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[Effects of bimodal intervention on the development of auditory and speech ability in infants with unilateral
M P Huang1, H B Sheng1, Y Ren1
1Department of Otorhinolaryngology Head and Neck Surgery, Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200011, China.
Insights
Bimodal intervention, combining cochlear implants and hearing aids, significantly enhances auditory and speech development in infants with unilateral cochlear implantation. This approach offers superior outcomes compared to cochlear implants alone.
Area of Science:
- Pediatric Audiology
- Cochlear Implantation
- Speech-Language Pathology
Background:
- Infants with bilateral profound sensorineural hearing loss often receive unilateral cochlear implantation (CI).
- Optimizing auditory and speech development in these infants is crucial for long-term outcomes.
- Bimodal intervention (CI plus contralateral hearing aid) is a potential strategy to enhance auditory input.
Purpose of the Study:
- To investigate the impact of bimodal intervention on auditory and speech abilities in infants with unilateral CI.
- To compare the developmental trajectories of infants receiving unilateral CI versus bimodal intervention.
Main Methods:
- A cohort of 35 infants (0.7-2.8 years) with unilateral CI was divided into two groups: unilateral CI (n=15) and bimodal (n=20).
- Auditory and speech skills were assessed using IT-MAIS, MUSS, CAP, and SIR scores at multiple time points up to 24 months post-CI activation.
- Statistical analyses compared outcomes between the unilateral CI and bimodal intervention groups.
Main Results:
- The bimodal group demonstrated significantly higher IT-MAIS, CAP, MUSS, and SIR scores compared to the unilateral CI group at various post-activation intervals.
- Statistically significant improvements in auditory integration (IT-MAIS) and auditory performance (CAP) were observed earlier in the bimodal group.
- Enhanced speech production (MUSS) and intelligibility (SIR) were noted in the bimodal group, particularly at later assessment points (12-24 months).
Conclusions:
- Bimodal intervention is effective in promoting auditory and speech development in infants with unilateral cochlear implantation.
- This combined approach offers significant advantages over unilateral cochlear implantation alone for early auditory and speech rehabilitation.
- Contralateral hearing aid fitting alongside a unilateral cochlear implant can accelerate and improve developmental outcomes in young children.
Abstract:
Objective: To explore the effects of bimodal intervention on the development of auditory and speech ability in the infants with unilateral cochlear implantation(CI). Methods: Total 35 bilateral profound sensorineural hearing loss infants with unilateral CI, aged 0.7 to 2.8 years old, were selected. The subjects were divided into two groups: the group with unilateral CI(cochlear implant alone, n= 15), and the bimodal group with CI and contralateral fitting hearing aid(n= 20). Their auditory and speech abilities were estimated at the different time points after switch-on(the 0th, 0.5th, 1st, 3rd, 6th, 12th, 18th, and 24th month, respectively) using Infant Toddler-Meaningful Auditory Integration Scale(IT-MAIS), Meaningful Use of Speech Scale(MUSS), Categories of Auditory Performance(CAP), and Speech Intelligibility Rating(SIR) scores. Results: The IT-MAIS scores of bimodal group after switch-on were higher than unilateral CI group(the 0.5th, 1st, 3rd, 6th, 12th, and 18th month), the statistical significances were identified at the 0.5th, 1st, 3rd, 6th, and 12th month, respectively(P<0.05). The CAP scores of bimodal group before CI operation and after switch-on(the 0.5th, 1st, 3rd, 6th, 12th, 18th and 24th month)were higher than unilateral CI group, the statistical significances were seen at the 3rd, 6th, 12th, 18th and 24th month after switch-on(P<0.05). The MUSS scores of bimodal group after switch-on were higher than unilateral CI group(the 1st, 3rd, 6th, 12th, 18th and 24th month), the statistical significances were found at the 12th, 18th and 24th month, respectively(P<0.05). The SIR scores of bimodal group after switch-on were higher than unilateral CI group(the 3rd, 6th, 12th, 18th and 24th month), and significant differences appeared at the 12th, 18th and 24th month after switch-on(P<0.05). Conclusion: Bimodal intervention could be helpful to the development of auditory and speech ability of infants.
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