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Hearing Disorders: HELP
Articles by Nae-Yuh Wang
Based on 13 articles published since 2010
(Why 13 articles?)
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Between 2010 and 2020, N. Y. Wang wrote the following 13 articles about Hearing Disorders.
 
+ Citations + Abstracts
1 Review [Effect of cochlear implantation on sound localization for patients with unilateral sensorineural hearing loss]. 2016

Liu, J F / Dai, J S / Wang, N Y. ·Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University; College of Otolaryngology, Capital Medical University; Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing 100020, China. ·Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi · Pubmed #27625137.

ABSTRACT: The aim of this review was to examine the current literature regarding application of cochlear implantation on patients with unilateral sensorineural hearing loss (USNHL) for improvement on sound localization. The literature were searched in the PubMed database with 'cochlear implantation AND single-sided deafness' or 'cochlear implantation AND unilateral deafness' as keywords. The publication date of the articles was up to 2015-2-12. A total of 12 articles were included. The results show that the ability of sound localization for most of the USNHL subjects (90%) with cochlear implantation was significantly improved than that without CI, which suggests that CI is a superior auditory rehabilitation treatment than BAHA and CROS hearing aids for patients with USNHL, because of the re-establishment of the benefits of binaural hearing. In addition, the benefit of CI for USNHL requires a period of auditory experience or training. About 30% subjects showed significantly improvement on sound localization ability after CI worked for three months. For most of the patients (90%), the sound localization ability improved after CI worked for six months. When CI worked for nine months, all the subjects would show improvement on sound localization ability. Sound localization of the USNHL subjects with a CI is based primarily on interaural level differences (ILD) while interaural time differences (ITD) provide little advantage or probably not perceptible at all. The younger subject suffers from USNHL, the stronger the plasticity of the auditory center shows, which results in more obvious degeneration of the affected side and adaptive enhancement of the contralateral side of the auditory pathway. Similarly, the longer duration of USNHL lead to more obvious degeneration of the affected side and adaptive enhancement of the contralateral side. An adaptive enhancement of auditory pathway corresponding to the healthy ear will rely more on the monaural spatial cues that available to the intact ear to improve the sound localization in the horizontal plane. Contrarily, the degeneration of auditory pathway corresponding to the USNHL may be limited to re-reorganize from auditory deprivation even after CI, which may increase the risk that a few subjects cannot re-establish the binaural benefits after CI. Therefore, patients with USNHL should accept CI as soon as possible to obtain good binaural benefits, especially for sound localization.

2 Article Hearing Norton Sound: a community randomised trial protocol to address childhood hearing loss in rural Alaska. 2019

Emmett, Susan D / Robler, Samantha Kleindienst / Wang, Nae-Yuh / Labrique, Alain / Gallo, Joseph J / Hofstetter, Philip. ·Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA. · Duke Global Health Institute, Durham, North Carolina, USA. · Department of Audiology, Norton Sound Health Corporation, Nome, Alaska, USA. · Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. · Departments of Biostatistics and Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. · Departments of International Health and Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA. · Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. · Norton Sound Health Corporation, Nome, Alaska, USA. ·BMJ Open · Pubmed #30782695.

