<div>Cochlear implants (CI) are sensory neuroprostheses capable of partially restoring hearing loss by electrically stimulating the auditory nerve to mimic normal hearing conditions. Despite their success and ongoing advances in both hardware and software, CI patients can still struggle to understand speech, most notably in complex auditory settings, also referred to as the cocktail party problem. Efforts to develop new CI algorithms to overcome this challenge rely on CI simulators and vocoders to test with normal hearing (NH) patients. However, recent studies have suggested that these tools fail to reproduce the stimuli perceived by CI patients. It is therefore critical to develop tools capable of producing better representations of the stimuli as perceived by CI patients. Thus, this work proposes a framework that incorporates physiological models of the peripheral auditory nerve. Using these models, the framework generates stimulations that elicit a neural response at the auditory nerve closer to that observed in NH conditions. Stimulations generated by the framework were evaluated by performing a vowel identification task. However, the task was performed by a classifier trained using deep learning techniques instead of a CI patient. These results give insight into how the framework could be applied for the development and validation of CI stimulation strategies.</div>

It is well-known that many people like to listen to music when they are running,something that is not always available for people with hearing aids [1].The experience of music is not often taken into account when people have lostparts of their hearing, but music is in many ways important for the well-being[2]. In this project has an application been developed, to make certain audioparameters accessible for adjustments according to the users individual hearing.The parameters chosen were latency, compression, balance and loudness. Theseparameters have been chosen with the argument that they have big impact onthe experience of the music. As an example there might be latency betweenthe hearing aids between the left and the right hearing. Very often people withhearing aids have different hearing at the left and the right ear, therefore thebalance was chosen as a parameter. Compression were chosen with respect tothe fact that hearing loss often leads to less capability to hear frequencies indifferent frequencies areas. Loudness was chosen due to that it is a subjectiveparameter, that will have different impact on different individuals. The parametershave been chosen with a hypothesis that they may affect the hearingexperience for different individuals. The result show that the participants changed audio settings, each of theaudio parameters to different values and appreciated the function to changethese parameters. The participants said that the application developed in thisproject, improved their music experience and they said that they would appreciateto use an application like this, to get more value of listening to music. Theapplication was well designed and easy to use during a sport session.

Children with sensorineural hearing loss may (re)gain hearing with a cochlear implant—a device that transforms sounds into electric pulses and bypasses the dysfunctioning inner ear by stimulating the auditory nerve directly with an electrode array. Many implanted children master the acquisition of spoken language successfully, yet we still have little knowledge of the actual input they receive with the implant and specifically which language sensitive cues they hear. This would be important however, both for understanding the flexibility of the auditory system when presented with stimuli after a (life-) long phase of deprivation and for planning therapeutic intervention. In rhythmic languages the general stress pattern conveys important information about word boundaries. Infant language acquisition relies on such cues and can be severely hampered when this information is missing, as seen for dyslexic children and children with specific language impairment. Here we ask whether children with a cochlear implant perceive differences in stress patterns during their language acquisition phase and if they do, whether it is present directly following implant stimulation or if and how much time is needed for the auditory system to adapt to the new sensory modality. We performed a longitudinal ERP study, testing in bimonthly intervals the stress pattern perception of 17 young hearing impaired children (age range: 9–50 months; mean: 22 months) during their first 6 months of implant use. An additional session before the implantation served as control baseline. During a session they passively listened to an oddball paradigm featuring the disyllable “baba,” which was stressed either on the first or second syllable (trochaic vs. iambic stress pattern). A group of age-matched normal hearing children participated as controls. Our results show, that within the first 6 months of implant use the implanted children develop a negative mismatch response for iambic but not for trochaic deviants, thus showing the same result as the normal hearing controls. Even congenitally deaf children show the same developing pattern. We therefore conclude (a) that young implanted children have early access to stress pattern information and (b) that they develop ERP responses similar to those of normal hearing children.

