Browsing by Subject "DEAF-CHILDREN"

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  • Torppa, Ritva; Faulkner, Andrew; Kujala, Teija; Huotilainen, Minna; Lipsanen, Jari (2018)
    THE PERCEPTION OF SPEECH IN NOISE IS challenging for children with cochlear implants (CIs). Singing and musical instrument playing have been associated with improved auditory skills in normal-hearing (NH) children. Therefore, we assessed how children with CIs who sing informally develop in the perception of speech in noise compared to those who do not. We also sought evidence of links of speech perception in noise with MMN and P3a brain responses to musical sounds and studied effects of age and changes over a 14-17 month time period in the speech-in-noise performance of children with CIs. Compared to the NH group, the entire CI group was less tolerant of noise in speech perception, but both groups improved similarly. The CI singing group showed better speech-in-noise perception than the CI non-singing group. The perception of speech in noise in children with CIs was associated with the amplitude of MMN to a change of sound from piano to cymbal, and in the CI singing group only, with earlier P3a for changes in timbre. While our results cannot address causality, they suggest that singing and musical instrument playing may have a potential to enhance the perception of speech in noise in children with CIs.
  • Välimaa, Taina; Kunnari, Sari; Laukkanen-Nevala, Paivi; Lonka, Eila; Natl Clinical Res Team (2018)
    BackgroundChildren with unilateral cochlear implants (CIs) may have delayed vocabulary development for an extended period after implantation. Bilateral cochlear implantation is reported to be associated with improved sound localization and enhanced speech perception in noise. This study proposed that bilateral implantation might also promote early vocabulary development. Knowledge regarding vocabulary growth and composition in children with bilateral CIs and factors associated with it may lead to improvements in the content of early speech and language intervention and family counselling. AimsTo analyse the growth of early vocabulary and its composition during the first year after CI activation and to investigate factors associated with vocabulary growth. Methods & ProceduresThe participants were 20 children with bilateral CIs (12 boys; eight girls; mean age at CI activation = 12.9 months). Vocabulary size was assessed with the Finnish version of the MacArthur Communicative Development Inventories (CDI) Infant Form and compared with normative data. Vocabulary composition was analysed in relation to vocabulary size. Growth curve modelling was implemented using a linear mixed model to analyse the effects of the following variables on early vocabulary growth: time, gender, maternal education, residual hearing with hearing aids, age at first hearing aid fitting and age at CI activation. Outcomes & ResultsDespite clear vocabulary growth over time, children with bilateral CIs lagged behind their age norms in receptive vocabulary during the first 12 months after CI activation. In expressive vocabulary, 35% of the children were able to catch up with their age norms, but 55% of the children lagged behind them. In receptive and expressive vocabularies of 1-20 words, analysis of different semantic categories indicated that social terms constituted the highest proportion. Nouns constituted the highest proportion in vocabularies of 101-400 words. The proportion of verbs remained below 20% and the proportion of function words and adjectives remained below 10% in the vocabularies of 1-400 words. There was a significant main effect of time, gender, maternal education and residual hearing with hearing aids before implantation on early receptive vocabulary growth. Time and residual hearing with hearing aids had a significant main effect also on expressive vocabulary growth. Conclusions & ImplicationsVocabulary development of children with bilateral CIs may be delayed. Thus, early vocabulary development needs to be assessed carefully in order to provide children and families with timely and targeted early intervention for vocabulary acquisition.
  • Torppa, Ritva; Faulkner, Andrew; Laasonen, Marja; Lipsanen, Jari; Sammler, Daniela (2020)
    Objectives: A major issue in the rehabilitation of children with cochlear implants (CIs) is unexplained variance in their language skills, where many of them lag behind children with normal hearing (NH). Here we assess links between generative language skills and the perception of prosodic stress, and with musical and parental activities in children with CIs and NH. Understanding these links is expected to guide future research and towards supporting language development in children with a CI. Method: 21 unilaterally and early-implanted children and 31 children with NH, aged 5 to 13, were classified as musically active or non-active by a questionnaire recording regularity of musical activities, in particular singing, and reading and other activities shared with parents. Perception of word and sentence stress, performance in word finding, verbal intelligence (WISC vocabulary) and phonological awareness (PA; production of rhymes) were measured in all children. Comparisons between children with a CI and NH were made against a sub-set of 21 of the children with NH who were matched to children with CIs by age, gender, socio-economic background and musical activity. Regression analyses, run separately for children with CIs and NH, assessed how much variance in each language task was shared with each of prosodic perception, the child’s own music activity, and activities with parents, including singing and reading. All statistical analyses were conducted both with and without control for age and maternal education. Results: Musically active children with CIs performed similarly to NH controls in all language tasks, while those who were not musically active performed more poorly. Only musically non-active children with CIs made more phonological and semantic errors in word finding than NH controls, and word finding correlated with other language skills. Regression analysis results for word finding and VIQ were similar for children with CIs and NH. These language skills shared considerable variance with the perception of prosodic stress and musical activities. When age and maternal education were controlled for, strong links remained between perception of prosodic stress and VIQ (shared variance: CI, 32%/NH, 16%) and between musical activities and word finding (shared variance: CI, 53%/NH, 20%). Links were always stronger for children with CIs, for whom better phonological awareness was also linked to improved stress perception and more musical activity, and parental activities altogether shared significantly variance with word finding and VIQ. Conclusions: For children with CIs and NH, better perception of prosodic stress and musical activities with singing are associated with improved generative language skills. Additionally, for children with CIs, parental singing has a stronger positive association to word finding and VIQ than parental reading. These results cannot address causality, but they suggest that good perception of prosodic stress, musical activities involving singing, and parental singing and reading may all be beneficial for word finding and other generative language skills in implanted children.