ABSTRACT: INTRODUCTION: The population in rural Alaska experiences a disproprionately high burden of infection-mediated hearing loss. While the state mandates school hearing screening, many children with hearing loss are not identified or are lost to follow-up before ever receiving treatment. A robust, tribally owned healthcare system exists in Alaska, but children with hearing loss must first be identified and referred for existing infrastructure to be used. This trial will evaluate a new school hearing screening and referral process in rural Alaska, with the goal of improving timely identification and treatment of childhood hearing loss. METHODS AND ANALYSIS: Comparative effectiveness community randomised trial testing digital innovations to improve school hearing screening and referral in 15 communities in the Norton Sound region of northwest Alaska, with data collection from October 2017 to February 2020. All children (K-12) attending school in Bering Strait School District with parental informed consent and child assent will be eligible (target recruitment n=1500). Participating children will undergo both the current school hearing screen and new mobile health (mHealth) screen, with screening test validity evaluated against an audiometric assessment. Communities will be cluster randomised to continue the current primary care referral process or receive telemedicine referral for follow-up diagnosis and treatment. The primary outcome will be time to International Statistical Classification of Diseases, 10th Revision, ear/hearing diagnosis from screening date, measured in days. Secondary outcomes will include: sensitivity and specificity of current school and mHealth screening protocols measured against a benchmark audiometric assessment (air and bone conduction audiometry, tympanometry and digital otoscopy); hearing loss prevalence; hearing-related quality of life; and school performance (AIMSweb). Intention-to-treat analysis will be used. ETHICS AND DISSEMINATION: This study has been approved by the Institutional Review Boards of Alaska Area, Norton Sound and Duke University and is registered on clinicaltrials.gov. Results will be distributed with equal emphasis on scientific and community dissemination. TRIAL REGISTRATION NUMBER: NCT03309553; Pre-results.

3 Article Hearing Norton Sound: mixed methods protocol of a community randomised trial to address childhood hearing loss in rural Alaska. 2019

Emmett, Susan D / Robler, Samantha Kleindienst / Gallo, Joseph J / Wang, Nae-Yuh / Labrique, Alain / Hofstetter, Philip. ·Department of Surgery, Duke University School of Medicine, Durham, NC, USA. · Duke Global Health Institute, Durham, NC, USA. · Department of Audiology, Norton Sound Health Corporation, Nome, Alaska, USA. · Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. · Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. · Departments of Biostatistics and Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. · Departments of International Health and Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA. · Norton Sound Health Corporation, Nome, Alaska, USA. ·BMJ Open · Pubmed #30674486.

ABSTRACT: INTRODUCTION: Childhood hearing loss has implications for school achievement, economic outcomes and quality of life. This study will engage rural Alaska communities in research to improve the school hearing screening and referral process, partnering with stakeholders to develop a locally derived, evidence-based solution to improve timely identification and treatment of childhood hearing loss. METHODS AND ANALYSIS: Mixed methods community randomised trial in 15 communities in the Norton Sound region of northwest Alaska. Data collection will span from April 2017 until February 2020. Qualitative and mixed methods components are described in this protocol and the community randomised trial in the companion protocol. Focus groups and community events will be held leading up to the randomised trial to obtain community perspectives on childhood hearing loss in Alaska and elicit community input during trial protocol refinement (exploratory sequential stage). Stakeholder groups, including parents, children, teachers, school administrators and community health aides, will participate, along with community leaders, tribal leaders and community members. The randomised trial will be combined with qualitative, semi-structured interviews to elicit stakeholder perspectives on the intervention (explanatory sequential stage). The five stakeholder groups described above will participate in interviews. The study will conclude with additional focus groups and community events to discuss results and provide community insight for future implementation. Concluding focus groups will include policymakers, healthcare administrators, and tribal and community leaders in addition to the stakeholder groups. Informed consent and child assent will be required. Recordings will be transcribed and deidentified, with only stakeholder group recorded. Analyses will include categorical coding as well as narrative and thematic analysis. ETHICS AND DISSEMINATION: The Hearing Norton Sound study has been approved by the Institutional Review Boards of Alaska Area, Norton Sound, and Duke University, with trial registration on clinicaltrials.gov. Study results will be distributed with equal emphasis on scientific and community dissemination. TRIAL REGISTRATION NUMBER: NCT03309553; Results.

4 Article [A long term effect on speech recognition in the patients with simultaneous bilateral cochlear implants]. 2018

Wang, B / Wei, C G / Cao, K L / Jin, X / Wang, Y / Wang, N Y. ·Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences Peking Union Medical College, Beijing 100730, China. · Department of Otorhinolaryngology Head and Neck Surgery, Peking University First Hospital, Beijing 100034, China. · Chinese Medical Association Publishing House, Beijing 100710, China. · Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China. ·Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi · Pubmed #29614551.

