Information about CI as an adult

[Kaitin]

I need information about CI success or failure in adults who were born with severe HoH. Can anyone help?

And I found this and have questions - Can anyone answer please?:

From Study of the Performance of Four Prelinguistically or Perilinguistically Deaf Patients With a Multi-Electrode, Intracochlear Implant.

Independent Papers
Laryngoscope. 102(7):797-806, July 1992.
Skinner, Margaret W. PhD 1; Binzer, Susan M. MA 1; Fears, Beverly T. MS 1; Holden, Timothy A. BS 1; Jenison, Virginia W. MA 1; Nettles, Elizabeth J. PhD 2

Individuals who are born deaf or become deaf in early childhood and are implanted as adults (or in late adolescence) with a multi-electrode, intracochlear implant often cannot understand speech by audition alone. Test results of four implanted patients were analyzed to determine 1. if there was a difference in performance between patients; 2. if there was a relation between performance and history of auditory stimulation; and 3. which tests revealed performance differences. On audition-only and audition-plus-vision tests, overall performance was rank-ordered from lowest to highest for patients 1,2,3, and 4, respectively. Patient 4 recognized a few words audition-only. Patients 1 and 2 had long periods of no auditory stimulation; patients 3 and 4 had long periods of auditory stimulation with hearing aids prior to implantation. Tests not revealing differences in performance were identified.

"often cannot understand speech by audition alone" = must lipread with CI?

---

From Cochlear Implantation in Adults with Prelingual Deafness. Part I. Clinical Results.

Triological Society Papers
Laryngoscope. 114(9):1536-1540, September 2004.
Wooi Teoh, Su MD; Pisoni, David B. PhD; Miyamoto, Richard T. MD

Abstract:
Objectives/Hypothesis: To examine the hypothesis that the newer generations of cochlear implants could provide considerable speech understanding to late-implanted, prelingually deaf adult patients.

Study Design: Retrospective review.

Methods: Speech perception scores of 103 patients with long-term prelingual deafness obtained from the recent clinical trials were compared with other previously published results.

Results: Unlike patients receiving implants in early childhood, the audiologic performance of most patients with long-term prelingual deafness rapidly approached asymptotic levels within 1 year after implantation. Beginning at 3 months postimplantation, statistically significant improvement was noted in their speech perception scores compared with their preimplant levels. However, the average performance plateau achieved by this group of patients was significantly below the levels published for postlingual patients. No statistically significant differences were observed between the test scores at any testing interval among patients with different devices.

Conclusions: Most patients with long-term prelingual deafness achieve their performance plateau within 1 year after implantation. The results suggest that patient characteristics, rather than device properties, are likely to be the major contributing factor responsible for the observed audiologic outcomes.

"patient characteristics" = how hard you try with CI or level of hearing before CI or what? Many threads say CI success is most from the person's work - really? Not age or amount of hearing loss? What is the "work"?



Edit to add: My (hearing) roommate is helping with the thread - full disclosure.

 

[jillio]

I need information about CI success or failure in adults who were born with severe HoH. Can anyone help?

And I found this and have questions - Can anyone answer please?:

From Study of the Performance of Four Prelinguistically or Perilinguistically Deaf Patients With a Multi-Electrode, Intracochlear Implant.

Independent Papers
Laryngoscope. 102(7):797-806, July 1992.
Skinner, Margaret W. PhD 1; Binzer, Susan M. MA 1; Fears, Beverly T. MS 1; Holden, Timothy A. BS 1; Jenison, Virginia W. MA 1; Nettles, Elizabeth J. PhD 2

Individuals who are born deaf or become deaf in early childhood and are implanted as adults (or in late adolescence) with a multi-electrode, intracochlear implant often cannot understand speech by audition alone. Test results of four implanted patients were analyzed to determine 1. if there was a difference in performance between patients; 2. if there was a relation between performance and history of auditory stimulation; and 3. which tests revealed performance differences. On audition-only and audition-plus-vision tests, overall performance was rank-ordered from lowest to highest for patients 1,2,3, and 4, respectively. Patient 4 recognized a few words audition-only. Patients 1 and 2 had long periods of no auditory stimulation; patients 3 and 4 had long periods of auditory stimulation with hearing aids prior to implantation. Tests not revealing differences in performance were identified.

