Sha Liu

The effects of age at cochlear implantation and hearing aid trial on auditory performance of Chinese infants

Abstract Conclusion: Most of the infants demonstrated rapid improvement in the three different auditory skills within the first year after switch-on. Infants undergoing hearing aid trial and habilitation demonstrated a significant positive effect on the development of auditory skills in comparison with infants without trial and habilitation. Objective: This paper aims to evaluate the auditory performance of infants of different age at cochlear implantation, emphasize the importance of the hearing aid trial and habilitation before implant, and provide baseline data of auditory development. Methods: In all, 259 infants with prelingually profound hearing loss participated in this study. The Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) was used to assess auditory skills in infants at different intervals. Results: The mean scores for the auditory skills improved significantly over time. The mean scores of three skills for each group at each interval were significantly different. The mean scores of the auditory skills were significantly superior for infants undergoing hearing aid trial and habilitation in comparison with those of infants without hearing aid trial and habilitation.

International outcome inventory for hearing aids (IOI-HA): Results from the Chinese version

Abstract Objective: The purpose of this study is to present normative data on the Chinese version of the international outcome inventory for hearing aids (IOI-HA) and examine the effective-ness of the hearing aid service. Design: Cross-sectional study. The IOI-HA was administered in a paper and pencil format. Study sample: The IOI-HA and self-designed questionnaire were mailed to 1502 experienced hearing-aid users who received their hearing aids from 14 hearing service centers in mainland China. In all, 1049 completed responses were included in the final analysis, and descriptive statistics were reported. Results: The mean scores of each item of the IOI-HA ranged from 3.55 to 4.16. The IOI-HA scores showed a skewed distribution, with the maximum frequency for a score of 4 or 5. The total IOI-HA scores ranged from 9 to 35, and the mean total score was 26.3. The results compared favorably with the previous reports, and slightly higher than the published norms, indicating a high level of self-reported outcomes. Conclusiones: The IOI-HA could be used as an effective tool to measure the general effectiveness of the hearing aid outcomes in China. The implementation of the IOI-HA is time-efficient, imposing little burden on the clinician and patient. Sumario Objetivo: El propósito de este estudio es presentar datos normativos de la versión en chino del Inventario Internacional de Resultados con Auxiliares Auditivos (IOI-HA) y examinar la efectividad del servicio de auxiliares auditivos. Diseño: Estudio transversal. El IOI-HA fue administrado en formato de papel y lápiz. Muestra Del Estudio: El IOI-HA y un cuestionario auto-diseñado fueron enviados por correo a 1502 usuarios con experiencia de auxiliares auditivos, quien habían recibido sus auxiliares auditivos de 14 centros de servicio auditivo en China continental. Globalmente, 1049 respuestas completas fueron incluidas en el análisis final, y se reportaron estadísticas descriptivas. Resultados: Los puntajes medios de cada ítem del IOI-HA fluctuaron de 3.55 a 4.16. Los puntajes del IOI-HA mostrados una distribución sesgada, con la mayor frecuencia para un puntaje de 4 o 5. Los puntajes totales del IOI-HA variaron de 9 a 35, el puntaje medio total fue de 26.3. Los resultados se compararon favorablemente con los reportes previos, y levemente más altos que las normas publicadas, indicando un alto nivel de resultados auto-reportados. Conclusiones: El IOI-HA puede servir como una herramienta efectiva para medir la efectividad general de los resultados en la adaptación de auxiliares auditivos en China. La implementación del IOI-HA es tiempo-efectivo, imponiendo una carga pequeña sobre el clínico y el paciente.

Effects of lexical characteristics and demographic factors on mandarin chinese open-set word recognition in children with cochlear implants.