ABSTRACT:

5 Article [Advances in effect of unilateral auditory deprivation on sound localization]. 2017

Liu, J F / Dai, J S / Wang, N Y. ·Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University; College of Otolaryngology, Capital Medical University; Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing 100020, China. ·Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi · Pubmed #28219180.

ABSTRACT: In patients with single-sided deafness (SSD), the interaural time difference and the interaural level difference signals are insufficient or missing, which result in the lack of sound localization ability and the decrease of speech comprehension in the noise environments. SSD can also cause the morphological and functional changes of the central auditory system, resulting in auditory deprivation. In early stage of the development, the auditory center is more susceptible to ambient environment and auditory inputs. It is a critical period of auditory function and morphological refinement. It is also sensitive period of central adaptability after auditory deprivation. SSD in the sensitive period of development can cause significant laterality activities of bilateral sound localization pathway. Unilateral auditory deprivation can distort tonotopic maps, disrupt the binaural integration, reorganize the neural network and change the synaptic transmission in the primary auditory cortex or sub cortex. In order to compensate for the deficiency of the interaural time difference and interaural level difference cues, the auditory pathway is used to improve the ability of sound source localization by using the spectral-shape cues remaining unchanged. In order to improve the effectiveness of the functional areas of the cortex, auditory center is also reorganized by cross-modal. However, central compensation after SSD is a double-edged sword. If SSD onset in the sensitive period, the laterality of auditory pathway will be continued and difficult to reverse by even long term bilateral hearing in the post-sensitive period. Therefore, in order to improve the understanding of the characteristics of unilateral auditory deprivation, this paper reviewed the evidence for adaptive changes in spatial hearing following a developmental hearing loss in one ear.

6 Article Symbolic Play and Novel Noun Learning in Deaf and Hearing Children: Longitudinal Effects of Access to Sound on Early Precursors of Language. 2016

Quittner, Alexandra L / Cejas, Ivette / Wang, Nae-Yuh / Niparko, John K / Barker, David H. ·Department of Psychology, University of Miami, Coral Gables, FL, United States of America. · Department of Otolaryngology, University of Miami Miller School of Medicine, Barton G. Kids Hear Now Cochlear Implant Family Resource Center, Miami, FL, United States of America. · School of Medicine, Johns Hopkins University, Baltimore, MD, United States of America. · Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, CA, United States of America. · Department of Child and Adolescent Psychiatry, Brown University, Providence, RI, United States of America. ·PLoS One · Pubmed #27228032.

ABSTRACT: In the largest, longitudinal study of young, deaf children before and three years after cochlear implantation, we compared symbolic play and novel noun learning to age-matched hearing peers. Participants were 180 children from six cochlear implant centers and 96 hearing children. Symbolic play was measured during five minutes of videotaped, structured solitary play. Play was coded as "symbolic" if the child used substitution (e.g., a wooden block as a bed). Novel noun learning was measured in 10 trials using a novel object and a distractor. Cochlear implant vs. normal hearing children were delayed in their use of symbolic play, however, those implanted before vs. after age two performed significantly better. Children with cochlear implants were also delayed in novel noun learning (median delay 1.54 years), with minimal evidence of catch-up growth. Quality of parent-child interactions was positively related to performance on the novel noun learning, but not symbolic play task. Early implantation was beneficial for both achievement of symbolic play and novel noun learning. Further, maternal sensitivity and linguistic stimulation by parents positively affected noun learning skills, although children with cochlear implants still lagged in comparison to hearing peers.

7 Article Age-dependent cost-utility of pediatric cochlear implantation. 2013

Semenov, Yevgeniy R / Yeh, Susan T / Seshamani, Meena / Wang, Nae-Yuh / Tobey, Emily A / Eisenberg, Laurie S / Quittner, Alexandra L / Frick, Kevin D / Niparko, John K / Anonymous6250754. ·Department of Otolaryngology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. ·Ear Hear · Pubmed #23558665.

