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Objectives: To assess skills in inferences during conversations and in metaphors comprehension of unilaterally cochlear implanted children with adequate abilities at the formal language tests, comparing them with well-matched hearing peers; to verify the influence of age of implantation on overall skills., Methods: The study was designed as a matched case-control study. 31 deaf children, unilateral cochlear implant users, with normal linguistic competence at formal language tests were compared with 31 normal hearing matched peers. Inferences and metaphor comprehension skills were assessed through the Implicit Meaning Comprehension, Situations and Metaphors subtests of the Italian Standardized Battery of "Pragmatic Language Skills MEDEA". Differences between patient and control groups were tested by the Mann-Whitney U test. Correlations between age at implantation and time of implant use with each subtest were investigated by the Spearman rank correlation coefficient., Results: No significant differences between the two groups were found in inferencing skills (p=0.24 and p=0.011 respectively for Situations and Implicit Meaning Comprehension). Regarding figurative language, unilaterally cochlear implanted children performed significantly below their normal hearing peers in Verbal Metaphor comprehension (p=0.001). Performances were related to age at implantation, but not with time of implant use., Conclusions: Unilaterally cochlear implanted children with normal language level showed responses similar to NH children in discourse inferences, but not in figurative language comprehension. Metaphors still remains a challenge for unilateral implant users and above all when they have not any reference, as demonstrated by the significant difference in verbal rather than figurative metaphors comprehension. Older age at implantation was related to worse performance for all items. These aspects, until now less investigated, had to receive more attention to deeply understand specific mechanisms involved and possible effects of different levels of figurative language complexity (presence or absence of contextual input, degree of transparency and syntactic frozenness). New insight is needed to orient programs in early intervention settings in considering and adequately responding to all these complex communicative need of children with hearing loss., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

The aim of the present study is to assess long-term outcomes of CI in prelingual deafened adolescents and adults, describing, where present, differences in performance, self perceived benefit and highlighting specific characteristics. Twenty-three patients were enrolled: 10 adolescents, 13 young adults. Each patient underwent speech perception/language development, psychological evaluation and structured interviews on self perception concerning CI. 70 % adolescents and 100 % adults used their cochlear implant for most of the day; two adolescents were partial users and one was a non-user. Adolescents' average word recognition and comprehension scores improved respectively from 7 to 29.8 % (p = 0.01) and 3 to 26 % (p = 0.1). Adults' average scores improved significantly from 1.5 to 41.9 % (p = 0.01) and from 18.5 to 52.7% (p = 0.001), respectively. None of the subjects showed a linguistic age adequate to the chronological one: average linguistic age was 7.6 years for adolescents and 19.3 for adults. Structured interviews showed improvement in self-esteem. Adults and most adolescents were fully or moderately satisfied with their implant. Cochlear implantation can be considered a valid option for the rehabilitation of highly motivated and well-selected pre-lingual deafened adolescents and adults. Although there is a substantial variability in both groups of patients and language skills are only marginally influenced by CI, there is still a significant improvement in speech perception. CI was described by both groups as having had a positive impact on their lives; nevertheless adolescents were the ones with a tendency to under-use CI, even those with better hearing outcomes.

Objective: To evaluate, with a long-term follow-up, the speech perception and language development in children with cytomegalovirus (CMV)-related deafness after cochlear implantation., Study Design: A retrospective study on CMV-related profound deafness and cochlear implantation was performed from 1995 to 2010. Six children with an average follow-up of 10 years were included in this research. Medical history, imaging, cognitive delay, speech perception and production data were reviewed., Results: Two of the 6 patients developed a functional language with the use of phrases and word sequences based on morphological and syntactic rules; the others demonstrated the development of a preverbal or transitional language with the use of single words only., Conclusion: Patients with CMV-related deafness benefit from cochlear implantation; however, the expectations of the parents must be evaluated in a series of counseling efforts prior to the surgery., (Copyright © 2012 S. Karger AG, Basel.)

The aim of the present study is to construct a reference model with the indication for the attitude, the requirements and the resources needed in order to be able to deal with deafness in the presence of disabilities or associated problems. The study group consisted of 13 adults and 18 children affected by profound deafness, with associated problems and disabilities, who were implanted with Clarion and Med-El devices. Selection criteria for candidacy to cochlear implantation and counselling, hospitalization, fitting and speech therapy/rehabilitation are described. Findings were assessed evaluating: (i) use of acoustic feedback, on the ground of Erber's model; (ii) self-sufficiency: assessed by a questionnaire; and (iii) social and family relationships: qualitative judgment based on direct observation, analysis of drawings and structured interviews with family, teachers and therapists. The whole group showed benefit from cochlear implantation, with particular satisfaction for post-lingual deaf-blind adults, as well as for subjects with associated psychopathologies and mental retardation. In conclusion, cochlear implants can improve life quality in profoundly deaf subjects with associated disabilities, increasing both listening and communication skills as well as self-sufficiency while family and social relationships tend to remain stable.