Objetivo: Identificar as contribuições tecnológicas do processador de fala Freedom® para pacientes implantados com Nucleus 22® e a satisfação dos usuários com a nova tecnologia. Entre os novos recursos disponíveis, foram analisados o efeito da tabela de alocação de frequências, o T-SPL e C-SPL e o ajuste de pré-processamento do som (ADRO®). Material: Este estudo foi prospectivo e exploratório. Foram incluídos adolescentes e adultos implantados com Nucleus 22® no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, usuários efetivos do processador de fala Spectra®, com alguma percepção de frases em contexto fechado e sem experiência anterior com a nova tecnologia. Foram selecionados 17 pacientes, entre as idades de 15 e 82 anos, e implantados há mais de oito anos. Para determinar a contribuição do Freedom®, os limiares auditivos e os testes de percepção de fala foram realizados com o último mapa utilizado com o Spectra® e comparados os mapas criados com o Freedom®. Para identificar o efeito da tabela de alocação de frequências, ambos os mapas convertidos (mesma tabela) e atualizados (tabela nova) foram programados. A tabela escolhida foi mantida, e foram realizados três mapas com diferentes parâmetros: o programa 1 (P1) com T-SPL de 30 dB e do C-SPL de 70 dB, programa 2 (P2) com T-SPL de 25 dB e do C-SPL de 65 dB, e o programa 3 (P3) com ADRO®. A ordem de apresentação dos mapas e dos testes foi randomizada. Para avaliar a satisfação com seus dispositivos auditivos foram utilizados os questionários SADL e APHAB após um mês e um ano de uso do Freedom®. Resultados: A contribuição do processador de fala Freedom® para pacientes usuários do Nucleus 22® foi estatisticamente superior em comparação com o Spectra® em todos os testes de percepção da fala e em todos os limiares audiométricos, tanto individualmente quanto em média, com exceção de 8000 Hz. Em relação à escolha da tabela de frequência, 64,7% dos pacientes (n=11) mantiveram o mapa com a tabela de frequências do Spectra®. Comparando os mapas com diferentes T-SPL e C-SPL, houve diferença estatística tanto nos limiares audiométricos de 500, 1000, 1500 e 2000 Hz quanto na média. Não houve diferença estatística entre os testes de fala com ou sem o uso do ADRO®. Os questionários de satisfação mostraram uma melhora estatisticamente significativa, apenas na subescala que avalia o desempenho em ambiente ruidoso e uso do telefone. Conclusão: A tecnologia contribuiu no desempenho de percepção de fala e nos limiares audiométricos dos pacientes usuários de Nucleus22®. A maioria manteve a tabela de frequência original. As mudanças nos parâmetros de T-SPL e C-SPL mostraram uma melhora dos limiares audiométricos nas frequências principais da fala. As diferenças significantes foram sutis nos questionários de satisfação, demonstrando que os pacientes já estavam adaptados e satisfeitos com o implante coclear / Objective: To identify the technological contributions of the Freedom® speech processor to the patients implanted with Nucleus 22® and the satisfaction of users of the new technology. Among the new features available, we focused on the effect of the frequency allocation table, the T-SPL and C-SPL and the pre-processing gain adjustments (ADRO®). Methods: This study was prospective and exploratory. It included teenage and adult patients implanted with Nucleus 22® who effectively used the implant with no previous experience with the new technology and had at least some speech recognition on a closed set with the Spectra® processor. Seventeen patients met the inclusion criteria, ranging in age from 15 to 82 years and deployed for over 8 years. To determine the contribution of the Freedom®, thresholds and speech perception tests were performed with the last map used with the Spectra® and the maps created for Freedom®. To identify the effect of the frequency allocation table, both converted (same table) and upgraded (new table) maps were programmed. The table selected is maintained, and maps were performed with three different parameters: the first program (P1) was programmed with 30 dB T-SPL and 70 dB C-SPL; the second program (P2) with was programmed with 25 dB T-SPL and 65 dB C-SPL; and the program 3 (P3) with ADRO®. The order of presentation of the maps and the testing was randomized. To assess satisfaction were used SADL and APHAB after one moth and one year of using the Freedom®. Results: The contribution of the Freedom® speech processor to patients with the Nucleus 22® was statistically superior compared to the Spectra® in all tests of speech perception and in all audiometric thresholds, both individually and on average, except for 8000 Hz. Regarding the choice of a frequency allocation table, 64.7% of patients (n=11) maintained