"often cannot understand speech by audition alone" = must lipread with CI?

---

From Cochlear Implantation in Adults with Prelingual Deafness. Part I. Clinical Results.

Triological Society Papers
Laryngoscope. 114(9):1536-1540, September 2004.
Wooi Teoh, Su MD; Pisoni, David B. PhD; Miyamoto, Richard T. MD

Abstract:
Objectives/Hypothesis: To examine the hypothesis that the newer generations of cochlear implants could provide considerable speech understanding to late-implanted, prelingually deaf adult patients.

Study Design: Retrospective review.

Methods: Speech perception scores of 103 patients with long-term prelingual deafness obtained from the recent clinical trials were compared with other previously published results.

Results: Unlike patients receiving implants in early childhood, the audiologic performance of most patients with long-term prelingual deafness rapidly approached asymptotic levels within 1 year after implantation. Beginning at 3 months postimplantation, statistically significant improvement was noted in their speech perception scores compared with their preimplant levels. However, the average performance plateau achieved by this group of patients was significantly below the levels published for postlingual patients. No statistically significant differences were observed between the test scores at any testing interval among patients with different devices.

Conclusions: Most patients with long-term prelingual deafness achieve their performance plateau within 1 year after implantation. The results suggest that patient characteristics, rather than device properties, are likely to be the major contributing factor responsible for the observed audiologic outcomes.

"patient characteristics" = how hard you try with CI or level of hearing before CI or what? Many threads say CI success is most from the person's work - really? Not age or amount of hearing loss? What is the "work"?



Edit to add: My (hearing) roommate is helping with the thread - full disclosure.

Yes, understanding without audition alone would refer to added visual cues such as lip reading and possibly sign.

Patient characteristics are variables such as those which allow some profoundly deaf to understand speech with even HA, while another person with similar patterns and ranges of loss may not be able to understand speech with HA. These variables are largely unknown and unaccounted for, and are considered to be extraneous and largely not measurable, but they do affect the results being measured.

In the conflicting findings of these two articles, you might want to consider that the first is an independent paper (unbiased as they have nothing to gain from the results reported) and the second is a professional journal for ENTs (biased in the sense that the otolaryngoglogy profession as a whole has something to gain from the results reported). That isn't to say that the results have been tampered with, but simply to say that the research design may have been such that the results obtained were more likely from the design chosen. Nor am I saying that the research is invalid, but simply showing you a way to critically analyze the research.

LOL on your full disclosure statement!

 

[Kaitin]

, Jillio - I hoped you answer!

Your reply is very helpful. I need to think about article strength more - good point. I had a entire class on reading science papers and abstract (SO painful :Ohno: - worst class ever but useful), but I don't think about this when reading often - hard enough to even know just good result or bad or any result sometimes.

Many articles say I think for me "with CI the hearing is better in a adult but maybe not for YOU - we don't know".

LOL on your full disclosure statement!

:P Now I say "full disclosure" so in the future I can be on The Supreme Court - no problem!

 

[jillio]

, Jillio - I hoped you answer!

Your reply is very helpful. I need to think about article strength more - good point. I had a entire class on reading science papers and abstract (SO painful :Ohno: - worst class ever but useful), but I don't think about this when reading often - hard enough to even know just good result or bad or any result sometimes.

Many articles say I think for me "with CI the hearing is better in a adult but maybe not for YOU - we don't know".



:P Now I say "full disclosure" so in the future I can be on The Supreme Court - no problem!

As always, you are very welcome. I jsut pointed out the part about bias because I have seen so many people quote research and claim that it is definitive and the last word without even checking the possible bias of the publishing or writing source. If we want to truly decide how valuable it is to us, and for our purposes, we need to be aware of that.

I would support your Supreme Court nomination. We could use some free thinkers on the panel of judges!