Objective: The auditory performance of cochlear implantees is linked to numerous variables, such as audiological characteristics, age and type of speech coding strategy. In recent years, many different ways of processing sounds have been developed, with possible implications for auditory performance. The purpose of this study was to evaluate the intra-individual differences of patients for speech perception tasks in quiet and in noise as a result of switching from a standard strategy [Continuous Interleaved Sampling (CIS)/Simultaneous Analog Strategy (SAS)] to Hi-Resolution (HiRes)., Material and Methods: A total of 14 post-lingual adults implanted with the Clarion CII were selected for trials. At switch-on, six patients chose a CIS strategy and eight an SAS strategy. After an average period of 9.3 months, all patients were switched over to HiRes. All patients were tested (open-set mode) with bisyllabic words and sentences, in both quiet and noise [speech/noise ratio (SNR) = +10]. Testing was carried out after an initial period with the CIS/SAS strategy and 3 months after switching over to HiRes., Results: After switch-over a significant improvement was seen for both speech in quiet (words +25.2%, sentences +10.8%) and speech in noise (words 44.8%, sentences 45.4%)., Conclusion: Despite individual differences, all patients improved their performance with HiRes use, the greatest improvements being seen under unfavourable listening conditions (SNR = +10). Subjective improvements in speech discrimination and overall sound quality perception were reported even after the first week of HiRes use.

Unlabelled: The paper is an attempt to answer the main questions raised by that part of the deaf community which still consider cochlear implants (CI) an attack against the psychophysical integrity of the pre-lingually deaf., Methods: The psychological well-being of six adolescents and six children was assessed pre- and post-implantation using various tools, i.e. projective tests, assessment scales (AS), and structured interviews with parents and teachers. The analysis of post-implant findings shows a reduction of stereotype elements, more dynamic modes of figurative expression, quite good relationships within their own social environment and gradual, positive integration both at home and at school. Cochlear implantation would seem to cause no psychological disruption. Our sample group show an improvement in their modes of expression--more consistent with the mental and effective age--and a greater awareness of personal limits, together with the ability to judge the appropriateness of their own behavior.

The aim was to extend the linguistic, social and cognitive aspects of communication skills. The method was to use meaningful contexts and to attribute new significance to errors. Methods used were phonetic games (to improve speech production) and exercises (to increase reading and writing skills). The results after 18 months of group rehabilitation are presented.

The reasons for which a group approach has been chosen for the small group rehabilitation of adolescent cochlear implant users are discussed. The most significant learning experiences after 18 months of treatment were the socialization of experience, the socialization of individual learning processes, the direct relationship between adolescents, practice discussion of topics of common interest, emphasizing of personal opinions and beliefs, experiencing collective 'products', the reinforcement of interpersonal relationships and the emphasizing of individual initiatives both at home and at school.

The relationship between the ENT specialist and the Deaf Community is discussed along with the relative role of the non-medical consultants who come into contact with this group of people. Suggestions are made to the clinician for a correct approach to deaf persons: acquisition of adeguate tools for communication and clear and understandable information. In this communication and clear and understandable information. In this context, the advent of Cochlear Implants and their impact on the Deaf Community are taken into consideration.

The aim of the present study is to construct a reference model with the indication for the attitude, the requirements and the resources needed in order to be able to deal with deafness in the presence of disabilities or associated problems. The study group consisted of 13 adults and 18 children affected by profound deafness, with associated problems and disabilities, who were implanted with Clarion® and Med-El® devices. Selection criteria for candidacy to cochlear implantation and counselling, hospitalization, fitting and speech therapy/rehabilitation are described. Findings were assessed evaluating: (i) use of acoustic feedback, on the ground of Erber's model; (ii) self-sufficiency: assessed by a questionnaire; and (iii) social and family relationships: qualitative judgment based on direct observation, analysis of drawings and structured interviews with family, teachers and therapists. The whole group showed benefit from cochlear implantation, with particular satisfaction for post-lingual deaf-blind adults, as well as for subjects with associated psychopathologies and mental retardation. In conclusion, cochlear implants can improve life quality in profoundly deaf subjects with associated disabilities, increasing both listening and communication skills as well as self-sufficiency while family and social relationships tend to remain stable. [ABSTRACT FROM AUTHOR]