience. These data were used as predictor variables in step-wise multiple linear regression analyses with the speech perception scores as the dependent variables. Shorter duration of profound hearing loss, later onset of profound hearing loss, exclusively oral communication mode following implantation, and longer implant experience were associated with significantly (p < 0.00 I) improved open-set speech perception. The use of the SPEAK signal coding scheme was shown to provide significantly better speech perception performance for children (p < 0.00 I). Developmental delay was associated with poorer speech perception outcomes (p < 0.0 I). Over 50% of the variance in speech perception scores was accounted for by these variables. The study suggests that younger implantation for congenitally deaf children leads to improved speech perception results. On the other hand, the development of auditory language skills in implanted children may be as important as age at implantation in enhancing long term outcomes. Regression equations derived from these results can be used to predict outcomes for cochlear implant candidates with a reasonable accuracy.
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ItemPre-operative hearing assessment in young cochlear implant candidates( 2000)Early implantation of congenitally deaf candidates is now a goal of most cochlear implant clinics. This objective can only be achieved through the use of audiological tests that are able to identify and quantify hearing loss in infancy. Behavioural conditioning techniques provide the most accurate indication of hearing acuity in older subjects, but these procedures are unreliable in young (6 months) or developmentally delayed children. This paper investigates the degree of accuracy with which two electrophysiological test techniques (click-ABR & steady-state evoked potential [SSEPD can be used to assess auditory function in infants with significant hearing loss. ABR and SSEP findings from 108 children were compared with hearing levels obtained behaviourally.
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ItemHow much residual hearing is too much?( 2000)The value of cochlear implants as an established clinical option for profoundly hearing-impaired adults and children has been supported by significant research results over a number of years (U.S. National Institutes of Health Consensus Statement 1995). As a direct consequence of the level of benefits shown for cochlear implant users on measures of speech perception, research has focused on investigating whether severely hearing impaired adults and children would be suitable candidates for cochlear implantation. I n considering the candidature of any individual, both medical and audiological suitability are investigated. The primary concern is to establish to what degree the patient would benefit from use of the cochlear implant.