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Biomedical subjects

M J Osberger

Publications and source records attributed to M J Osberger.

At least 19 recordsLinked to original sources
PubMed1999

Management of the child with sensorineural hearing loss. Medical, surgical, hearing aids, cochlear implants.

Optimal comprehensive management of a child with SNHL involves constructive dialogue and coordination with the child's family and teachers. Not all children with SNHL benefit from conventional amplification, even after parents have invested significant amounts of money in hearing aids. Parents may encounter frustration and disappointment if their children fail to achieve communicative and academic goals they have established in their own mind. If the child is a potential candidate for cochlear implantation, this decision not only involves the risks (albeit modest) of surgery but also often a substantial financial commitment to help defray the cost of this sophisticated electronic device. The parents may encounter conflicting advice from friends and members of the adult deaf community about the benefit of cochlear implantation. Throughout the course of all of these difficult considerations, the health professionals caring for a child with hearing loss should be a source for information, guidance, and support to the family.

Child↗
PubMed1998

Audition and visual attention: the developmental trajectory in deaf and hearing populations.

This study examined the development of visual attention in 5- to 13-year-olds who differed in their access to sound. Hearing children, deaf children with cochlear implants, and deaf children without implants participated in a task in which they were to respond to some visual signals and not others. The results of Experiment I indicated that the timing of developmental changes in visual selective attention was similar for all 3 groups, occurring around 8 years. The magnitude of age-related change differed among groups; hearing children and older deaf children using a cochlear implant reached higher levels of performance with age than did deaf children without enhanced access to sound. The results of Experiment 2 suggest that the developmental differences between deaf children with and without cochlear implants begin prior to 8 years and may be related to their use of environmental sounds to organize visual attention.

Adolescent↗
PubMed1998

Imitative consonant feature production by children with multichannel sensory aids.

OBJECTIVE: To examine changes over time in consonant feature production by children with profound hearing impairments who used either the Nucleus multichannel cochlear implant or the multichannel vibrotactile aid, Tactaid 7. DESIGN: Imitative consonant productions of children with prelingual deafness were elicited and transcribed at two intervals: 1) before receiving their respective devices (predevice interval), and 2) after an average of 1.5 yr of device use (postdevice interval). The consonant productions were analyzed in terms of the percentage of consonant features (manner, place, and voicing) produced by the child that matched the features of the examiner's target. The percentage of features produced correctly was then averaged across repetitions, vowel environments, and participants within each group. RESULTS: At the predevice interval, the cochlear implant and Tactaid 7 participants demonstrated similar imitative consonant production abilities. After an average of 1.5 yr of device use, the cochlear implant participants demonstrated significantly greater gains than did the Tactaid 7 participants for the features of voicing and place of articulation. Although the cochlear implant participants showed a trend towards better production of the consonant manner features, this difference failed to reach significance. CONCLUSIONS: The current results suggest that the use of a multichannel sensory aid yields improvements in consonant feature production. Furthermore, use of a cochlear implant appears to promote the production of consonant voicing and place features to a greater degree than does the use of a multichannel tactile aid.

Analysis of Variance↗
PubMed1998

The effect of auditory feedback on the control of oral-nasal balance by pediatric cochlear implant users.

OBJECTIVE: This study examined the control of oral-nasal balance by pediatric cochlear implant (CI) users, with and without auditory feedback. DESIGN: Five CI users read lists of sentences in two conditions: with their devices on and with their devices off. Their oral-nasal balance (ratio of energy radiated from the oral and nasal cavities) was measured in both conditions and compared with values obtained from children with normal hearing. RESULTS: CI users showed different patterns of abnormal oral-nasal balance with their devices off, but they generally achieved values that were closer to normal when their devices were on. CONCLUSIONS: The results suggest that children with CIs use the auditory signal provided by their device to improve their control of nasalization. It is also possible that at least part of the changes in oral-nasal balance were driven by changes in related articulatory parameters.

Adolescent↗
PubMed1998

Speech recognition performance of older children with cochlear implants.

HYPOTHESIS: The primary purpose of this study was to determine if children, > or =5 years old, with onset of deafness before the acquisition of spoken language (i.e., prelingually deafened) derived more benefit from multichannel cochlear implants than from conventional hearing aids. It was hypothesized that children who used oral communication (speech plus listening) would demonstrate higher levels of performance after implantation than children who used total communication (English sign system plus speech and listening). BACKGROUND: Previous research suggests that prelingually deafened children given implants at an older age derive limited benefit from these devices. Changes in candidacy criteria and advances in technology, however, may make cochlear implants a more viable treatment option for this group of patients. METHODS: A repeated-measures design was to used to compare patients' preoperative performance with hearing aids to postoperative performance with the CLARION cochlear implant after 3 and 6 months of device use. Pre- and postoperative performance were analyzed separately for children who used oral and total communication. RESULTS: Both groups of children (oral and total communication) demonstrated significant postoperative improvement on all outcome measures over time. Postoperative scores of the children who used oral communication were significantly higher than those of the children who used total communication on four of the five outcome measures. CONCLUSIONS: Prelingually deafened children who do not receive cochlear implants until > or =5 years of age derive significant benefit from current implant devices compared with that obtained with conventional hearing aids. The greatest benefit is derived by children who use oral communication, with much more limited benefit demonstrated by children who use total communication.