  • Välimaa, Taina T.; Kunnari, Sari; Aarnisalo, Antti A.; Dietz, Aarno; Hyvärinen, Antti; Laitakari, Jaakko; Mykkänen, Sari; Rimmanen, Satu; Salonen, Jaakko; Sivonen, Ville; Tennilä, Tanja; Tsupari, Teija; Vikman, Sari; Virokannas, Nonna; Laukkanen-Nevala, Päivi; Tolonen, Anna-Kaisa; Tuohimaa, Krista; Löppönen, Heikki (2022)
    Objectives: Early hearing aid (HA) fitting and cochlear implants (CIs) aim to reduce the effects of hearing loss (HL) on spoken language development. The goals of this study were (1) to examine spoken language skills of children with bilateral HAs and children with bilateral CIs; (2) to compare their language skills to the age-norms of peers with normal hearing (NH); and (3) to investigate factors associated with spoken language outcomes. Design: Spoken language results of 56 Finnish children with HL were obtained from a nationwide prospective multicenter study. Children with HL comprised two groups: children with mild-to-severe HL who used bilateral HAs (BiHA group, n = 28) and children with profound HL who used bilateral CIs (BiCI group, n = 28). Children's spoken language comprehension, expressive and receptive vocabulary, and phonological skills were compared with normative values of children with NH at the age of three years. Odds ratio (OR) was calculated to compare proportions of children below age-norms in BiHA and BiCI groups. Factors associated with spoken language outcomes were modeled with analysis of covariance. Results: At the age of 3 years, 50%-96% of children with HL performed 1 SD or more below the mean of the normative sample of age-peers with NH in spoken language skills, depending on the language domain. Receptive vocabulary and phonological skills were the most vulnerable language domains. In receptive vocabulary, 82% of the children in the BiHA group and 50% of the children in the BiCI group scored 1 SD or more below the normative mean. The BiHA group was 4.4 times more likely to have poorer receptive vocabulary than the BiCI group. In phonological skills, 96% of children in the BiHA group and 60% of the children in the BiCI group scored 1 SD or more below the normative mean. The BiHA group was 18.0 times more likely to have poorer phonological skills than the BiCI group. The analysis of covariance models showed that unaided pure-tone average, PTA(0.5-4 kHz), had a significant effect on spoken language comprehension in the BiHA group. For the BiCI group, age at HL diagnosis and age at CI activation had a significant effect on expressive vocabulary. High maternal level of education had a significant effect on language comprehension and expressive vocabulary and female gender on phonological skills. Conclusions: At the age of 3 years, especially receptive vocabulary and phonological skills caused difficulties for children with HL showing also considerable individual variation. Children with bilateral HAs seemed to be more likely to have poorer receptive vocabulary and phonological skills than children with bilateral CIs. A variety of factors was associated with outcomes in both groups. Close monitoring of spoken language skills of children with HL is important for ensuring similar opportunities for all children with HL and timely intervention, when needed.
  • Looi, Valerie; Torppa, Ritva; Prvan, Tania; Vickers, Debi (2019)
    The primary aim of this current study was to compare the role, importance and value placed on music by families with normally hearing (NH) children, to those who had a child with a hearing loss (HL) who wore either hearing aids and/or cochlear implants. A secondary aim was to see whether this differed between the countries. Parents of children aged 2–6 years living in Australia, Finland, and the United Kingdom were invited to complete the Role of Music in Families Questionnaire (RMFQ). Two groups of participants were recruited from each country: (i) parents of NH children, and (ii) parents of children with a HL. The RMFQ had seven subsections covering topics such as music participation, attitudes to music, importance of music in the family, and future perspectives on music. Three hundred and twenty-two families of NH children, and 56 families of children with HL completed the questionnaire (Australia: 50 NH, 25 HL; Finland: 242 NH, 21 HL; United Kingdom: 30 NH, 10 HL). Analyses compared between NH and HL groups within each country, and between the three countries for the NH group, and the HL group, independently. Overall, there were few significant differences between the participation levels, role, or importance of music in families with NH children compared to those with a child who had a HL, regardless of whether the families lived in Australia, Finland or the United Kingdom. Children first started to respond to music at similar ages, and overall music participation frequency, and music enjoyment were relatively similar. The importance of music in the family was also similar between the NH and HL groups. In comparing between the countries, Finnish children had a tendency to have higher participation rates in musical activities, with few other differences noted. Overall, the results of this study indicate that children, regardless of hearing levels or country of residence, have similar levels of music engagement and enjoyment, and HL is not seen as a contraindication to music participation and involvement by the parents involved in this study.
  • Torppa, Ritva; Huotilainen, Minna (2019)
    This paper presents evidence for a strong connection between the development of speech and language skills and musical activities of children and adolescents with hearing impairment and/or cochlear implants. This conclusion is partially based on findings for typically hearing children and adolescents, showing better speech and language skills in children and adolescents with musical training, and importantly, showing increases of speech and language skills in children and adolescents taking part in musical training. Further, studies of hearing-impaired children show connections between musical skills, involvement in musical hobbies, and speech and language skills. Even though the field is still lacking large-scale randomised controlled trials on the effects of musical interventions on the speech and language skills of children and adolescents with hearing impairments and cochlear implants, the current evidence seems enough to urge speech therapists, music therapists, music teachers, parents, and children and adolescents with hearing impairments and/or cochlear implants to start using music for enhancing speech and language skills. For this reason, we give our recommendations on how to use music for language skill enhancement in this group.