John F. Knutson

Maltreatment and disabilities: a population-based epidemiological study.

OBJECTIVES To assess the prevalence of abuse and neglect among a population of children identified as a function of an existing disability, relate specific types of disabilities to specific types of abuse, and to determine the effect of abuse and neglect on academic achievement and attendance rates for children with and without disabilities. METHOD An electronic merger of school records with Central Registry, Foster Care Review Board, and police databases was followed by a detailed record review of the circumstances of maltreatment. RESULTS Analyses of the circumstances of maltreatment and the presence of disabilities established a 9% prevalence rate of maltreatment for nondisabled children and a 31% prevalence rate for the disabled children. Thus, the study established a significant association between the presence of an educationally relevant disability and maltreatment. CONCLUSIONS Children with disabilities are 3.4 times more likely to be maltreated than nondisabled peers. School professionals need to be cognizant of the high base rate of maltreatment among the children they serve. Disability status needs to be considered in national incidence studies of maltreatment.

Multivariate Predictors of Audiological Success with Multichannel Cochlear Implants

To predict the audiological outcomes of 2 multichannel cochlear implants, a preoperative battery of historical, audiological, electrophysiologic, and psychologic variables from 48 postlingually deafened adults was tested in a prospective randomized clinical trial. Multivariate analyses were used to select and combine these preoperative variables in a predictive index that was significantly related to audiological outcome at 9 months. The preoperative variables included in the predictive index were duration of profound deafness, speech reading ability, residual hearing, cognitive ability, measures of compliance and engagement with treatment, and use of nonverbal communication strategies. The preoperative predictive index had correlations of .81 with the Iowa Sentences Test, and .78 with the NU6 word understanding scores, both obtained in a sound-only test Probability and percentile curves generated from these data offer considerable optimism in forecasting the range of likely audiological outcomes that would be realized by postlingually deafened adult candidates for multichannel cochlear implants.

The self-report of punitive childhood experiences of young adults and adolescents

A questionnaire designed to assess childhood disciplinary experiences was administered to a large sample of university students. The responses of these subjects indicated many of these predominantly middle-class young adults had experienced disciplinary activities that could be considered abusive. The results provide prevalence data on child abuse histories in a nonclinical sample and were seen as supporting the idea that physical abuse of children is widespread and not restricted to groups identified on the basis of clinical service or social deviance. Regardless of the criterion for physical abuse applied to the data, most respondents who met a criterion for having been abused failed to label themselves as having been abused. Additionally, correlations between severe physical punishment and abuse-related domains were shown to obtain in these nonclinical samples in a manner consistent with descriptions of abusive families in the clinical literature. A second study conducted with truly abused and nonabused adolescents established the validity of the questionnaire approach used in this research, and the two studies indicated the feasibility of conducting research on physical child abuse in natural collectivities of nonclinical subjects.

Recognition of familiar melodies by adult cochlear implant recipients and normal‐hearing adults

Abstract The purpose of this study was to compare melody recognition and pitch perception of adult cochlear implant recipients and normal-hearing adults and to identify factors that influence the ability of implant users to recognize familiar melodies. Forty-nine experienced cochlear implant recipients and 18 normal-hearing adults were tested on familiar melody recognition. The normal-hearing adults were significantly (p < 0.0001) more accurate than implant recipients. Implant recipients showed considerable variability in perception of complex tones and pure tones. There were significant negative correlations between melody recognition, age at the time of testing, length of profound deafness and complex-tone perception, and significant positive relations between melody recognition and speech recognition scores.

The association between child maltreatment and disabilities in a hospital-based epidemiological study

OBJECTIVE Circumstances of maltreatment and the presence of disabilities. METHOD An electronic merger of the records of all pediatric patients. RESULTS Detailed record analysis of circumstances of maltreatment and the presence of disabilities. CONCLUSIONS Differences between the Hospital and Residential samples, maltreatment and perpetrator characteristics, disability/maltreatment relationships, and their implications for primary health care are discussed.