Acoustic Stimulation↗
PubMed1997

Cochlear implantation in children under the age of two years: candidacy considerations.

Within recent years, there has been a growing trend to lower the age at implantation below 2 years in children. The motivation for this trend is to provide children with access to auditory stimulation as early as possible, thereby taking advantage of crucial periods for speech and language development. Determining implant candidacy in very young children, however, poses numerous challenges and requires the development and evaluation of assessment procedures appropriate for this population. Issues in determining audiologic candidacy and evaluating implant benefit in young children are discussed. Measures that can be used to assess auditory development in this population and the application of some of these procedures in the pediatric study of the Clarion cochlear implant (Advanced Bionics Corp., Sylmar, Calif.) are also presented.

Acoustic Stimulation↗
PubMed1997

A comparison of vowel production by children with multichannel cochlear implants or tactile aids: perceptual evidence.

OBJECTIVE: To examine changes in perceived vowel production accuracy over time in prelingually deafened children who use a multichannel cochlear implant (Nucleus 22 channel) or a multichannel tactile aid (Tactaid 7) and to compare the levels of perceived vowel production accuracy attained by the two device groups. DESIGN: The subjects were participants in longitudinal studies of the effects of sensory aids on the development of perceptual, speech, and language skills. As part of these studies, imitative vowel productions were elicited and transcribed before each child received their sensory aid and at 6 mo intervals thereafter. Data for the current study was obtained from the predevice interval and a later interval (postdevice) that was an average of 1.8 yr after the subjects received their respective devices. The subjects' vowel productions were judged for accuracy in matching an imitative model and for correctness of vowel features (height and place). Within-group analyses were completed to determine if vowel production scores improved over the course of the study for each device group. Between group comparisons were performed to examine differences in mean scores at each interval. RESULTS: Before receiving their multichannel devices, the two groups of subjects demonstrated similar imitative vowel production skills. After an average of 1.8 yr of device use, the cochlear implant subjects demonstrated significantly improved production of diphthongs and all vowel categories except low vowels. The Tactaid 7 subjects demonstrated significant improvement only in the production of diphthongs. Thus, cochlear implant recipients' vowel production skills were found to be significantly better than those of the Tactaid 7 users after a comparable amount of device experience. CONCLUSIONS: The vowel production gains of the cochlear implant subjects were similar in amount to those noted in other studies of children who use the Nucleus multichannel cochlear implant and further confirm the potential of this device for improved speech production in prelingually deafened children. The differences between the performance of the two groups demonstrate that vowel production skills improved to a greater degree through use of a multichannel cochlear implant than through use of the Tactaid 7.

Child↗
PubMed1997

Use of a parent-report scale to assess benefit in children given the Clarion cochlear implant.

OBJECTIVE: To assess the auditory skills in everyday situations of prelingually deafened children with Clarion cochlear implants compared with hearing aids used preoperatively. STUDY DESIGN: The Meaningful Auditory Integration Scale (MAIS) was used to determine the preoperative and postoperative auditory skills of the children. RESULTS AND DISCUSSION: After implantation, the children showed improvement in three skill areas: bonding to the device, spontaneous alerting to sound in everyday situations, and ability to derive meaning from sound in the environment.

Adolescent↗
PubMed1997

Speech recognition performance of pediatric Clarion patients.

OBJECTIVE: To evaluate the speech performance of children with the Clarion Multi-Strategy Cochlear Implant. PATIENTS: Prelingually deafened children who had received the Clarion implant. METHODS: The Spondee and Monosyllable Word Identification subtest of the Early Speech Perception test, the Glendonald Auditory Screening Procedure (GASP), and the Phonetically Balanced Kindergarten test (PB-K) were administered to subjects 3 and 6 months after implantation. RESULTS: At 3 months, subjects' performance was higher than preoperatively with hearing aids. At 6 months, performance improved further. Scores were higher on the ESP and GASP than on the PB-K. The scores indicate better levels of speech recognition than were obtained with older implant processing strategies. Subjects varied considerably in their performance. The results are preliminary because of the small sample.

Adolescent↗
PubMed1997

Comparative study of English- and German-speaking children with the Clarion cochlear implant.

OBJECTIVE: To compare the performance of English-speaking and German-speaking children with Clarion cochlear implants on the Meaningful Auditory Integration Scale (MAIS). SUBJECTS AND METHODS: Prelingually deafened German-speaking children and English-speaking children with Clarion cochlear implants were assessed on the MAIS pre- and postoperatively. Data were analyzed in terms of the absolute score, preoperatively and at two postoperative intervals, and the improvement score. RESULTS AND DISCUSSION: Preoperatively, the MAIS scores of German-speaking children were slightly lower than those of English-speaking children. Postoperatively, this difference became more pronounced. Substantial deviation within each group of subjects was suggested by the size of the standard deviations.