ABSTRACT: OBJECTIVES: Cochlear implantation (CI) has become the mainstay of treatment for children with severe-to-profound sensorineural hearing loss (SNHL). Yet, despite mounting evidence of the clinical benefits of early implantation, little data are available on the long-term societal benefits and comparative effectiveness of this procedure across various ages of implantation-a choice parameter for parents and clinicians with high prognostic value for clinical outcome. As such, the aim of the present study is to evaluate a model of the consequences of the timing of this intervention from a societal economic perspective. Average cost utility of pediatric CI by age at intervention will be analyzed. DESIGN: Prospective, longitudinal assessment of health utility and educational placement outcomes in 175 children recruited from six U.S. centers between November 2002 and December 2004, who had severe-to-profound SNHL onset within 1 year of age, underwent CI before 5 years of age, and had up to 6 years of postimplant follow-up that ended in November 2008 to December 2011. Costs of care were collected retrospectively and stratified by preoperative, operative, and postoperative expenditures. Incremental costs and benefits of implantation were compared among the three age groups and relative to a nonimplantation baseline. RESULTS: Children implanted at <18 months of age gained an average of 10.7 quality-adjusted life years (QALYs) over their projected lifetime as compared with 9.0 and 8.4 QALYs for those implanted between 18 and 36 months and at >36 months of age, respectively. Medical and surgical complication rates were not significantly different among the three age groups. In addition, mean lifetime costs of implantation were similar among the three groups, at approximately $2000/child/year (77.5-year life expectancy), yielding costs of $14,996, $17,849, and $19,173 per QALY for the youngest, middle, and oldest implant age groups, respectively. Full mainstream classroom integration rate was significantly higher in the youngest group at 81% as compared with 57 and 63% for the middle and oldest groups, respectively (p < 0.05) after 6 years of follow-up. After incorporating lifetime educational cost savings, CI led to net societal savings of $31,252, $10,217, and $6,680 for the youngest, middle, and oldest groups at CI, respectively, over the child's projected lifetime. CONCLUSIONS: Even without considering improvements in lifetime earnings, the overall cost-utility results indicate highly favorable ratios. Early (<18 months) intervention with CI was associated with greater and longer quality-of-life improvements, similar direct costs of implantation, and economically valuable improved classroom placement, without a greater incidence of medical and surgical complications when compared to CI at older ages.

8 Article Influence of implantation age on school-age language performance in pediatric cochlear implant users. 2013

Tobey, Emily A / Thal, Donna / Niparko, John K / Eisenberg, Laurie S / Quittner, Alexandra L / Wang, Nae-Yuh / Anonymous4710751. ·Dallas Cochlear Implant Program, University of Texas at Dallas, Dallas, Texas, USA. etobey@utdallas.edu ·Int J Audiol · Pubmed #23448124.

ABSTRACT: OBJECTIVE: This study examined specific spoken language abilities of 160 children with severe-to-profound sensorineural hearing loss followed prospectively 4, 5, or 6 years after cochlear implantation. STUDY SAMPLE: Ninety-eight children received implants before 2.5 years, and 62 children received implants between 2.5 and 5 years of age. DESIGN: Language was assessed using four subtests of the Comprehensive Assessment of Spoken Language (CASL). Standard scores were evaluated by contrasting age of implantation and follow-up test time. RESULTS: Children implanted under 2.5 years of age achieved higher standard scores than children with older ages of implantation for expressive vocabulary, expressive syntax, and pragmatic judgments. However, in both groups, some children performed more than two standard deviations below the standardization group mean, while some scored at or well above the mean. CONCLUSIONS: Younger ages of implantation are associated with higher levels of performance, while later ages of implantation are associated with higher probabilities of continued language delays, particularly within subdomains of grammar and pragmatics. Longitudinal data from this cohort study demonstrate that after 6 years of implant experience, there is large variability in language outcomes associated with modifiers of rates of language learning that differ as children with implants age.

9 Article Language and behavioral outcomes in children with developmental disabilities using cochlear implants. 2012

Cruz, Ivette / Vicaria, Ishabel / Wang, Nae-Yuh / Niparko, John / Quittner, Alexandra L / Anonymous9510728. ·Department of Otolaryngology, University of Miami, Miami, Florida 33136, USA. icruz@med.miami.edu ·Otol Neurotol · Pubmed #22699986.