 

[shel90]

As always, you are very welcome. I jsut pointed out the part about bias because I have seen so many people quote research and claim that it is definitive and the last word without even checking the possible bias of the publishing or writing source. If we want to truly decide how valuable it is to us, and for our purposes, we need to be aware of that.

I would support your Supreme Court nomination. We could use some free thinkers on the panel of judges!

In my Foundations of Research class, we were taught to be careful about reading research papers and their validity of it. At the time, it was so complicated to me! LOL!

 

[deafskeptic]

Although I don't have a four year degree or anything like that, much of what I learned about research had to be self taught. I know better than to use Wiki for research purposes. It's good for an general overview of things but not so great for in depth stuff. Also because anyone can edit and post the info, you do have to take it with a grain of salt.

But I'm a bit suprised that people would think the results of research is always the last word; it always seemed clear to me that research is never definative. One also has to account for bias and factor that into your research or it can skew scienfic findings. The AG Bell site or a Pro ASL site is not what I'd call an unbiased site. I'll be the first to admit to a bias toward ASL. I think Jillio or Shel90 mentioned a deaf ed site that's neutural toward both but I forget the name I wish I could remember the name of that site. I'd be more trusting of a site that's neutral toward both oralism and ASL.

 

[shel90]

Although I don't have a four year degree or anything like that, much of what I learned about research had to be self taught. I know better than to use Wiki for research purposes. It's good for an general overview of things but not so great for in depth stuff. Also because anyone can edit and post the info, you do have to take it with a grain of salt.

But I'm a bit suprised that people would think the results of research is always the last word; it always seemed clear to me that research is never definative. One also has to account for bias and factor that into your research or it can skew scienfic findings. The AG Bell site or a Pro ASL site is not what I'd call an unbiased site. I'll be the first to admit to a bias toward ASL. I think Jillio or Shel90 mentioned a deaf ed site that's neutural toward both but I forget the name I wish I could remember the name of that site. I'd be more trusting of a site that's neutral toward both oralism and ASL.

It is Journal of Deaf Education and another one is American Annals of the Deaf

 

[deafskeptic]

It is Journal of Deaf Education and another one is American Annals of the Deaf

, Shel90.

 

[R2D2]

Hi Kaitlin,

Question 1

"often cannot understand speech by audition alone" = must lipread with CI?

Yes, I believe that a lot of prelingually deaf adults continue to lipread after the CI and that to me is not bad. The good part is that there is less dependency and work involved in the lipreading compared to before because of the improved audition. This is certainly true in my case and I've observed that many adults like me (prelingually deaf) have made the same remarks. Prior to my CI I would get exhausted after a session involved in lipreading and now I don't.

Question 2

"patient characteristics" = how hard you try with CI or level of hearing before CI or what? Many threads say CI success is most from the person's work - really? Not age or amount of hearing loss? What is the "work"?

Yeah, I believe its refering to the level of auditory stimulation and speech that a prelingually deaf adult has had before implantation, often developed say with hearing aids. Basically, the skills learned with the hearing aid can then be transferred to the use of the CI. It's considerably more difficult if a deaf adult hasn't heard sound or has learned receptive or expressive speech skills.

Hope that helps. I agree with the previous remarks about taking research carefully. The first study only had four subjects in it which is a ridiculously small sample and it was dated 1992. Quite old! In fact, back then cochlear implants only just started to be good enough then for prelingually deaf adults to really benefit from them.

 

[deafdyke]

Patient characteristics are variables such as those which allow some profoundly deaf to understand speech with even HA, while another person with similar patterns and ranges of loss may not be able to understand speech with HA. These variables are largely unknown and unaccounted for, and are considered to be extraneous and largely not measurable, but they do affect the results being measured.

Exactly! Which is the exact reason why when people post about looking into CI canidacy, I tell them that it might be worth it to experiment.The studies treat ALL profoundly deaf people the same. It's like it's promoted as a cure all.
and why is it, that pro ci people harp on the possibilty of not lipreading? Why is that considered a "crutch?" EVERYONE reads lips..........its just that hearies do it subconsciously, while we dhh folks do it consciously.