Adolescent↗
PubMed1995

Lexical effects on spoken word recognition by pediatric cochlear implant users.

OBJECTIVE: The purposes of this study were 1) to examine the effect of lexical characteristics on the spoken word recognition performance of children who use a multichannel cochlear implant (CI), and 2) to compare their performance on lexically controlled word lists with their performance on a traditional test of word recognition, the PB-K. DESIGN: In two different experiments, 14 to 19 pediatric CI users who demonstrated at least some open-set speech recognition served as subjects. Based on computational analyses, word lists were constructed to allow systematic examination of the effects of word frequency, lexical density (i.e., the number of phonemically similar words, or neighbors), and word length. The subjects' performance on these new tests and the PB-K also was compared. RESULTS: The percentage of words correctly identified was significantly higher for lexically "easy" words (high frequency words with few neighbors) than for "hard" words (low frequency words with many neighbors), but there was no lexical effect on phoneme recognition scores. Word recognition performance was consistently higher on the lexically controlled lists than on the PB-K. In addition, word recognition was better for multisyllabic than for momosyllabic stimuli. CONCLUSIONS: These results demonstrate that pediatric cochlear implant users are sensitive to the acoustic-phonetic similarities among words, that they organize words into similarity neighborhoods in long-term memory, and they use this structural information in recognizing isolated words. The results further suggest that the PB-K underestimates these subjects' spoken words recognition.

Age of Onset↗
PubMed1995

Speech perception skills of children with multichannel cochlear implants or hearing aids.

Perceptual skills were evaluated at two intervals of cochlear implant (CI) use in 24 children with prelingual deafness who received the Nucleus multichannel CI. Their performance was compared to that of age-matched children with prelingual profound hearing losses who used conventional hearing aids (HAs). The HA subjects were grouped by unaided thresholds: "gold" subjects (pure tone average of 92 dB hearing level) and "silver" subjects (pure tone average of 104 dB hearing level). The CI users' perceptual abilities increased significantly with time. At the "early" interval (mean, 2 months of CI use), performance of the CI and silver HA groups was similar on measures of phoneme, word, and sentence recognition; the gold HA subjects' performance was superior to that of the other groups. At the "late" interval, (mean, 2.5 years of CI use), CI subjects' performance exceeded that of the silver group on all measures, and was similar to that of the gold group on vowel recognition and auditory-plus-visual sentence recognition measures.

Audiometry, Pure-Tone↗
PubMed1995

Issues in protocol design for cochlear implant clinical trials in children: the Clarion Pediatric Study.

Clinical trials of the Clarion multichannel cochlear implant in postlingually deaf adults have been ongoing since 1991, and clinical investigation of the device in children is projected to begin in the first quarter of 1995. The purpose of this paper is to present some of the issues encountered in developing research protocols for clinical trials of cochlear implants in the pediatric population, with special reference to the protocol that will be employed in the Clarion pediatric investigation.

Child↗
PubMed1995

Speech intelligibility of implanted children.

The speech intelligibility of 61 prelingually deaf children was measured prior to their receiving a multichannel cochlear implant (CI) and at subsequent intervals. The speech intelligibility of the implanted subjects was compared to that of three groups of subjects with profound hearing loss who used conventional hearing aids (HAs), grouped on the basis of unaided thresholds: "gold" (pure tone average [PTA] = 93 dB hearing level [HL]), "silver" (PTA = 103 dB HL), and "bronze" (PTA > or = 110 dB HL). Intelligibility was measured in terms of the percentage of words from a set of 10 sentences that were correctly understood by a panel of listeners. The speech intelligibility of the implanted subjects increased gradually over time, remaining relatively low throughout the first 2 years of implant use. After that time, the average speech intelligibility of the CI subjects surpassed that of the silver HA users. The gold HA subjects demonstrated speech intelligibility that was markedly better than that of the CI subjects, even after 3 1/2 or more years of implant use.

Child, Preschool↗
PubMed1995

Comparison of multichannel tactile aids and multichannel cochlear implants in children with profound hearing impairments.

Speech perception skills of prelingually deafened children who used the multichannel Tactaid 7 (n = 10) were compared to those of a matched group of children who used the Nucleus 22 channel cochlear implant (n = 10). Group scores were compared on a closed-set test of word recognition and on an open-set test of phrase recognition in the pre-device condition and at a post-device interval after an average of 1.5 years of multichannel device use. The results revealed that the scores of the implant users improved significantly between the pre- and post-device intervals on all measures. Moreover, the scores of the implant users were significantly higher than those of the tactile aid users on all measures. In contrast, the scores of the tactile aid users showed negligible change over time, except on a test that evaluated open-set recognition of phrases with both auditory and visual cues. The results suggest that children can learn to recognize words and understand speech without lipreading with a multichannel implant, whereas children who used the multichannel tactile aid demonstrate limited speech recognition skills only if auditory/tactile cues are combined with lipreading.

Child↗