the same map that had been used with the Spectra® processor. The sound field threshold was statistically significant at 500, 1000, 1500 and 2000 Hz with 25 dB T-SPL/ 65 dB C-SPL. The patients\' satisfaction there was a statistically significant improvement, only in the sub-scale of speech in noise abilities and telephone use. Conclusions: The Freedom® technology improved the performance of patients with the Nucleus 22®. Most of the patients retained the original frequency table. The changes in the parameters of T-SPL and C-SPL showed an improvement in the audiometric thresholds for the main frequencies of speech. Significant differences were subtle in questionnaires of satisfaction, demonstrating that patients were already adapted and satisfied with the cochlear implant

<p>Кохлеарна имплантација представља интервенцију којом се код деце са глувоћом и тешком до дубоком наглувошћу може обезбедити приступ звуку и сензорним информацијама путем слушног модалитета, у циљу рaзвоjа гoвoрнo-jeзичких и кoгнитивних пoтeнциjaла и укључивања у сoциjaлну срeдину. Услед мождане реорганизације као последице ране слушне депривације, и звучне стимулације путем кохлеарног импланта, која је ограниченог квалитета, значајан број деце са кохлеарним имплантом не успева да сустигне своје вршњаке у говорно-језичком развоју, у когнитивном функционисању, различитим академским областима и социјалним компетенцијама. Циљеви истраживања су да се утврди ниво развијености егзекутивних функција и аритметичких вештина ученика са кохлеарним имплантом узраста у односу на вршњаке очуваног слуха, да се испита међусобна повезаност егзекутивних функција и аритметичких вештина и да ли на њих утичу узраст и дужина коришћења кохлеарног импланта. Истраживање је спроведено као студија пресека током 2016. и 2017. године, у Клиничком центру Војводине, Клиника за болести уха, грла и носа у Новом Саду; Клиничком центру Србије, ОРЛ одсек за аудиолошку рехабилитацију у Београду; две школе за образовање деце са сметњама у развоју и три редовне школе. Узорак је чинило 46 ученика са кохлеарним имплантом, узраста од 9 до 16 година (АС 12;11, СД 2;1) и 114 ученика очуваног слуха (АС 12;9, СД 1;10).<br />У истраживању су примењени: тестови за испитивање егзекутивних функција (Тест прављења трага у боји за децу &ndash; Children Color Trail Making Test (CCTT), Распон бројева унапред и уназад, Визуелни распон меморије, Тест вербалне флуентности, Тест пет тачака &ndash; Five-Point Test, Шифра, Карте са променом правила) и Упитник за процену егзекутивних функција на основу понашања &ndash; Behavior rating inventory of executive function, BRIEF; тестови за процену аритметичких вештина (суптест Рачунање и тест Математичка флуентност), као и општи упитник са социо-демографским, социо-економским карактеристикама и упитник о подацима у вези са глувоћом и уградњом кохлеарног импланта и начином комуникације за ученике са кохлеарним имплантом. Према резултатима у нашем истраживању, код ученика са кохлеарним имплантом су забележена лошија постигнућа у области Вербалних (F = 119,44, p = 0,000) и Невербалних (F = 14,857, p = 0,000) аспекара егзекутивних функција у односу на ученике очуваног слуха. Испитиване групе се нису разликовале у односу на Аспект понашања. У области аритметичких вештина, ученици са кохлеарним имплантом су постигли лошије резултате у односу на ученике очуваног слуха и на суптесту Рачунање (F = 42,172, p = 0,000) и на тесту Математичке флуентности (F = 24,070, p = 0,000). Резултати показују да се сви аспекти егзекутивних функција налазе у позитивној корелацији са аритметичким вештинама ученика са кохлеарним имплантом. Хијерархијском регресионом анализом је утврђено да су егзекутивне функције предиктори нивоа развијености аритметичких вештина, при чему концептуално и процедурално знање из аритметике више предвиђају Вербални аспекти егзекутивних функција, а декларативно знање Невербални аспекти егзекутивних функција. Узраст ученика са кохлеарним имплантом позитивно је повезан са Вербалним и Невербалним аспектима егзекутивних функција, али не и са Аспектом понашања. Узраст ученика такође корелира и са постигнућима из аритметике, док је дужина коришћења кохлеарног импланта, након контролисања узраста, у позитивној корелацији једино са постигнућима на суптесту Рачунање. Нижи ниво развијености егзекутивних функција и аритметичких вештина ученика са кохлеарним имплантом у односу на ученике очуваног слуха, намеће потребу да се поред подршке у говорно-језичком развоју, обезбеди и праћење и подршка како у развоју егзекутивних функција, тако и у академским областима, као што је математика. Успешна рехабилитација и образовање захтевају сагледавање целокупног развоја и функционисања ученика са кохлеарним имплантом, како би им се омогућило да остваре своје максималне потенцијале и искористе све предности које кохлеарни имплант пружа. очуваног слуха, намеће потребу да се поред подршке у говорно-језичком развоју, обезбеди и праћење и подршка како у развоју егзекутивних функција, тако и у академским областима, као што је математика. Успешна рехабилитација и образовање захтевају сагледавање целокупног развоја и функционисања ученика са кохлеарним имплантом, како би им се омогућило да остваре своје максималне потенцијале и искористе све предности које кохлеарни имплант пружа.