The mathematical abilities of children with cochlear implants

Research has shown that cochlear implants give rise to improvements in speech recognition and production in children with profound hearing loss but very few studies have explored mathematical abilities in these children. The current study compared the mathematical abilities of 24 children with cochlear implants (mean age 10 years 1 month) to a control group of 22 hearing children (mean age 9 years 8 months). The math questions were categorized into questions that tapped into arithmetic or geometrical reasoning. It was predicted that the cochlear implant group would perform below the hearing group on the arithmetic questions but not the geometrical reasoning questions. Unexpectedly, the results showed that the cochlear implant group performed significantly below the hearing group on both types of math questions, but that this difference was mediated by language skill as assessed by vocabulary knowledge. The clinical implications of these results and possible future research results are considered.     

Recognition of Affective Speech Prosody and Facial Affect in Deaf Children with Unilateral Right Cochlear Implants

Cochlear implant (CI) devices provide the opportunity for children who are deaf to perceive sound by electrical stimulation of the auditory nerve, with the goal of optimizing oral communication. One part of oral communication concerns meaning, while another part concerns emotion: affective speech prosody, in the auditory domain, and facial affect, in the visual domain. It is not known whether childhood CI users can identify emotion in speech and faces, so we investigated speech prosody and facial affect in children who had been deaf from infancy and experienced CI users. METHOD: Study participants were 18 CI users (ages 7–13 years) who received right unilateral CIs and 18 age- and gender-matched controls. Emotion recognition in speech prosody and faces was measured by the Diagnostic Analysis of Nonverbal Accuracy. RESULTS: Compared to controls, children with right CIs could identify facial affect but not affective speech prosody. Age at test and time since CI activation were uncorrelated with overall outcome measures. CONCLUSION: Children with right CIs recognize emotion in faces but have limited perception of affective speech prosody.     

The Signal-Cognition interface: Interactions between degraded auditory signals and cognitive processes

A hearing loss leads to problems with speech perception; this is exacerbated when competing noise is present. The speech signal is recognized by the cognitive system of the listener; noise and distortion tax the cognitive system when interpreting it. The auditory system must interact with the cognitive system for optimal signal decoding. This article discusses this interaction between the signal and cognitive system based on two models: an auditory model describing signal transmission and degeneration due to a hearing loss and a cognitive model for Ease of Language Understanding. The signal distortion depends on the specifics of the hearing impairment and thus differently distorted signals can affect the cognitive system in different ways. Consequently, the severity of a hearing loss may not only depend on the lesion itself but also on the cognitive recourses required to interpret the signal.     

Sentence comprehension and production in children with cochlear implants: Errorless procedures and equivalence-based instruction

Research supports equivalence-based instruction (EBI) and matrix training for increased listening and speaking skills in children with cochlear implants (CI). We incorporated errorless procedures to optimize the EBI and evaluated the effects on the auditory comprehension and verbal responding at-sentences level in six CI children who were readers and showed inaccurate tacting. Subject-verb-object sentences were arranged in two matrices; diagonal combinations were trained and evaluated non-diagonal combinations. EBI included stimulus fading and exclusion to directly teach the dictated sentence-picture matching; written-sentences construction upon dictation also was taught. Probes assessed the derived stimulus-stimulus and stimulus-response relations. All participants learned the auditory-visual discriminations and the exclusion resulted in fewer errors than on a stimulus fading procedure. Five participants formed equivalence classes and increased verbal responding to equivalent stimuli, especially pictures tacting. They also showed recombinative generalization for both matrices. Professionals can incorporate errorless procedures to EBI for improving sentence comprehension, tacting, and productivity in CI children.     

Implantologie orale et responsabilité : à propos du choix du dispositif implantaire

Dental implants are medical devices designed to create stable, strong, non-iatrogenic and durable anchors in the maxilla or mandible to which a removable or fixed dental prothesis fits, to replace one or more missing teeth. From the 1970s to 2000, these medical devices experienced changes in shape and materials before a consensus was reached on a type of implant that responded to the standard of care. This raises the question of the medical liability of healthcare professionals who use different implant systems in their practices. The present article proposes to highlight the choice of the dental implant by dental practitioner, its design and the materials used, on the field of the medical liability, through a retrospective study of judicial decisions in France. The “Brånemark-type” endosseous cylindrical-conical screw implant is considered as standard of care in France. The dental surgeon has the possibility to use other types of dental implants when the clinical situation strictly contraindicates the use of cylindrical-conical screw implants. In case of litigation, he must be able to justify his choices.     

耳蜗退行性病变疗效评价

耳蜗退行性病变所致疾病已成为影响人类生活质量的主要问题之一。本文从发病机制、影响因素、临床决策方面阐述耳蜗退行性病变的研究进展,为耳蜗退行性病变所致的耳聋、耳鸣等疾病的科学研究及临床对策制定提供参考。旨在干预耳蜗退行病变,降低其发生率,提高人们生活质量。     

Computer‐assisted reading intervention with a phonics approach for children using cochlear implants or hearing aids

The present study examined computer‐assisted reading intervention with a phonics approach for deaf and hard of hearing (DHH) children in Sweden using cochlear implants or hearing aids, or a combination of both. The study included 48 children, 5, 6 and 7 years of age. Sixteen children with normal hearing (NH) served as a reference group. The first purpose of the study was to compare NH and DHH children's reading ability at pre and post‐intervention. The second purpose was to investigate effects of the intervention. Cognitive and demographic factors were analyzed in relation to reading improvement. Results showed no statistically significant difference for reading ability at the group level, although NH children showed overall higher reading scores at both test points. Age comparisons revealed a statistically significant higher reading ability in the NH 7‐year‐olds compared to the DHH 7‐year‐olds. The intervention proved successful for word decoding accuracy, passage comprehension and as a reduction of nonword decoding errors in both NH and DHH children. Reading improvement was associated with complex working memory and phonological processing skills in NH children. Correspondent associations were observed with visual working memory and letter knowledge in the DHH children. Age was the only demographic factor that was significantly correlated with reading improvement. The results suggest that DHH children's beginning reading may be influenced by visual strategies that might explain the reading delay in the older children.     

The ethics of assessing health technologies

Health technology assessment (HTA) consists of thesystematic study of the consequences of theintroduction or continued use of the technology in aparticular context, with the explicit objective toarrive at a judgment of the value or merit of thetechnology. Ideally, it is aimed at assessing allaspects of a given technology or group oftechnologies, including non-technical, e.g.socio-ethical, aspects. However, methods for assessingsocio-ethical implications of health technology arerelatively undeveloped and few mechanisms exist totake action based on the results of such evaluations.Still, the examples of cochlear inplants (CI) and other cases illustratethat HTA is not a matter of merely collecting thefacts about a technology. The facts must beplausible and relevant from a particular framework,which is not always shared by different groups. It ishere that socio-ethical aspects are encountered. Ifhealth technology assessment aims to enhance theaccountability of the decision making processregarding funding and use of health technology, it isa major challenge to assessors of health technologiesto deal adequately with existing value pluralism. Inthis respect interactive evaluation may have somethingto offer.     

听觉植入技术的进展与临床应用

听觉植入技术是随着现代科学技术的进展而发展起来的新技术,其成功应用得益于现代科技的进步,更离不开科学家的创新思维和勇于探索精神。听觉植入技术的进展体现了多学科联合发展的要求及创新思维的重要性,其应用前景也是无限光明的。