Implicit sequence learning (SL) is crucial for language acquisition and has been studied in children with organic language deficits (e.g., specific language impairment). However, language delays are also seen in children with non-organic deficits, such as those with hearing loss or from low socioeconomic status (SES). While some children with cochlear implants (CI) develop strong language skills, variability in performance suggests that degraded auditory input (nature) may affect SL. Low SES children typically experience language delays due to environmental deprivation (nurture). The purpose of this study was to investigate nature versus nurture effects on auditory SL. A total of 100 participants were divided into normal hearing (NH) children, young adults, CI children from high-moderate SES, and NH children from low SES who were tested with two Serial Reaction Time (SRT) tasks with speech and environmental sounds, and with cognitive tests. Results showed SL for speech and nonspeech stimuli for all participants, suggesting that SL is resilient to degradation of auditory and language input and that SL is not specific to speech. Absolute reaction time (RT) (reflecting a combination of complex processes including SL) was found to be a sensitive measure for differentiating between groups and between types of stimuli. Specifically, normal hearing groups showed longer RT for speech compared to environmental stimuli, a prolongation that was not evident for the CI group, suggesting similar perceptual strategies applying for both sound types; and RT of Low SES children was the longest for speech stimuli compared to other groups of children, evidence of the negative impact of language deprivation on speech processing. Age was the largest contributing factor to the results (~ 50%) followed by cognitive abilities (~ 10%). Implications for intervention include speech-processing targeted programs, provided early in the critical periods of development for low SES children.

Pediatric cochlear implant (CI) recipients with cochlear malformations face challenges due to variable speech recognition outcomes.

This study assesses the predictive value of intraoperative electrically evoked compound action potential (eCAP) thresholds, residual hearing, age at implantation, Intelligent Quotient (IQ), and malformation type for speech recognition outcomes.

A prospective cohort of 52 children (aged 1-4 years) with cochlear malformations who underwent CI between 2016 and 2024 was analyzed. Intraoperative eCAP thresholds were recorded, and disyllable word recognition scores (WRS) were evaluated 24 months postoperatively.

Patients included incomplete partition (IP-II, 46.2%), cochlear hypoplasia (30.8%), IP-I (13.5%), and common cavity (9.6%). IP-II cases had higher mean eCAP thresholds (18.85 µV) compared to cochlear hypoplasia and common cavity cases. Higher eCAP thresholds correlated with better WRS outcomes (p < 0.001). Logistic regression revealed eCAP thresholds, residual hearing, age, IQ, and malformation type as significant predictors, with an AUC of 0.92.

Intraoperative eCAP thresholds and residual hearing strongly predict auditory outcomes in children with cochlear malformations. Tailored CI strategies based on individual profiles can optimize speech recognition outcomes.

Objectives: This study aims to describe the stress levels experienced by parents of children with hearing loss who use conventional hearing aids or cochlear implants, and to assess the correlation between parental stress and the auditory skills acquired by the children. Methods: The study was conducted at the Policlinic "Gaetano Martino" in Messina, evaluating data from 42 pairs of parents of children using hearing aids or cochlear implants. Parents completed the LittlEARS Auditory Questionnaire (LEAQ) and the Parental Stress Scale (PSS) 18 months after the initial device (hearing aid or cochlear implant) had been activated. Additionally, information was collected regarding the presence of peripartum issues (including preterm birth) or associated conditions, congenital hearing loss, the total number of children in the family, and the number of children with hearing loss in the family. Results: Significant differences were found in the months to effective stimulation (p = 0.026), the age of the children at the time of the survey (p = 0.024) and the PSS score (p = 0.029). Univariate and multivariate logistic regression revealed significant correlations between LEAQ scores and both the months to effective stimulation and the age of the children at the time of the survey; univariate and multivariate linear regression revealed significant correlations between PSS scores and the type of device, months to effective stimulation, age of the children at the time of the survey, peripartum issues, and the number of children. A Spearman correlation showed a positive relationship between LEAQ and age of the children at the time of the survey, and a negative correlation between the PSS scores and the age of the children at the time of the survey. Conclusions: Parents of children with cochlear implants reported higher stress levels than those with children using hearing aids, although auditory performance was comparable between groups. Improved auditory performance was associated with reduced parental stress. The PSS and LEAQ are effective tools used in clinical practice for assessing parental stress and tracking auditory recovery, respectively.

To identify factors affecting functional hearing performance and quality of life (QoL) outcomes in paediatric cochlear implantation (CI) recipients at two University centres in mainland China.

Two university centres in mainland China, part of the prospective longitudinal Paediatric Implanted Recipient Observational Study (P-IROS), contributed participant data. Participants were aged under 10 years at time of CI. Functional hearing performance and QoL measures were collected prior to device activation, and at 6-monthly intervals for 2 years post-implantation. Functional hearing endpoints including Categories of Auditory Performance-II (CAP-II) and QoL were evaluated and analysed using ordinal mixed-effects regression models.

Data were from 288 children with a mean age at implant of 2.74 years. Overall follow-up at 1 year was 59% and 51% at 2 years. Younger age at implantation (p<0.001) and hearing aid use preimplantation (p=0.026) were associated with significant benefit. Bilateral device users (both CI and bimodal) achieved significantly better functional hearing performance on the CAP-II than unilateral CI users (p<0.001). Slower functional hearing improvements were observed in those with lower parental expectations compared to higher expectations (p<0.001). QoL improved over time but followed a different initial trajectory between centres.