</p> / <p>Kohlearna implantacija predstavlja intervenciju kojom se kod dece sa gluvoćom i teškom do dubokom nagluvošću može obezbediti pristup zvuku i senzornim informacijama putem slušnog modaliteta, u cilju razvoja govorno-jezičkih i kognitivnih potencijala i uključivanja u socijalnu sredinu. Usled moždane reorganizacije kao posledice rane slušne deprivacije, i zvučne stimulacije putem kohlearnog implanta, koja je ograničenog kvaliteta, značajan broj dece sa kohlearnim implantom ne uspeva da sustigne svoje vršnjake u govorno-jezičkom razvoju, u kognitivnom funkcionisanju, različitim akademskim oblastima i socijalnim kompetencijama. Ciljevi istraživanja su da se utvrdi nivo razvijenosti egzekutivnih funkcija i aritmetičkih veština učenika sa kohlearnim implantom uzrasta u odnosu na vršnjake očuvanog sluha, da se ispita međusobna povezanost egzekutivnih funkcija i aritmetičkih veština i da li na njih utiču uzrast i dužina korišćenja kohlearnog implanta. Istraživanje je sprovedeno kao studija preseka tokom 2016. i 2017. godine, u Kliničkom centru Vojvodine, Klinika za bolesti uha, grla i nosa u Novom Sadu; Kliničkom centru Srbije, ORL odsek za audiološku rehabilitaciju u Beogradu; dve škole za obrazovanje dece sa smetnjama u razvoju i tri redovne škole. Uzorak je činilo 46 učenika sa kohlearnim implantom, uzrasta od 9 do 16 godina (AS 12;11, SD 2;1) i 114 učenika očuvanog sluha (AS 12;9, SD 1;10).<br />U istraživanju su primenjeni: testovi za ispitivanje egzekutivnih funkcija (Test pravljenja traga u boji za decu &ndash; Children Color Trail Making Test (CCTT), Raspon brojeva unapred i unazad, Vizuelni raspon memorije, Test verbalne fluentnosti, Test pet tačaka &ndash; Five-Point Test, Šifra, Karte sa promenom pravila) i Upitnik za procenu egzekutivnih funkcija na osnovu ponašanja &ndash; Behavior rating inventory of executive function, BRIEF; testovi za procenu aritmetičkih veština (suptest Računanje i test Matematička fluentnost), kao i opšti upitnik sa socio-demografskim, socio-ekonomskim karakteristikama i upitnik o podacima u vezi sa gluvoćom i ugradnjom kohlearnog implanta i načinom komunikacije za učenike sa kohlearnim implantom. Prema rezultatima u našem istraživanju, kod učenika sa kohlearnim implantom su zabeležena lošija postignuća u oblasti Verbalnih (F = 119,44, p = 0,000) i Neverbalnih (F = 14,857, p = 0,000) aspekara egzekutivnih funkcija u odnosu na učenike očuvanog sluha. Ispitivane grupe se nisu razlikovale u odnosu na Aspekt ponašanja. U oblasti aritmetičkih veština, učenici sa kohlearnim implantom su postigli lošije rezultate u odnosu na učenike očuvanog sluha i na suptestu Računanje (F = 42,172, p = 0,000) i na testu Matematičke fluentnosti (F = 24,070, p = 0,000). Rezultati pokazuju da se svi aspekti egzekutivnih funkcija nalaze u pozitivnoj korelaciji sa aritmetičkim veštinama učenika sa kohlearnim implantom. Hijerarhijskom regresionom analizom je utvrđeno da su egzekutivne funkcije prediktori nivoa razvijenosti aritmetičkih veština, pri čemu konceptualno i proceduralno znanje iz aritmetike više predviđaju Verbalni aspekti egzekutivnih funkcija, a deklarativno znanje Neverbalni aspekti egzekutivnih funkcija. Uzrast učenika sa kohlearnim implantom pozitivno je povezan sa Verbalnim i Neverbalnim aspektima egzekutivnih funkcija, ali ne i sa Aspektom ponašanja. Uzrast učenika takođe korelira i sa postignućima iz aritmetike, dok je dužina korišćenja kohlearnog implanta, nakon kontrolisanja uzrasta, u pozitivnoj korelaciji jedino sa postignućima na suptestu Računanje. Niži nivo razvijenosti egzekutivnih funkcija i aritmetičkih veština učenika sa kohlearnim implantom u odnosu na učenike očuvanog sluha, nameće potrebu da se pored podrške u govorno-jezičkom razvoju, obezbedi i praćenje i podrška kako u razvoju egzekutivnih funkcija, tako i u akademskim oblastima, kao što je matematika. Uspešna rehabilitacija i obrazovanje zahtevaju sagledavanje celokupnog razvoja i funkcionisanja učenika sa kohlearnim implantom, kako bi im se omogućilo da ostvare svoje maksimalne potencijale i iskoriste sve prednosti koje kohlearni implant pruža. očuvanog sluha, nameće potrebu da se pored podrške u govorno-jezičkom razvoju, obezbedi i praćenje i podrška kako u razvoju egzekutivnih funkcija, tako i u akademskim oblastima, kao što je matematika. Uspešna rehabilitacija i obrazovanje zahtevaju sagledavanje celokupnog razvoja i funkcionisanja učenika sa kohlearnim implantom, kako bi im se omogućilo da ostvare svoje maksimalne potencijale i iskoriste sve prednosti koje kohlearni implant pruža.