Hypothesis: Adding a low-frequency acoustic signal to the cochlear implant (CI) signal (i.e., bimodal stimulation) for a period of time early in life improves language acquisition. Background: Children must acquire sensitivity to the phonemic units of language to develop most language-related skills, including expressive vocabulary, working memory, and reading. Acquiring sensitivity to phonemic structure depends largely on having refined spectral (frequency) representations available in the signal, which does not happen with CIs alone. Combining the low-frequency acoustic signal available through hearing aids with the CI signal can enhance signal quality. A period with this bimodal stimulation has been shown to improve language skills in very young children. This study examined whether these benefits persist into childhood. Methods: Data were examined for 48 children with CIs implanted under age 3 years, participating in a longitudinal study. All children wore hearing aids before receiving a CI, but upon receiving a first CI, 24 children had at least 1 year of bimodal stimulation (Bimodal group), and 24 children had only electric stimulation subsequent to implantation (CI-only group). Measures of phonemic awareness were obtained at second and fourth grades, along with measures of expressive vocabulary, working memory, and reading. Results: Children in the Bimodal group generally performed better on measures of phonemic awareness, and that advantage was reflected in other language measures. Conclusions: Having even a brief period of time early in life with combined electric-acoustic input provides benefits to language learning into childhood, likely because of the enhancement in spectral representations provided.
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