Objective: The purpose of this study was to examine the open-set word recognition performance of Mandarin Chinese–speaking children who had received a multichannel cochlear implant (CI) and examine the effects of lexical characteristics and demographic factors (i.e., age at implantation and duration of implant use) on Mandarin Chinese open-set word recognition in these children. Design: Participants were 230 prelingually deafened children with CIs. Age at implantation ranged from 0.9 to 16.0 years, with a mean of 3.9 years. The Standard-Chinese version of the Monosyllabic Lexical Neighborhood test and the Multisyllabic Lexical Neighborhood test were used to evaluate the open-set word identification abilities of the children. A two-way analysis of variance was performed to delineate the lexical effects on the open-set word identification, with word difficulty and syllable length as the two main factors. The effects of age at implantation and duration of implant use on open-set, word-recognition performance were examined using correlational/regressional models. Results: First, the average percent-correct scores for the disyllabic “easy” list, disyllabic “hard” list, monosyllabic “easy” list, and monosyllabic “hard” list were 65.0%, 51.3%, 58.9%, and 46.2%, respectively. For both the easy and hard lists, the percentage of words correctly identified was higher for disyllabic words than for monosyllabic words, Second, the CI group scored 26.3%, 31.3%, and 18.8 % points lower than their hearing-age–matched normal-hearing peers for 4, 5, and 6 years of hearing age, respectively. The corresponding gaps between the CI group and the chronological-age–matched normal-hearing group were 47.6, 49.6, and 42.4, respectively. The individual variations in performance were much greater in the CI group than in the normal-hearing group, Third, the children exhibited steady improvements in performance as the duration of implant use increased, especially 1 to 6 years postimplantation. Last, age at implantation had significant effects on postimplantation word-recognition performance. The benefit of early implantation was particularly evident in children 5 years old or younger. Conclusions: First, Mandarin Chinese–speaking pediatric CI users’ open-set word recognition was influenced by the lexical characteristics of the stimuli. The score was higher for easy words than for hard words and was higher for disyllabic words than for monosyllabic words, Second, Mandarin-Chinese–speaking pediatric CI users exhibited steady progress in open-set word recognition as the duration of implant use increased. However, the present study also demonstrated that, even after 6 years of CI use, there was a significant deficit in open-set, word-recognition performance in the CI children compared with their normal-hearing peers. Third, age at implantation had significant effects on open-set, word-recognition performance. Early implanted children exhibited better performance than children implanted later.

Standard-Chinese Lexical Neighborhood Test in normal-hearing young children

OBJECTIVEnThe purposes of the present study were to establish the Standard-Chinese version of Lexical Neighborhood Test (LNT) and to examine the lexical and age effects on spoken-word recognition in normal-hearing children.nnnMETHODSnSix lists of monosyllabic and six lists of disyllabic words (20 words/list) were selected from the database of daily speech materials for normal-hearing (NH) children of ages 3-5 years. The lists were further divided into easy and hard halves according to the word frequency and neighborhood density in the database based on the theory of Neighborhood Activation Model (NAM). Ninety-six NH children (age ranged between 4.0 and 7.0 years) were divided into three different age groups of 1-year intervals. Speech-perception tests were conducted using the Standard-Chinese monosyllabic and disyllabic LNT.nnnRESULTSnThe inter-list performance was found to be equivalent and inter-rater reliability was high with 92.5-95% consistency. Results of word-recognition scores showed that the lexical effects were all significant. Children scored higher with disyllabic words than with monosyllabic words. Easy words scored higher than hard words. The word-recognition performance also increased with age in each lexical category. A multiple linear regression analysis showed that neighborhood density, age, and word frequency appeared to have increasingly more contributions to Chinese word recognition.nnnCONCLUSIONnThe results of the present study indicated that performances of Chinese word recognition were influenced by word frequency, age, and neighborhood density, with word frequency playing a major role. These results were consistent with those in other languages, supporting the application of NAM in the Chinese language. The development of Standard-Chinese version of LNT and the establishment of a database of children of 4-6 years old can provide a reliable means for spoken-word recognition test in children with hearing impairment.

The contribution of apical stimulation to Mandarin speech perception in users of the MED-EL COMBI 40+ cochlear implant.