</p> / <p>Cochlear implantation is an intervention which enables children with deafness and severe to profound hearing loss an access to sound and sensory information via hearing modality, with the goal of developing speech-language and cognitive potentials and involvement in the social surroundings. Due to neural reorganization as a consequence of early auditory deprivation, and auditory stimulation via cochlear implant, which is of a limited quality, a significant number of children with cochlear implants cannot catch up to their peers in speech-language development, cognitive functioning, different academic areas and social competencies. The goals of the research are establishing the level of development of executive functions and arithmetic skills of students with cochlear implants compared to peers with healthy hearing, inquiring into the mutual connection of executive functions and arithmetic skills and whether age and the duration of use of cochlear implants produce a significant effect. The research was conducted in the form of a cross-sectional study during 2016 and 2017, in the Clinical Centre of Vojvodina, The Otorhinolaryngology Clinic in Novi Sad; Clinical Centre of Serbia, ORL department for audiological rehabilitation in Belgrade; two schools for education of children with developmental difficulties and three regular schools. The sample consisted of 46 students with cochlear implants, aged 3 to 16 years (M=12,11; SD=2,1) and 114 students with healthy hearing (M=12,9; SD= 1,10). For the purpose of the research, the following instruments were used: executive function tests (Children Color Trail Making Test (CCTT), Digits forward and backward, The Spatial Span test, Verbal Fluency test, the Five-Point Test, Code, and the Rule Shift Card Test) and Behavior Rating Inventory Of Executive Function (BRIEF); tests for the assessment of arithmetic skills (subtests Calculation and Mathematical Fluency), as well as a general questionnaire for socio-demographic, socio-economical characteristics and a questionnaire about information in regards to deafness and the implantation of the cochlear implant and modes of communication for students with cochlear implants. According to the results of this research, students with cochlear implants have lower achievement in the area of Verbal (F = 119,44, p = 0,000) and Nonverbal (F = 14,857, p = 0,000) aspects of executive functions compared to students of healthy hearing. The tested groups did not differ in the area of behavioral aspect. When it comes to arithmetic skills, students with cochlear implants had lower achievement compared to that of students with healthy hearing on both the Calculation subtest (F = 42,172, p = 0,000) and the subtest of Mathematical Fluency (F = 24,070, p = 0,000). Results show that all aspects of executive functions correlate positively with arithmetical skills of students with cochlear implants. Hierarchal regression analysis confirmed that executive functions predict the level of arithmetical skills development, where conceptual and procedural knowledge of arithmetic predicts the Verbal aspect of executive functions, while declarative knowledge predicts the Nonverbal aspect of executive functions. The age of students with cochlear implants is positively correlated to Verbal and Nonverbal aspects of executive functions, but not with the Behavioral aspect. The age of students also correlates with achievement in arithmetic, while the duration of use of cochlear implants, after controlling the age variable, is in correlation only with the achievement on the Calculation subtest. A lower level of development of executive functions and arithmetic skills of students with cochlear implants compared to students with healthy hearing emphasizes a need for establishing tracking and support, in addition to support in the speech-language development, for both the development of excutive functions and academic areas, such as mathematics. Successful rehabilitation and education demand an overview of complete development and the functioning of students with cochlear implants in order to enable them to achieve their maximum potential and harvest all the benefits of cochlear implants.</p>

