Graeme Clark Collection
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ItemSpeech perception in implanted children: influence of preoperative residual hearing on outcomes [Abstract]( 1998)Since the first child was implanted with the Nucleus 22-channel prosthesis in Melbourne in 1985, several thousand children world-wide have now benefitted from this technology. More effective paediatric assessment and management procedures have now been developed, allowing cochlear implants to be offered to children under the age of 2 years. Improvements in speech processing strategy have also been implemented in the Nucleus implant system, resulting in increased mean speech perception benefits for implanted adults. Although a range of performance on formal measures of hearing, speech or language has been reported for children using implants, results from the first decade of implant experience consistently show that significant benefits are available to children receiving their implant at an early age. Reported speech perception results for implanted children show that a considerable proportion (60%) of paediatric patients in the Melbourne and Sydney clinics are able to understand some open-set speech using electrical stimulation alone. These results, and the upward trend of mean speech perception benefits shown for postlinguistically deafened adults have raised questions as to whether severely, or severely-to-profoundly deaf children currently using hearing aids would in fact benefit more from a cochlear implant. To investigate the potential influence of the degree of preoperative residual hearing on postoperative speech perception, results for all implanted children in the Melbourne and Sydney cochlear implant programs were analysed. Results showed that as a group, children with higher levels of preoperative residual hearing were consistently more likely to achieve open-set speech perception benefits. Potential factors in this finding could be higher levels of ganglion cell survival or greater patterning of the auditory pathways using conventional hearing aids prior to implantation. Conversely, children with the least preoperative residual hearing were less predictable, with some children achieving open-set perception, and others showing more limited closed-set benefits to perception. For these children, it is likely that preoperative residual hearing is of less significance than other factors in outcomes.
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ItemA clinical report on vocabulary skills in cochlear implant users [Abstract]( 1994)Receptive vocabulary results are reported for 32 children, adolescents and prelinguistically deafened adults implanted with the 22-electrode cochlear implant at the Melbourne Cochlear Implant Clinic. Age at implantation ranged from 2 years, 6 months to 20 years and implant use ranged from 1 year to 7 years, 8 months. There were significant gains from pre- to postoperative assessments on the Peabody Picture Vocabulary Test (PPVT) for the majority of subjects. Rates of improvement found are compatible with previous reports on smaller numbers of implant users, but cannot be attributable unambiguously to use of the implant. The group postoperative performance was significantly higher than mean preoperative performance (n =25). The relationship of variables such as duration of implant use, duration of profound deafness and speech perception ability to improvement on the PPVT is discussed. Expressive vocabulary results on the Renfrew Word Finding Vocabulary Scale are reported for 11 of the subjects. Less substantial gains were made on this measure.