Early Communication Development of Children with Auditory Brainstem Implants

Abstract

The auditory brainstem implant (ABI) is an auditory sensory device that is surgically placed on the cochlear nucleus of the brainstem for individuals who are deaf but unable to benefit from a cochlear implant (CI) due to anatomical abnormalities of the cochlea and/or eighth nerve, specific disease processes, or temporal bone fractures. In the United States, the Food and Drug Administration has authorized a Phase I clinical trial to determine safety and feasibility of the ABI in up to 10 eligible young children who are deaf and either derived no benefit from the CI or were anatomically unable to receive a CI. In this paper, we describe the study protocol and the children who have enrolled in the study thus far. In addition, we report the scores on speech perception, speech production, and language (spoken and signed) for five children with 1-3 years of assessment post-ABI activation. To date, the results indicate that spoken communication skills are slow to develop and that visual communication remains essential for post-ABI intervention.

Trial registration: ClinicalTrials.gov NCT02102256.

Figures

Figure 1

Protocol for the Los Angeles pediatric auditory brainstem implant (ABI) clinical trial.

Figure 2

Individual category scores reached on the Early Speech Perception (ESP) Test for Cases 1, 2, 3, 5, and 8. DNT = did not test.

Figure 3

Individual subtest levels reached on the Test of Auditory Comprehension (TAC) for Cases 2 and 5. DNT = did not test; * = tested but did not meet criterion to pass Subtest 1.

Figure 4

Individual percent composite scores for word patterns, vowels, and consonants on the Identifying Early Phonological Needs in Children with Hearing Impairment (IEPN) for Cases 2, 3, 5, and 8. DNT = did not test; CNT= could not test; N/A = not applicable.

Figure 5

Composite (Auditory Comprehension and Expressive Communication) raw scores (left vertical axis) and age equivalents (right vertical axis) are displayed for the Preschool Language Scales (PLS-5) for Cases 2, 3, 5, and 8. As a comparison, the bars to the far right display the scores for Case 7, a nonqualifying auditory brainstem implant (ABI) candidate using a cochlear implant (CI). The outer bars represent scores for total communication administration. The inner shaded bars represent scores for verbal administration. TC = total communication; AO = auditory oral.

Figure 6

Individual raw scores (left vertical axis) and age equivalents in years (right vertical axis) are displayed for the Peabody Picture Vocabulary Test (PPVT-4) for Cases 2, 3, 5, and 8. The outer bars represent scores for total communication administration. The inner shaded bars represent scores for verbal administration. TC = total communication; AO = auditory oral; DNT = did not test.