Average Reviews:
(More customer reviews)As a Speech and Language Therapist working with preschool deaf and partially hearing children, I found this book fascinating reading. I ploughed through its jargon and statistics from cover to cover, wanting to demystify the contents for families. I found out two main things:
What the research shows: After any residual hearing in an ear is destroyed during cochlear implant surgery, that implanted ear provides speech understanding, on average, like an ear with a 100-110dB hearing loss (at best, an equivalent of about 77dB hearing loss, at worst no speech perception). Speech intelligibility is also on average like that of a person with a 100-110dB hearing loss. Cochlear implants are therefore, by my reckoning, worth considering for children with hearing losses greater than 110dB. Powerful hearing aids seem to offer about as much speech/language benefit as implants to other profoundly hearing-impaired children.
Complications occur in between 1% (according to the first author in Chapter 9, who appears be ignoring his own data) and 10% (according to Article 9D) of implant patients, depending on what you call a complication. Prior to March 1998, data provided by two manufacturers presented indicate a 10.36% complication rate in Clarion implants in children, and a 14.68% complication rate in Nucleus implants in both children and adults. Complications included healing problems, dizziness, pain, facial nerve stimulation, extrusion of the device, migration of the electrode array and electrode array damage. 3% of adults and 4.7% of children with Clarion implants required re-implantation (equivalent Nucleus figures are not quoted). Article 9A reports 'no mortality, meningitis or facial palsies were registered in our series' (p176).
The critical period for language-learning appears to be drawing to a close at around age 6. This, I would suggest, allows time for 2-year-old children to try out hearing aids for an extended period, and still get an implant well within the critical period, if hearing aids provide no language benefit.
This book is dismissive of sign language, and many authors seem to be trying unconvincingly to substantiate the use of 'oral' education methods. Only one author (in chapter 14) refers to another text which discusses the body of research indicating that natural sign language (e.g. Auslan here in Australia, ASL in the US) actually assists deaf children with their oral language and literacy skill development.
Article 12B discusses a 1996 parent survey in the US and Canada, which was sent to 2626 parents of children with cochlear implants, with 1008 replies. 49.3 of the children still using their implants (9 children were not) were enrolled full-time in mainstream classes; 25% were in special classes for hearing-impaired children. 75.3% were in the same class level as other children their own age. The other 24.7% of children had school delays from 1-6 years, averaging 1.5 years. 53.1% of children used auditory/spoken language as their primary means of communication.
What the book says the research shows: A lot of the book's research into language outcomes of cochlear implants is poorly designed and controlled, uses questionable measures (e.g. speech perception tests done in an audiology suite, but no information about a child's actual communication skills at home or at preschool) and inflated 'improvement/growth/rate of learning' figures rather than children's actual test scores. These design flaws are generally glossed over or dismissed e.g. 'The usual confounding issues of device/strategy, age at implantation and length of deafness did exist' (p204). The large quantity of badly designed research proves very little, but there are a few delightful 'findings' such as 'children in both the early CI and late CI groups identified lexically easy words with significantly greater accuracy than lexically hard words (P
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Packed with new, previously unpublished data, this comprehensive reference covers all aspects of cochlear implantation and related sciences for the many specialists working in the field. You will find an emphasis on the most recent developments in basic and clinical sciences, including: the effects of electrical stimulation; processing capabilities; preoperative criteria; medical, surgical and radiological issues; device programming; rehabilitation; and education. Plus, you will benefit from the experience of an outstanding team of interdisciplinary experts, who share insights on: * The full continuum of care in cochlear implantation in adults and children -- combining basic principles and theory with practical clinical management* Complete sections on hair cell regeneration, deprivation and effects of electrical stimulation* Full section on cochlear implant imaging -- never available before* New perspective on outcomes measurement* Future directions in implant design and processing strategiesComplete with in-depth discussions of language development and speech production, COCHLEAR IMPLANTS is a highly useful professional tool for audiologists, otolaryngologists and speech-language pathologists who work with this challenging patient population. Its wide, balanced, and expert perspective on the issues affecting the field is unique in the literature.
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