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Children with hearing loss (HL) are at risk for a lower educational achievement. This longitudinal study compared the school career of a nationwide Dutch cohort with and without HL based on descriptive data of the governmental authority Statistics Netherlands. From 2008 to 2018, 3,367,129 children, of whom 1,193 used cochlear implants (CIs) and 8,874 used hearing aids (HAs), were attending primary and/or secondary education. Sixty-one percent of children with HL attended mainstream and 31% special primary education. Compared to mainstreamed pupils without HL, mainstreamed pupils with HL achieved lower levels for language and mathematics in primary education but eventually attended comparable types of secondary education. Children with HL attending special primary education attained lower types of secondary education compared to mainstreamed peers with and without HL. These findings suggest that future educational (and as a result professional) attainment of a child with HL depends on the type of primary educational setting., (© The Author(s) 2021. Published by Oxford University Press.)

One way to improve speech understanding in noise for HI with a unilateral hearing loss is by contralateral routing of signals (CROS). Such a CROS-system captures sounds with an additional microphone at the worst hearing ear and transmits these to the better one. The better ear is then provided with a mix of signals originating from both ears. The goal of this study is to quantify the effect of a CROS-system on speech reception thresholds (SRTs) with unilaterally implanted CI-users in diffuse and directional noise as a function of speaker location. Listening tests are performed and an accurate directional intelligibly model is proposed used for further analysis. In diffuse noise it is concluded that the use of a CROS system results in a maximum gain in SRT of 7.9 dB when speech comes from the CROS side compared to a maximum loss in SRT of 2.1 dB when speech comes from the implanted side. In the case of directional noise, the effect of the CROS is symmetric and the maximum loss or gain in SRT was around 9 dB. The study therefore shows a clear potential of using the CROS system in diffuse noise.

The purpose of this study was to examine several behavioral problems in school-aged hearing-impaired children with hearing aids or cochlear implants, compared to normally hearing children. Additionally, we wanted to investigate which sociodemographic, linguistic, and medical factors contributed to the level of behavioral problems, to pinpoint where targeted interventions can take place. This large, retrospective study included a sample of 261 school-aged children (mean age = 11.8 years, SD = 1.6), that consisted of three age- and gender-matched subgroups: 75 with hearing aids, 57 with cochlear implants, and 129 normally hearing controls. Self- and parent-reports concerning reactive and proactive aggression, delinquency, and symptoms of psychopathy, attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder were used. In addition, several language and intelligence tests were administered. Hearing-impaired children showed significantly more proactive aggression, symptoms of psychopathy, attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder than their normally hearing peers. More behavioral problems were associated with special schools for the deaf, sign (-supported) language, hearing aids (in contrast to cochlear implants), higher age, male gender, lower socioeconomic status, lower intelligence, and delayed language development. Hearing-impaired children face multiple problems regarding their behavior. The outcomes implicate that professionals should be aware of the higher risk of developing behavioral problems, in order to screen, detect, and treat in time. Furthermore, the associated risk and protective factors emphasize that clinicians must always consider the heterogeneity of the group of hearing-impaired children, in order to help and support the individual patient.

Objectives/hypothesis: The objectives of this study were to examine the levels of anxiety in hearing-impaired children with hearing aids or cochlear implants compared to normally hearing children, and to identify individual variables that were associated with differences in the level of anxiety., Study Design: Large retrospective cohort study., Methods: Self-reports and parent-reports concerning general anxiety, social anxiety, and generalized anxiety disorder were used. The study group (mean age, 11.8 years) consisted of three age-matched subgroups: 32 children with cochlear implants, 51 children with conventional hearing aids, and 127 children without hearing loss., Results: Levels of anxiety in children with cochlear implants and normally hearing children were similar. Early implantation was associated with lower levels of general and social anxiety. Remarkably, children with conventional hearing aids had higher levels of social anxiety, and their parents also reported more generalized anxiety disorder., Conclusions: The outcomes demonstrate that in their level of anxiety, children with cochlear implants might be more comparable to normally hearing children than to children with hearing aids. This positive finding can be the consequence of audiological factors or other aspects of the cochlear implant rehabilitation program., (Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.)

This study introduced a dual-masker forward masking technique and evaluated whether this objective method could measure electrode independency in a cochlear implant; more particularly, whether the optimal locations and number of active electrodes could be determined. This method further enabled the investigation of the efficacy of current steering, because the proposed recording method could also be described as applying a sequentially current steered masker. The paradigm requires 5 frames involving 2 maskers and 1 probe and is referred to as the Apple Core method (MP5-AC). For each recording, both the masker and probe amplitude were varied independently, producing 3-D eCAP plots that showed the eCAP amplitude for independent variations of masker and probe amplitudes. A simple quantitative model was developed to aid interpretation of the results. Theory and model were clinically tested in 14 patients. On the basis of the model, the multi-variate, color-coded plots could be subdivided into seven distinct regions, each depicting a unique relationship between the probe and the maskers. The model's predictions supported interpretation of the results, and indicated independence for the probe electrode contacts only at lower current levels and/or at greater inter-electrode separations. The clinical results revealed a lack of selectivity in the electrode array for stimulus levels larger than 600 microA. This suggests that sequential current steering is only capable of producing a single excitation area at higher current levels, or smaller electrode distances, without additional loudness correction being applied. Thus, the MP5-AC paradigm provided insight concerning the independence of electrodes and the efficacy of current steering in clinical patients. However, its current clinical applicability is limited because measurements were adequate only in anesthetized patients.

Objective: People with cochlear implants have severe problems with speech understanding in noisy surroundings. This study evaluates and quantifies the effect of two assistive directional microphone systems compared to the standard headpiece microphone on speech perception in quiet surroundings and in background noise, in a laboratory setting developed to reflect a situation whereby the listener is disturbed by a noise with a mainly diffuse character due to many sources in a reverberant room., Design: Thirteen postlingually deafened patients, implanted in the Leiden University Medical Centre with the Clarion CII device, participated in the study. An experimental set-up with 8 uncorrelated steady-state noise sources was used to test speech perception on monosyllabic words. Each subject was tested with a standard headpiece microphone, and the two assistive directional microphones, TX3 Handymic by Phonak and the Linkit array microphone by Etymotic Research. Testing was done in quiet at a level of 65 dB SPL and with decreasing signal-to-noise ratios (SNR) down to -15 dB., Results: Using the assistive directional microphones, speech recognition in background noise improved substantially and was not affected in quiet. At an SNR of 0 dB, the average CVC scores improved from 45% for the headpiece microphone to 67% and 62% for the TX3 Handymic and the Linkit respectively. Compared to the headpiece, the Speech Reception Threshold (SRT) improved by 8.2 dB SNR and 5.9 dB SNR for the TX3 Handymic and the Linkit respectively. The gain in SRT for TX3 Handymic and Linkit was neither correlated to the SRT score with headpiece nor the duration of CI-use., Conclusion: The speech recognition test in background noise showed a clear benefit from the assistive directional microphones for cochlear implantees compared to the standard microphone. In a noisy environment, the significant benefit from these assistive device microphones may allow understanding of speech with greater ease.