Browsing by Author "Lombaard, Suryn"

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    Review of pediatric cochlear implantation records at the Tygerberg Hospital – Stellenbosch University Cochlear Implant Unit from 1990 – 2018
    (Stellenbosch : Stellenbosch University, 2020-03) Lombaard, Suryn; Klop, D.; Muller, A. M. U.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Speech Language and Hearing Therapy.
    ENGLISH ABSTRACT : The decision of parents of deaf children to proceed with cochlear implantation is often based on the expectation that the improved access to sound provided by the cochlear implant system will result in spoken language development that will improve the long-term educational development and occupational prospects of the child. These positive outcomes associated with pediatric cochlear implantation may result in financial benefits to society. A variety of factors may however determine the outcomes achieved. Cochlear implantation is an elective procedure and information about the expected outcomes and prognostic variables associated with outcome should be available to parents of candidates and funders to enable them to make informed decisions about their options. The main aim of the study was to describe the demographic and pre-operative clinical characteristics of pediatric cochlear implant recipients in the Tygerberg Hospital-Stellenbosch University Cochlear Implant Unit, the long-term post-operative trends in outcome in the domains of implant use, mode of communication, speech perception development, educational placement, occupational status and the variables associated with mainstream educational placement. The records of 216 recipients who received cochlear implants between 1990 and 2014 were reviewed. The recipients were grouped according to the age at onset of severe to profound sensorineural hearing loss: 0 to 2 years (n=166); > 2-5 years (n=17); >5 years (n=24) and Auditory Neuropathy Spectrum Disorder (n=9). Speech perception results recorded at annual visits were categorized in increasing order of difficulty in categories 0 to 7 (Dowell, Blamey & Clark, 1995). Implant use, mode of communication, educational placement during primary and secondary school and higher education were documented. The employment status of recipients was categorized according to the South African Standard Classification of Occupations (SASCO). Statistical analysis was performed to identify possible prognostic variables (age at onset and duration of deafness, age at implantation, co-morbidities, socio-economic status, maternal education, home language education and speech perception category) associated with mainstream educational placement. All the recipients who were implanted during childhood continued to use their devices. Ninety-six percent of the recipients (n=207) developed open-set speech perception and 95% (n=206) used oral language as mode of communication. In primary school, 39.4% of the recipients were placed in mainstream schools, while 91.3% were able to follow a mainstream curriculum. Forty-three percent of the recipients were in mainstream education during secondary school and 77% of the recipients were able to follow a mainstream curriculum. Fifty-four percent of the recipients who completed basic education were enrolled for or completed higher education and training. Seventy-three percent of the recipients seeking employment were employed. The average SASCO occupational skill level for these recipients was 2.4 (SD 0.96).The absence of a co-morbidity, maternal education level and speech perception category after two years of implant use, were independent variables associated with mainstream placement at primary and secondary school level. These findings are relevant for the parents of cochlear implant candidates, the funders of cochlear implant systems and clinicians.