Abstract Conclusion: Not stimulating the apical cochlear region in tonal language speaking cochlear implantees significantly reduces discrimination of Mandarin vowels. The data presented here suggest that electrode arrays that allow complete cochlear coverage with stimulation pulses seem to be preferable over shorter arrays for use in cochlear implant (CI) indications. Objective: To assess the contribution of electrical stimulation beyond the first cochlear turn on tonal language speech perception. Methods: Twelve Mandarin-speaking users of the MED-EL COMBI 40+ cochlear implant with complete insertion of the standard COMBI 40+ electrode array participated in the study. Acute speech tests were performed in seven electrode configurations with stimulation either distributed over the whole length of the cochlea or restricted to the apical, middle or basal regions. The test battery comprised tone, consonant, and vowel identification in quiet as well as a sentence recognition task in quiet and noise. Results: While neither tone nor consonant identification depended crucially on the placement of the active electrodes, vowel identification and sentence recognition decreased significantly when the four apical electrodes were not stimulated.

Longitudinal performance of spoken word perception in Mandarin pediatric cochlear implant users.

OBJECTIVEnThe objective of the present study was to investigate the longitudinal performance on open-set word perception in Mandarin children with cochlear implants (CIs).nnnMETHODSnProspective cohort study. One hundred and five prelingually deaf children implanted with CIs participated in the study. The Standard-Chinese Version of Monosyllabic Lexical Neighborhood Test (LNT) and Multisyllabic Lexical Neighborhood Test (MLNT) were used as open-set word perception evaluation tools. Evaluations were administrated at 6, 12, 24, 36, 48, 60, 72, and 84 months post CI stimulation, respectively.nnnRESULTSn(1) Spoken word perception performance of congenitally deaf children with CIs improved significantly over time. (2) The fastest improvement occurred in the first 36 months after initial activation, then the improvement slowed down and the final peak score of 81.7% correct was achieved at 72 months after initial activation. (3) Early implanted children exhibited better longitudinal performance. (4) Lexical factors affected consistently in each evaluation session. For lexically harder words, such as monosyllabic hard words, there was substantial room for improvement even after long-term use of CI.nnnCONCLUSIONSn(1) CI continuously provided significant benefits in word perception to children with severe/profound sensorineural hearing loss. (2) Age at implantation and Mandarin lexical factor affected longitudinal performance significantly.

Cochlear implants with fine structure processing improve speech and tone perception in Mandarin-speaking adults

Abstract Conclusion: This study indicates that Mandarin-speaking subjects acquire significant benefit from a cochlear implant (CI) and audio processor with the fine structure processing (FSP) coding strategy. It can take adult Mandarin CI users time to become accustomed to their CI and appreciate the benefits. Objectives: This study aimed to determine speech perception outcomes in Mandarin-speaking adults who received the FSP coding strategy. Methods: This was a prospective study. Ten adults who were implanted unilaterally with a PULSARCI100, and received an OPUS 1 or OPUS 2 speech processor, were included in this study. The mean age at implantation was 31.1 years. We determined the benefit to postlingually deafened Mandarin-speaking adults with a severe to profound hearing loss using the tests: monosyllables in quiet, sentences in quiet and the Mandarin Hearing in Noise Test (MHINT). Tone perception was evaluated using a tone perception test. A visual analog scale (VAS) was used to score sound quality and ease of listening. Results: The results showed a significant improvement between first fitting and 6 months in all speech tests and in tone perception. The VAS scores showed a significant improvement over 6 months in sound quality and an immediate benefit in ease of listening.

The development of auditory skills in infants with isolated Large Vestibular Aqueduct Syndrome after cochlear implantation

OBJECTIVEnThe purpose of this study was to investigate the auditory performance of infants with isolated Large Vestibular Aqueduct Syndrome (LVAS) after cochlear implantation, compare their performance with those of infants with a normal inner ear, and establish a database of auditory development.nnnMETHODn435 infants with congenital severe to profound hearing loss participated in this study. 62 infants in group A were diagnosed with isolated LVAS. 373 infants in group B had a normal inner ear. Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) was used to evaluate the development of auditory skills.nnnRESULTSnThe mean scores for auditory ability showed no significant difference between groups A and B. The mean scores for the three different auditory skills increased significantly over time. The differences were statistically significant in mean scores among the three different auditory skills for group B.nnnCONCLUSIONnAuditory skills of infants with isolated LVAS developed rapidly after cochlear implantation, in a similar manner to those of infants with a normal inner ear. Cochlear implantation is an effective interventional approach and an established therapeutic option for infants with isolated LVAS.

