Graeme Clark Collection

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    Speech perception benefits for implanted children with preoperative residual hearing [Abstract]
    Hollow, R. ; Rance, G. ; Dowell, R.C. ; Pyman, B. ; Clark, Graeme M. ; Cowan, R. S. C. ; Galvin, K. L. ; Barker, E. J. ; Sarant, J. Z. ; Dettman, S. ( 1995)
    Since the implantation of the first children with the Nucleus 22-channel cochlear prosthesis in Melbourne in 1985, there has been rapid expansion in the number of implanted children world-wide. Improved surgical technique and experience in paediatric assessment and management have contributed to a trend to implant very young children. At the same time there has also been continuing development of improved speech processing strategies resulting in greater speech perception benefits. In the Melbourne program, over 60% of children obtain significant scores on open-set word and sentence tests using their cochlear implant alone without the aid of lipreading. As parents and professionals have become aware of these improved benefits to speech perception benefits in profoundly deaf children, there have been requests to consider implanting severely-to-profoundly deaf children. In these children with higher levels of residual hearing, only those children with poorer-than-expected performance on speech perception tests using hearing aids have been considered for surgery. A number of such cases have now been implanted in the Melbourne program. The speech perception benefits for this group are reported and are being compared with benefits for the profoundly deaf group of children.
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    Results of multichannel cochlear implantation in very young children [Abstract]
    Galvin, K. ; Clark, Graeme M. ; Dettman, S. ; Dowell, R. ; Barker, E. ; Rance, G. ; Hollow, R. ; Cowan, R. ( 1995)
    Most researchers and clinicians working in the cochlear implant field have assumed that profoundly deaf children will have a better prognosis in terms of speech perception, speech production and language development. if implanted at as young an age as possible. However, it has been difficult to gather direct evidence for this hypothesis due to the problems in assessing children under the age of five years with formal tests. Recent results with older children have supported the view that early implantation may provide the optimal outcome in most cases. The implantation of very young children raises two areas of concern that do not apply in adults and older children: accurate assessment of degree of hearing loss and auditory potential; and postoperative assessment of outcomes. This paper will describe research results from the University of Melbourne which address these issues and present results for children implanted as young as eighteen months of age.
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    Clinical results for profoundly deaf patients using the 22-elctrode cochlear prosthesis [Abstract]
    Dowell, R. C. ; Clark, Graeme M. ( 1987)
    The 22-electrode cochlear prosthesis developed in Australia by the University of Melbourne and Cochlear Pty. Limited has been in clinical use in Melbourne for five years. Results for 40 postlingually deaf adults have shown significant communication benefit for 90% of patients. Twenty patients (50%) have demonstrated the ability to understand conversational speech without lipreading or visual cues. No electronic or mechanical failures have been observed in any of the implanted devices. There have been no serious medical complications, but psychological disturbance has occurred in two cases. Experience with prelingually deaf adults has indicated that initial hearing responses for this group are not as good as for the postlingually deaf patients. However, improvement over time has been evident with consistent use of the device. Long-term benefit for these patients will depend to a large extent on motivational and social factors. Results for a small number of young deaf children have been encouraging. The age at onset of profound deafness, intelligence, educational management and family support are all important factors affecting the potential benefit of a cochlear implant for a child.
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    Results for the Nucleus multiple-electrode cochlear implant in two children [Abstract]
    Tong, Y. C. ; Blamey, P. J. ; Dowell, R. C. ; Nienhuys, T. G. ; Musgrave, G. N. ; Busby, P. A. ; Roberts, S. A. ; Rickards, F. W. ; Dettman, S. J. ; Altidis, P. M. ; Clark, Graeme M. ( 1988)
    Two males, 9 years 10 months (CHILD 1) and 5 years 5 months (CHILD 2) at time of surgery, were implanted with the Nucleus multiple-electrode cochlear implant. Both patients were deafened as a result of meningitis in their third year. Assessments of speech perception, speech production and language skills were undertaken at regular intervals, pre and post operatively. For both patients in the audition alone condition, some speech perception post operative scores were significantly higher than pre operative scores and progressive improvements in scores over successive post operative data collection times were seen. Significant differences between the visual alone and auditory-visual condition scores were also observed for CHILD 1 post operatively. Speech production post operative scores were significantly higher than pre operative scores for both patients. The receptive vocabulary scores for both patients improved at a higher rate than that of age-matched normal children. The acquisition of expressive and receptive language skills for CHILD 2 was at a higher rate than that of age-matched children. Differences in the results between the two patients were seen, and this may be related to age and duration of deafness.