Audiology and Speech Pathology - Research Publications
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ItemCochlear Implants in Forty-Eight Children with Cochlear and/or Vestibular Abnormality(KARGER, 2011)CT and MRI scans for 48 children with cochlear and/or vestibular abnormality were classified in decreasing severity; common cavity, Mondini plus enlarged vestibular aqueduct, Mondini dysplasia alone and enlarged vestibular aqueduct alone. No significant relationship between degree of cochlea abnormality and surgical issues (cerebrospinal fluid gusher, depth of insertion, number of electrodes) or speech perception/language outcomes was found. A significant relationship was observed between cerebrospinal fluid gusher and partial electrode insertion, fewer active electrodes and poorer sentence understanding. Optimum language outcomes were associated with younger age at implant.
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ItemLong term communication outcomes for children receiving cochlear implants younger than 12 months: A multi-centre study(Wolters Kluwer, 2017)Objective: Examine the influence of age at implant on speech perception, language and speech production outcomes in a large unselected paediatric cohort. Study Design: This study pools available assessment data (collected prospectively and entered into respective databases from 1990 to 2014) from three Australian centres. Patients: Children (N=403) with congenital bilateral severe to profound hearing loss who received cochlear implants under 6 years of age (excluding those with acquired onset of profound hearing loss after 12 months, those with progressive hearing loss and those with mild/moderate/severe additional cognitive delay/disability). Main Outcome Measure(s): Speech Perception; open-set words (scored for words and phonemes correct) and sentence understanding at school entry and late primary school time points. Language; PLS and PPVT standard score equivalents at school entry, CELF standard scores. Speech Production; DEAP percentage accuracy of vowels, consonants, phonemes-total and clusters and percentage word-intelligibility at school entry. Results: Regression analysis indicated a significant effect for age-at-implant for all outcome measures. Cognitive skills also accounted for significant variance in all outcome measures except open-set phoneme scores. ANOVA with Tukey pairwise comparisons examined group differences for children implanted younger than 12 months (Group 1), between 13 and 18 months (Group 2), between 19 and 24 months (Group 3), between 25 and 42 months (Group 4), and between 43 to 72 months (Group 5). Open-set speech perception scores for Groups 1, 2 and 3 were significantly higher than Groups 4 and 5. Language standard scores for Group 1 were significantly higher than Groups 2, 3, 4 and 5. Speech production outcomes for Group 1 were significantly higher than scores obtained for Groups 2, 3, and 4 combined. Cross tabulation and Chi-square tests supported the hypothesis that a greater percentage of Group 1 children (than Groups 2, 3, 4, or 5) demonstrated language performance within the normative range by school entry. Conclusions: Results support provision of cochlear implants younger than 12 months of age for children with severe to profound hearing loss to optimise speech perception and subsequent language acquisition and speech production accuracy.