Prosody can be characterized as the rhythm and the melody of speech. Prosodic features convey emotions, thoughts and geographic origins of each individual. Spoken language without prosody would be monotonous, without variations in loudness and rate. Children with cochlear implants perceive speech in a different way than children with normal hearing. Consequently the speech produced by a child with cochlear implants may sound different. The purpose of this study was to examine prosodic skills in Swedish children with cochlear implants and to compare them with the prosodic skills in Swedish children with normal hearing. The purpose of the study was also to examine differences between these two groups and to characterize those differences. Eight children with cochlear implants and eight controls matched to age, sex and regional accent were included in the study. The children’s production and perception of prosody was tested. The results show that there are differences in prosodic skills between the children with cochlear implants and their matched controls at word, phrase and discourse levels. The differences were significant in production but not in perception. Observed differences in the speech of the children with cochlear implants included omission of unstressed syllables and function words, difficulties producing contrast of tonal word accents and pro-longed maintenance of phonological processes. The study contributes to the knowledge about prosodic and linguistic skills in Swedish children with cochlear implants.

<p>Prosody can be characterized as the rhythm and the melody of speech. Prosodic features convey emotions, thoughts and geographic origins of each individual. Spoken language without prosody would be monotonous, without variations in loudness and rate. Children with cochlear implants perceive speech in a different way than children with normal hearing. Consequently the speech produced by a child with cochlear implants may sound different.</p><p>The purpose of this study was to examine prosodic skills in Swedish children with cochlear implants and to compare them with the prosodic skills in Swedish children with normal hearing. The purpose of the study was also to examine differences between these two groups and to characterize those differences.</p><p>Eight children with cochlear implants and eight controls matched to age, sex and regional accent were included in the study. The children’s production and perception of prosody was tested.</p><p>The results show that there are differences in prosodic skills between the children with cochlear implants and their matched controls at word, phrase and discourse levels. The differences were significant in production but not in perception. Observed differences in the speech of the children with cochlear implants included omission of unstressed syllables and function words, difficulties producing contrast of tonal word accents and pro-longed maintenance of phonological processes.</p><p>The study contributes to the knowledge about prosodic and linguistic skills in Swedish children with cochlear implants.</p>

Ett fåtal tidigare studier har visat att barn med cochleaimplantat (CI) har sämre förmåga till såväl ordflöde som verbalt analogiskt resonerande jämfört med normalhörande barn. Det finns ett förhållande mellan språk och analogiskt resonerande, men förhållandet mellan ordflödesförmåga och förmågan till analogiskt resonerande har inte undersökts tidigare för varken barn med CI eller normalhörande barn, vilket motiverar föreliggande studie. Syftet var att undersöka huruvida det finns skillnader mellan barn med CI och normalhörande barn vad gäller ordflöde och analogiskt resonerande. Studien syftade även till att undersöka förhållandet mellan ordflöde och analogiskt resonerande hos barn med CI respektive normalhörande barn. Nio barn med CI i åldrarna 6;4–8;2 år och en kontrollgrupp av trettio normalhörande barn i åldrarna 6;1–7;1 år medverkade. Ordflödesförmågan undersöktes med det fonologiska ordflödestestet FAS och det semantiska ordflödestestet Djur. Visuellt analogiskt resonerande undersöktes med AnimaLogica och verbalt analogiskt resonerande undersöktes med deltestet Auditiv analogi från Illinois Test of Psycholinguistic Abilities-3 (ITPA-3). I föreliggande studie har barnen med CI sämre ordflödesförmåga och analogiskt resonerande än de normalhörande barnen. Det finns ett samband mellan semantiskt ordflöde och verbalt analogiskt resonerande hos normalhörande barn, med ett liknande mönster hos barn med CI. Förmågan till ordflöde och analogiskt resonerande samt sambandet mellan dessa förmågor har klinisk relevans för logopeden i och med att detta blir ännu en aspekt att ta hänsyn till vid språkliga utredningar och behandlingar hos såväl normalhörande som barn med CI. / Previous studies have shown that children with cochlear implant (CI) have worse word fluency