All participants demonstrated significant improvements in auditory performance and QoL over time. Younger age at CI, and bilateral/bimodal device fitting contributed to earlier improvements. Other potential factors that could help inform families, professionals, and health authorities about choice of hearing device and educational supports required included aetiology of hearing loss and level of maternal education.

Assess the feasibility of cochlear implantation as day-surgery in children and identify variables influencing admission, readmission, and unplanned postoperative consultation.

This retrospective observational monocentric study was conducted according to the STROBE recommendations. Between January 2017 and July 2022, all medical records of children who underwent cochlear implantation were analyzed. Eligible children were admitted for the first time to the pediatric day-surgery unit. Exclusion criteria were children planned for inpatient procedure, bilateralization or explantation-reimplantation. Sex assigned at birth, analgesic medication, anesthesia and complications were related to categorical variables. Age, duration of anesthesia, length of stay and ASA score were related to continuous variables.

We included 66 children from a total of 106. Mean age was 53 months [SD: 46 months, range 8-184 months]. Successful day-surgery management was observed in 86% of cases. In 14% of cases, children were admitted to the pediatric ENT unit for the following reasons: late awakening in 6%, non-controlled pain in 4.5%, postoperative nausea and vomiting in 3.5% of cases. Univariate analysis did not observe any factor promoting success of day-surgery regarding anesthetic agents. Age was not statistically significant as a factor of ambulatory failure. Time spent in the operating room was not a determining factor (p = 0.559). None of the children were rehospitalized. Early unplanned consultations were observed in 3% of cases for vertex edema in 1 case and uncomplicated otorrhea in 1 case.

This study adds to the knowledge on pediatric cochlear implantation and suggests that this procedure is suitable for day-surgery at any age.

To assess the safety of cochlear implants (CIs) in children under 9 months of age to better understand expected postoperative complication rates, and to provide a preliminary look at efficacy.

Single-center retrospective review.

Tertiary referral center.

Children 5 to 8 months of age who received a CI between 2011 and 2021.

Therapeutic-CI.

The primary outcome was 6-month postoperative complication rate. Secondary outcomes included length of stay, device explantation/reimplantation, rehabilitation supports, and hearing and language outcomes. Complications of children implanted under than 9 months of age was compared with a cohort of children implanted 9 to 18 months of age between the years 2011 and 2016 using a chi-squared test ( p < 0.05).

One hundred six children under 9 months of age were implanted (204 CIs) at a mean age of 6.6 months (range: 5-8). Postoperative complications occurred in 28 patients (26%) and were often minor. There were no mortalities. There was no statistically significant difference in complications, including reimplantation rates, between patients implanted under 9 months of age and those implanted 9 to 18 months of age. Speech discrimination outcomes were excellent, and mean spoken language outcomes were near normative for typically developing children.

Cochlear implantation can be a safe and effective treatment option for children 5 to 8 months of age. Early hearing screening and referral for infants to receive appropriate intervention will continue to play a critical role in optimizing speech and language outcomes.

This multi-center study examined the safety and effectiveness of cochlear implantation of children between 9 and 11 months of age. The intended impact was to support practice regarding candidacy assessment and prognostic counseling of pediatric cochlear implant candidates. Data in the clinical chart of children implanted at 9-11 months of age with Cochlear Ltd devices at five cochlear implant centers in the United States and Canada were included in analyses. The study included data from two cohorts implanted with one or two Nucleus devices during the periods of January 1, 2012-December 31, 2017 (Cohort 1, n = 83) or between January 1, 2018 and May 15, 2020 (Cohort 2, n = 50). Major adverse events (requiring another procedure/hospitalization) and minor adverse events (managed with medication alone or underwent an expected course of treatment that did not require surgery or hospitalization) out to 2 years post-implant were monitored and outcomes measured by audiometric thresholds and parent-reports on the IT-MAIS and LittlEARS questionnaires were collected. Results revealed 60 adverse events in 41 children and 227 ears implanted (26%) of which 14 major events occurred in 11 children; all were transitory and resolved. Improved hearing with cochlear implant use was shown in all outcome measures. Findings reveal that the procedure is safe for infants and that they show clear benefits of cochlear implantation including increased audibility and hearing development.

The development of language, memory and intellectual functions is linked to normal hearing and correct sounds interpretation. Hearing loss (HL), especially in its severe form, negatively affects the development of these functions. This prospective study aimed at comparing the Intelligent Quotients (IQ) of children with cochlear implants (CI) with the ones of people wearing hearing aids (HA) after one year of hearing rehabilitation. 21 subjects with severe/profound bilateral hearing loss (deafness) were included in this study. Eleven children with congenital profound HL underwent CI and ten children with moderate to severe HL (congenital and acquired) were rehabilitated by HA. Children's IQs were assessed at enrolment (T0) and 12 months after hearing aids/CI use plus speech therapy. Statistical analyses were performed to analyze the data within and between groups. Comparison of IQs showed no statistically significant differences between CI and HA none at T0 and T1. The subtests showed lower scores in verbal comprehension and process speed index in patients treated with HA when compared to CI. This study showed that auditory rehabilitation can support the normal development of cognitive function in children between six and eight years of age. The use of the correct hearing aids based on the patient's hearing thresholds is important to maximize the rehabilitation outcomes. Due to the small sample size, although stratified for age, our results must be considered preliminary and further analyses on larger samples are needed to confirm our data.