 

[jillio]

Although I don't have a four year degree or anything like that, much of what I learned about research had to be self taught. I know better than to use Wiki for research purposes. It's good for an general overview of things but not so great for in depth stuff. Also because anyone can edit and post the info, you do have to take it with a grain of salt.

But I'm a bit suprised that people would think the results of research is always the last word; it always seemed clear to me that research is never definative. One also has to account for bias and factor that into your research or it can skew scienfic findings. The AG Bell site or a Pro ASL site is not what I'd call an unbiased site. I'll be the first to admit to a bias toward ASL. I think Jillio or Shel90 mentioned a deaf ed site that's neutural toward both but I forget the name I wish I could remember the name of that site. I'd be more trusting of a site that's neutral toward both oralism and ASL.

You don't need a college degree to ber a critical thinker, deafskeptic. Obviously, critical thinking skills are very natural for you. And I agree with you about Wiki. Use Wiki as a source for academic research, and you will get laughed out of the field! Most professors refuse to accept Wiki as a source for any paper written for a class, as well.

And shel is correct about the two sources she has given. Both are very neutral sources because they have nothing to gain from the results of the research they publish.

 

[Audiofuzzy]

You don't need a college degree to ber a critical thinker, deafskeptic.

She's right, and no number of degrees or years of degrees will help one to become a "critical thinker".... You either have it, or you don't.

By the same token, no amount od studying will make one intelligent. You either are intelligent, or not.

Fuzzy

 

[deafskeptic]

Exactly! Which is the exact reason why when people post about looking into CI canidacy, I tell them that it might be worth it to experiment.The studies treat ALL profoundly deaf people the same. It's like it's promoted as a cure all.

and why is it, that pro ci people harp on the possibilty of not lipreading? Why is that considered a "crutch?" EVERYONE reads lips..........its just that hearies do it subconsciously, while we dhh folks do it consciously.

I agree that the studies shouldn't treat all profoundly deaf the same. No responible doctor would say it's a cure for deafness. I mantain that ti's the media that portrays it as a cure.

As for lipreading, I've never thought of it as a crutch. It's just that the sound is so much clearer so I do much less lipreading than in the past. It's exhausting to have to lipread so much. I still lipread as not all speakers are easy for me to understand. I still have a horrid time with Indian accents.

 

[shel90]

, Shel90.

No problem!

 

[Kaitin]

I would support your Supreme Court nomination. We could use some free thinkers on the panel of judges!

!

 

[Kaitin]

Although I don't have a four year degree or anything like that, much of what I learned about research had to be self taught. I know better than to use Wiki for research purposes. It's good for an general overview of things but not so great for in depth stuff. Also because anyone can edit and post the info, you do have to take it with a grain of salt.

But I'm a bit suprised that people would think the results of research is always the last word; it always seemed clear to me that research is never definative. One also has to account for bias and factor that into your research or it can skew scienfic findings. The AG Bell site or a Pro ASL site is not what I'd call an unbiased site. I'll be the first to admit to a bias toward ASL. I think Jillio or Shel90 mentioned a deaf ed site that's neutural toward both but I forget the name I wish I could remember the name of that site. I'd be more trusting of a site that's neutral toward both oralism and ASL.

DeafSkeptic: Your posts seem logical and thoughtful to me - no degree needed for you I guess!

Agree about Wiki. Wki helps with fun info but not reliable. I use Google Scholar and PubMed most. Or normal Google but put "technical" term in a search (example: "bee yellowjacket taxonomy" - search for difference between "bee" and "yellowjacket").

I read deaf forums and blogs about CI, but with caution for bias. People's experience is overwhelming - positive or negative. But these people aren't me, so maybe my experience is completely different.

And so much emotion - again positive or negative - about CI! Rant is not helpful, either "CI is a miracle!" with no facts about hearing, complications etc OR "CI suck! Never for me!" with no explanation really. People don't know that rant is counterproductive I guess, pro-CI or anti-CI. I know CI is a hot topic with emotion and lot of self-image (Deaf or deaf, oral etc). All these make people's personal discussion not useful often. And there shouldn't be "pro-CI" and "anti-CI", just personal experience with knowledge that one personal experience is NOT for all.