abilities and analogical reasoning abilities compared to normal-hearing children. There is a relationship between language and analogical reasoning. However, a possible relationship between word fluency and analogical reasoning has not been studied before among children with CI or among normal-hearing children. This warrants the present study, which aimed to examine if there are differences between children with CI and normal-hearing children regarding word fluency and analogical reasoning. The study also aimed to examine the relationship between word fluency and analogical reasoning in children with CI and normal-hearing children. The present study involved nine children with CI aged 6;4–8;2 years and thirty normal-hearing children aged 6;1–7;1 years. Word fluency was examined using the phonological word fluency test FAS and the semantic word fluency test Animal. Visual analogical reasoning was examined using AnimaLogica and verbal analogical reasoning using Spoken Analogies from Illinois Test of Psycholinguistic Abilities-3 (ITPA-3). The results of the present study show that the children with CI had poorer word fluency ability and analogical reasoning compared to the normal-hearing children. A relationship between semantic word fluency and verbal analogical reasoning in normal-hearing children was found, with the children with CI showing the same trend. Word fluency ability and analogical reasoning and their relationship has a clinical relevance for speech-language pathologists since this must be considered when investigating and treating language difficulties in children with CI as well as normal-hearing children.

Objetivo: Identificar as contribuições tecnológicas do processador de fala Freedom® para pacientes implantados com Nucleus 22® e a satisfação dos usuários com a nova tecnologia. Entre os novos recursos disponíveis, foram analisados o efeito da tabela de alocação de frequências, o T-SPL e C-SPL e o ajuste de pré-processamento do som (ADRO®). Material: Este estudo foi prospectivo e exploratório. Foram incluídos adolescentes e adultos implantados com Nucleus 22® no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, usuários efetivos do processador de fala Spectra®, com alguma percepção de frases em contexto fechado e sem experiência anterior com a nova tecnologia. Foram selecionados 17 pacientes, entre as idades de 15 e 82 anos, e implantados há mais de oito anos. Para determinar a contribuição do Freedom®, os limiares auditivos e os testes de percepção de fala foram realizados com o último mapa utilizado com o Spectra® e comparados os mapas criados com o Freedom®. Para identificar o efeito da tabela de alocação de frequências, ambos os mapas convertidos (mesma tabela) e atualizados (tabela nova) foram programados. A tabela escolhida foi mantida, e foram realizados três mapas com diferentes parâmetros: o programa 1 (P1) com T-SPL de 30 dB e do C-SPL de 70 dB, programa 2 (P2) com T-SPL de 25 dB e do C-SPL de 65 dB, e o programa 3 (P3) com ADRO®. A ordem de apresentação dos mapas e dos testes foi randomizada. Para avaliar a satisfação com seus dispositivos auditivos foram utilizados os questionários SADL e APHAB após um mês e um ano de uso do Freedom®. Resultados: A contribuição do processador de fala Freedom® para pacientes usuários do Nucleus 22® foi estatisticamente superior em comparação com o Spectra® em todos os testes de percepção da fala e em todos os limiares audiométricos, tanto individualmente quanto em média, com exceção de 8000 Hz. Em relação à escolha da tabela de frequência, 64,7% dos pacientes (n=11) mantiveram o mapa com a tabela de frequências do Spectra®. Comparando os mapas com diferentes T-SPL e C-SPL, houve diferença estatística tanto nos limiares audiométricos de 500, 1000, 1500 e 2000 Hz quanto na média. Não houve diferença estatística entre os testes de fala com ou sem o uso do ADRO®. Os questionários de satisfação mostraram uma melhora estatisticamente significativa, apenas na subescala que avalia o desempenho em ambiente ruidoso e uso do telefone. Conclusão: A tecnologia contribuiu no desempenho de percepção de fala e nos limiares audiométricos dos pacientes usuários de Nucleus22®. A maioria manteve a tabela de frequência original. As mudanças nos parâmetros de T-SPL e C-SPL mostraram uma melhora dos limiares audiométricos nas frequências principais da fala. As diferenças significantes foram sutis nos questionários de satisfação, demonstrando que os pacientes já estavam adaptados e satisfeitos com o implante coclear / Objective: To identify the technological contributions of the Freedom® speech processor to the patients implanted with Nucleus 22® and the satisfaction of users of the new technology. Among the new features