Effects of Frequency, Instrumental Family, and Cochlear Implant Type on Timbre Recognition and Appraisal:

The purpose of this study was to compare postlingually deafened cochlear implant recipients and normal-hearing adults on timbre (tone quality) recognition and appraisal of 8 musical instruments representing 3 frequency ranges and 4 instrumental families. The implant recipients were significantly less accurate than the normal-hearing adults on timbre recognition. The implant recipients gave significantly poorer ratings than did the normal-hearing adults to those instruments played in the higher frequency range and to those from the string family. The timbre measures were weakly correlated with speech perception measures, but were significantly correlated with 3 cognitive measures of sequential processing.

Perception of rhythmic and sequential pitch patterns by normally hearing adults and adult cochlear implant users

Objective: This study compares the musical perception of 17 adult recipients of the Nucleus cochlear implant using two different format extraction processing strategies (F0F1F2 and MPEAK). Design: Over a 12 mo period, participants were alternately switched between two strategies every 3 mo. Performance was evaluated using three measures of rhythmic and sequential pitch perception. Results: Three individuals performed significantly better with the MPEAK strategy on one particular rhythm task, 11 participants performed better with the MPEAK strategy on another rhythm task, and no significant differences were found between the two strategies on a sequential pitch pattern task. Conclusions: Neither strategy seems clearly superior for perception of either sequential pitch or rhythmic patterns.

Recognition of "real-world" musical excerpts by cochlear implant recipients and normal-hearing adults.

Objective: The purposes of this study were (a) to compare recognition of “real-world” music excerpts by postlingually deafened adults using cochlear implants and normal-hearing adults; (b) to compare the performance of cochlear implant recipients using different devices and processing strategies; and (c) to examine the variability among implant recipients in recognition of musical selections in relation to performance on speech perception tests, performance on cognitive tests, and demographic variables. Design: Seventy-nine cochlear implant users and 30 normal-hearing adults were tested on open-set recognition of systematically selected excerpts from musical recordings heard in real life. The recognition accuracy of the two groups was compared for three musical genre: classical, country, and pop. Recognition accuracy was correlated with speech recognition scores, cognitive measures, and demographic measures, including musical background. Results: Cochlear implant recipients were significantly less accurate in recognition of previously familiar (known before hearing loss) musical excerpts than normal-hearing adults (p < 0.001) for all three genre. Implant recipients were most accurate in the recognition of country items and least accurate in the recognition of classical items. There were no significant differences among implant recipients due to implant type (Nucleus, Clarion, or Ineraid), or programming strategy (SPEAK, CIS, or ACE). For cochlear implant recipients, correlations between melody recognition and other measures were moderate to weak in strength; those with statistically significant correlations included age at time of testing (negatively correlated), performance on selected speech perception tests, and the amount of focused music listening following implantation. Conclusions: Current-day cochlear implants are not effective in transmitting several key structural features (i.e., pitch, harmony, timbral blends) of music essential to open-set recognition of well-known musical selections. Consequently, implant recipients must rely on extracting those musical features most accessible through the implant, such as song lyrics or a characteristic rhythm pattern, to identify the sorts of musical selections heard in everyday life.

Care Neglect, Supervisory Neglect, and Harsh Parenting in the Development of Children’s Aggression: A Replication and Extension

To understand the effects of neglectful parenting, poor supervision, and punitive parenting in the development of children’s aggression, 218 children ages 4 to 8 years who were disadvantaged and their mothers were recruited from two states to develop a sample that was diverse with respect to degree of urbanization and ethnicity. Multimethod and multisource indices of the predictive constructs (Social Disadvantage, Denial of Care Neglect, Supervisory Neglect, and Punitive Discipline) and the criterion construct (Aggression) were used in a test of a theoretical model using structural equation modeling. The results established the role of care neglect, supervisory neglect, and punitive parenting as mediators of the role of social disadvantage in the development of children’s aggression, the importance of distinguishing between two subtypes of neglect, and the need to consider the role of discipline in concert with neglect when attempting to understand the parenting in the development of aggression.

Outcomes and Achievement of Students Who Grew Up with Access to Cochlear Implants

Objectives/Hypothesis: To provide long‐term speech perception and production, educational, vocational, and achievement outcome data for pediatric cochlear implant recipients.