Lexical and age effects on word recognition in noise in normal-hearing children.

OBJECTIVESnThe purposes of the present study were (1) to examine the lexical and age effects on word recognition of normal-hearing (NH) children in noise, and (2) to compare the word-recognition performance in noise to that in quiet listening conditions.nnnMETHODSnParticipants were 213 NH children (age ranged between 3 and 6 years old). Eighty-nine and 124 of the participants were tested in noise and quiet listening conditions, respectively. The Standard-Chinese Lexical Neighborhood Test, which contains lists of words in four lexical categories (i.e., dissyllablic easy (DE), dissyllablic hard (DH), monosyllable easy (ME), and monosyllable hard (MH)) was used to evaluate the Mandarin Chinese word recognition in speech spectrum-shaped noise (SSN) with a signal-to-noise ratio (SNR) of 0dB. A two-way repeated-measures analysis of variance was conducted to examine the lexical effects with syllable length and difficulty level as the main factors on word recognition in the quiet and noise listening conditions. The effects of age on word-recognition performance were examined using a regression model.nnnRESULTSnThe word-recognition performance in noise was significantly poorer than that in quiet and the individual variations in performance in noise were much greater than those in quiet. Word recognition scores showed that the lexical effects were significant in the SSN. Children scored higher with dissyllabic words than with monosyllabic words; easy words scored higher than hard words in the noise condition. The scores of the NH children in the SSN (SNR=0dB) for the DE, DH, ME, and MH words were 85.4, 65.9, 71.7, and 46.2% correct, respectively. The word-recognition performance also increased with age in each lexical category for the NH children tested in noise.nnnCONCLUSIONSnBoth age and lexical characteristics of words had significant influences on the performance of Mandarin-Chinese word recognition in noise. The lexical effects were more obvious under noise listening conditions than in quiet. The word-recognition performance in noise increased with age in NH children of 3-6 years old and had not reached plateau at 6 years of age in the NH children.

The development of auditory skills in young children with Mondini dysplasia after cochlear implantation.

The aim of this study is to survey and compare the development of auditory skills in young children with Mondini dysplasia and profoundly-deaf young children with radiologically normal inner ears over a period of 3 years after cochlear implantation. A total of 545 young children (age 7 to 36 months) with prelingual, severe to profound hearing loss participated in this study. All children received cochlear implantation. Based on whether or not there was a Mondini dysplasia as diagnosed with CT scanning, the subjects were divided into 2 groups: (A) 514 young children with radiologically normal inner ears and (B) 31 young children with Mondini dysplasia. The Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) was used to assess the childrens auditory skills that include vocalization changes, spontaneous alerting to sounds in everyday living environments, and the ability to derive meaning from sounds. The assessment was performed prior to surgery and at 1, 3, 6, 9, 12, 24, and 36 months after implant device switch-on. The mean scores for overall auditory skills were not significantly different between groups A and B at pre-surgery, 1, 12, 24, and 36 months post-surgery, but were significantly different at 3, 6, and 9 months post-surgery. The mean scores for all auditory skills in children with Mondini dysplasia showed significant improvement over time. The mean scores for the three subcategories of auditory skills in children with Mondini dysplasia also showed significant differences at pre-surgery, 1, 3, 6, and 9 months, however, there were no significant differences at 12, 24, and 36 months. Overall, the auditory skills of young children with Mondini dysplasia developed rapidly after cochlear implantation, in a similar manner to that of young children with radiologically normal inner ears. Cochlear implantation is an effective intervention for young children with Mondini dysplasia.