available, we focused on the effect of the frequency allocation table, the T-SPL and C-SPL and the pre-processing gain adjustments (ADRO®). Methods: This study was prospective and exploratory. It included teenage and adult patients implanted with Nucleus 22® who effectively used the implant with no previous experience with the new technology and had at least some speech recognition on a closed set with the Spectra® processor. Seventeen patients met the inclusion criteria, ranging in age from 15 to 82 years and deployed for over 8 years. To determine the contribution of the Freedom®, thresholds and speech perception tests were performed with the last map used with the Spectra® and the maps created for Freedom®. To identify the effect of the frequency allocation table, both converted (same table) and upgraded (new table) maps were programmed. The table selected is maintained, and maps were performed with three different parameters: the first program (P1) was programmed with 30 dB T-SPL and 70 dB C-SPL; the second program (P2) with was programmed with 25 dB T-SPL and 65 dB C-SPL; and the program 3 (P3) with ADRO®. The order of presentation of the maps and the testing was randomized. To assess satisfaction were used SADL and APHAB after one moth and one year of using the Freedom®. Results: The contribution of the Freedom® speech processor to patients with the Nucleus 22® was statistically superior compared to the Spectra® in all tests of speech perception and in all audiometric thresholds, both individually and on average, except for 8000 Hz. Regarding the choice of a frequency allocation table, 64.7% of patients (n=11) maintained the same map that had been used with the Spectra® processor. The sound field threshold was statistically significant at 500, 1000, 1500 and 2000 Hz with 25 dB T-SPL/ 65 dB C-SPL. The patients\' satisfaction there was a statistically significant improvement, only in the sub-scale of speech in noise abilities and telephone use. Conclusions: The Freedom® technology improved the performance of patients with the Nucleus 22®. Most of the patients retained the original frequency table. The changes in the parameters of T-SPL and C-SPL showed an improvement in the audiometric thresholds for the main frequencies of speech. Significant differences were subtle in questionnaires of satisfaction, demonstrating that patients were already adapted and satisfied with the cochlear implant

Children with sensorineural hearing loss may (re)gain hearing with a cochlear implant—a device that transforms sounds into electric pulses and bypasses the dysfunctioning inner ear by stimulating the auditory nerve directly with an electrode array. Many implanted children master the acquisition of spoken language successfully, yet we still have little knowledge of the actual input they receive with the implant and specifically which language sensitive cues they hear. This would be important however, both for understanding the flexibility of the auditory system when presented with stimuli after a (life-) long phase of deprivation and for planning therapeutic intervention. In rhythmic languages the general stress pattern conveys important information about word boundaries. Infant language acquisition relies on such cues and can be severely hampered when this information is missing, as seen for dyslexic children and children with specific language impairment. Here we ask whether children with a cochlear implant perceive differences in stress patterns during their language acquisition phase and if they do, whether it is present directly following implant stimulation or if and how much time is needed for the auditory system to adapt to the new sensory modality. We performed a longitudinal ERP study, testing in bimonthly intervals the stress pattern perception of 17 young hearing impaired children (age range: 9–50 months; mean: 22 months) during their first 6 months of implant use. An additional session before the implantation served as control baseline. During a session they passively listened to an oddball paradigm featuring the disyllable “baba,” which was stressed either on the first or second syllable (trochaic vs. iambic stress pattern). A group of age-matched normal hearing children participated as controls. Our results show, that within the first 6 months of implant use the implanted children develop a negative mismatch response for iambic but not for trochaic deviants, thus showing the same result as the normal hearing controls. Even congenitally deaf children show the same developing pattern. We therefore conclude (a) that young implanted children have early access to stress pattern information and (b) that they develop ERP responses similar to those of normal hearing children.