You are right about research is never definative. In the summer I work in a asthma research lab and my data is in 2 papers (very, very small part of papers - a "drop" - I am not a scientist). Science never stops - you can't say "Ok! Now we know all!".

If you remember the site that's neutral to both oralism and ASL please post.

 

[Kaitin]

In my Foundations of Research class, we were taught to be careful about reading research papers and their validity of it. At the time, it was so complicated to me! LOL!

SO complicated! Rediculous sometimes! My class about research papers made my head ache.

 

[Kaitin]

Yes, I believe that a lot of prelingually deaf adults continue to lipread after the CI and that to me is not bad. The good part is that there is less dependency and work involved in the lipreading compared to before because of the improved audition. This is certainly true in my case and I've observed that many adults like me (prelingually deaf) have made the same remarks. Prior to my CI I would get exhausted after a session involved in lipreading and now I don't.

THANK YOU, R2D2! I wonder about lipreading and CI. Now lipread is SO exhausting! If I meet with professor or someone I need to lipread and understand all (not just social conversation), after I am tired and have headaches. So when I read about continuing lipread after the CI........seemed like no benefit then. But less work would be a benefit.

Yeah, I believe its refering to the level of auditory stimulation and speech that a prelingually deaf adult has had before implantation, often developed say with hearing aids. Basically, the skills learned with the hearing aid can then be transferred to the use of the CI. It's considerably more difficult if a deaf adult hasn't heard sound or has learned receptive or expressive speech skills.

I need to talk with my audiologist I guess (I know). But this part for me probably is unknown unless I get CI - probably no person can say how CI will be for me really.

Hope that helps. I agree with the previous remarks about taking research carefully. The first study only had four subjects in it which is a ridiculously small sample and it was dated 1992. Quite old! In fact, back then cochlear implants only just started to be good enough then for prelingually deaf adults to really benefit from them.

That helps a lot. I do read some old articles because I want to see change in science and thinking about CI - year before how do scientists think about CI benefit, surgery etc? now? I only don't read articles I think "sell" one brand of CI.

 

[Kaitin]

Exactly! Which is the exact reason why when people post about looking into CI canidacy, I tell them that it might be worth it to experiment.The studies treat ALL profoundly deaf people the same. It's like it's promoted as a cure all.

Agree, DeafDyke about "a cure all" and "the same". These thinking is not helpful - none are all the same, so how is CI for me? Nothing is "a cure all". Even if CI is perfect for one (and probably none really "perfect"), CI is not perfect for all.

How to "experiment"?

and why is it, that pro ci people harp on the possibilty of not lipreading? Why is that considered a "crutch?" EVERYONE reads lips..........its just that hearies do it subconsciously, while we dhh folks do it consciously.

Great point! I didn't think about hearing lipreading also. But now for me lipreading is so hard. If I need to lipread the same after CI, then no CI for me. R2D2 said lipreading after CI is easier - something for me to think more about. But nothing is wrong with lipreading - not a "crutch". So much weird thinking about CI.

 

[jillio]

She's right, and no number of degrees or years of degrees will help one to become a "critical thinker".... You either have it, or you don't.

By the same token, no amount od studying will make one intelligent. You either are intelligent, or not.

Fuzzy

You are incorrect on critical thinking skills. These can be taught, and, in fact, are taught. However, some people come by these skills easier than others because of the innate way in which they process information. They naturally teach themselves to become critical thinkers because of a natural fluidity in their intelligence. However, a concrete thinker cna be taught critical thinking skills by learning those skills which allow for synthesization of information and fluid application of knowledge. The cross discipline nature of higher education is designed to develop critical thinking skills.

However, I beleive we were discussing the ways in which to evaluate research properly. That, indeed is a critical thinking skill that can be taught.......but with great difficulty those who seem to have difficulty overcoming their concrete way of thinking.