A retrospective study of cochlear implant outcomes in children with residual hearing

BACKGROUND: There has been increasing demand for the cochlear implantation of children who demonstrate some auditory capacity with conventional hearing aids. The purpose of this study was to examine speech recognition outcomes in a group of children who were regarded as borderline candidates for cochlear implantation as their residual hearing and/or auditory functioning levels exceeded typical audiologic candidacy criteria. METHODS: A retrospective chart review was undertaken at one Canadian cochlear implant centre to identify children implanted at age 4 or older with a pure-tone-average of 90 dB or better and speech recognition of 30% or greater. Pre-implant and post-implant open-set word and sentence test scores were analyzed. RESULTS: Eleven children of 195 paediatric cochlear implant recipients met the inclusion criteria for this study. Speech recognition results for the10 English-speaking children indicated significant gains in both open-set word and sentence understanding within the first 6 to 12 months of implant use. Seven of 9 children achieved 80% open-set sentence recognition within 12 months post-surgery. CONCLUSION: Children with several years of experience using conventional amplification demonstrated rapid progress in auditory skills following cochlear implantation. These findings suggest that cochlear implantation may be an appropriate intervention for selected children with severe hearing losses and/or auditory capacity outside current candidacy criteria

Roadmap on multiscale materials modeling

Modeling and simulation is transforming modern materials science, becoming an important tool for the discovery of new materials and material phenomena, for gaining insight into the processes that govern materials behavior, and, increasingly, for quantitative predictions that can be used as part of a design tool in full partnership with experimental synthesis and characterization. Modeling and simulation is the essential bridge from good science to good engineering, spanning from fundamental understanding of materials behavior to deliberate design of new materials technologies leveraging new properties and processes. This Roadmap presents a broad overview of the extensive impact computational modeling has had in materials science in the past few decades, and offers focused perspectives on where the path forward lies as this rapidly expanding field evolves to meet the challenges of the next few decades. The Roadmap offers perspectives on advances within disciplines as diverse as phase field methods to model mesoscale behavior and molecular dynamics methods to deduce the fundamental atomic-scale dynamical processes governing materials response, to the challenges involved in the interdisciplinary research that tackles complex materials problems where the governing phenomena span different scales of materials behavior requiring multiscale approaches. The shift from understanding fundamental materials behavior to development of quantitative approaches to explain and predict experimental observations requires advances in the methods and practice in simulations for reproducibility and reliability, and interacting with a computational ecosystem that integrates new theory development, innovative applications, and an increasingly integrated software and computational infrastructure that takes advantage of the increasingly powerful computational methods and computing hardware

Indices for the determination of the degree of communication skills improvement in prelingual children with cochlear implantation

En Abstract Introduction Monitoring and documenting the progress in communication skills of cochlear implanted (CI) children is important for intervention planning, conduction of evidence-based studies, and reporting parents about their children’s progress. Aim The aim of the present study was to provide reliable indices that may be used to monitor a child’s communication skills progress after CI and to grade his or her performance. Patients The study was carried out on 53 prelingual CI children (28 boys and 25 girls). Their ages ranged from 2.5 to 6 years. They were all of average intelligence and showed no associated disorders. They were all enrolled for verbal auditory training at the Unit of Phoniatrics. Methodology The CI children were evaluated postoperatively using the quasi-objective description of communicative ability, following scaling by transformation from the lower stages to the higher stages in communicative performance. This entailed the determination of the levels for auditory performance, receptive and expressive language, speech intelligibility, mode of communication, approximate language age, vocabulary size, and speech sounds perception. After 1 year of implantation, the children were re-evaluated and the levels achieved in each item and on the therapy program were recorded. The subjective impression of improvement was marked as poor, fair, or good, which was determined by the phoniatrician, therapist, and the parents for each child. Conclusion Expressive language development and speech intelligibility in the presence of marked speech perception are significant indicators for communication skills progress. The indices provided for various degrees of improvement are helpful to conduct evidence-based research, especially in the absence of reliable formal testing