ABSTRACT: OBJECTIVE: Over the past decade, the number of deaf children with developmental disabilities receiving cochlear implants has increased dramatically. However, little is known about the developmental outcomes of these children post-implantation. The current study evaluated oral language and behavioral outcomes over 3 years after implantation in a sample of typically developing deaf children and children with developmental disabilities. STUDY DESIGN: A three year longitudinal study of the effects of cochlear implantation on language and behavioral outcomes in children with and without additional disabilities. SETTING: Six cochlear implant centers in the United States. PATIENTS: The study cohort consisted of 188 deaf children. Eighty-five percent of the sample (n = 157) had a single diagnosis of severe to profound hearing loss and 15% (n = 31) had an additional disability. MAIN OUTCOME MEASURES: Oral language was assessed using the Reynell Developmental Language Scales, and behavioral outcomes were assessed using the Child Behavior Checklist. RESULTS: Results using multilevel modeling indicated that deaf children with and without additional disabilities improved significantly in oral language skills post-implantation. However, children with additional disabilities made slower progress. In terms of specific diagnoses, children with developmental disorders, such as autism, made the slowest progress over time. In addition, behavior problems increased significantly in this group, whereas behavior problems decreased over 3 years in the typically developing deaf sample. CONCLUSION: Overall, given the improvements in expressive and receptive language skills documented over 3 years, these findings support the use of cochlear implants for deaf children with developmental disabilities.

10 Article Timing of cochlear implantation and parents' global ratings of children's health and development. 2012

Clark, James H / Wang, Nae-Yuh / Riley, Anne W / Carson, Christine M / Meserole, Rachel L / Lin, Frank R / Eisenberg, Laurie S / Tobey, Emily A / Quittner, Alexandra L / Francis, Howard W / Anonymous1690726 / Niparko, John K. ·Department of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. ·Otol Neurotol · Pubmed #22588232.

ABSTRACT: OBJECTIVE: To assess children's health-related quality of life (HRQL) and development after cochlear implant (CI) surgery and compare improvements between different age of implantation categories. STUDY DESIGN: Prospective, longitudinal study comparing outcomes of deaf children post-CI with hearing controls. SETTING: Six US CI centers. PATIENTS: Deaf children who received CI (n = 188) and hearing children of comparable ages (n = 97). INTERVENTION: CI before 5 years of age. MAIN OUTCOME MEASURE: Parental ratings of global HRQL and development, as assessed over the first 4 years of follow-up using visual analog scales. Development scores assess parental views of children's growth and development, motor skills, ability to express themselves and communicate with others, and learning abilities. Associations of baseline child and family characteristics with post-CI HRQL and development were investigated using multivariable analysis, controlling for factors that influence post-CI language learning. RESULTS: Baseline deficits of CI candidates relative to hearing controls were larger in development than HRQL. Development scores improved significantly by 4 years after CI, particularly in the youngest CI recipients. Developmental deficits of older CI recipients with early, extended hearing aid use were only partially remediated by CI. Overall, no significant health deficits were observed in CI children after 4 years. Cognition and speech recognition were positively associated with both HRQL and development. CONCLUSION: Parental perspectives on quality of their child's life and development provide practical insight into the optimal timing of interventions for early-onset deafness. Validity of parental global assessments is supported by clinical measures of speech perception and language learning and comparison with a well-validated health status instrument.

11 Article Measuring communicative performance with the FAPCI instrument: preliminary results from normal hearing and cochlear implanted children. 2011

Clark, James H / Aggarwal, Pooja / Wang, Nae-Yuh / Robinson, Raymond / Niparko, John K / Lin, Frank R. ·Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA. ·Int J Pediatr Otorhinolaryngol · Pubmed #21296432.

ABSTRACT: OBJECTIVE: To develop preliminary "growth curves" of Functioning after Pediatric Cochlear Implantation (FAPCI) scores using a cross-sectional sample of normal hearing children and to compare these curves to trajectories of FAPCI scores in children receiving cochlear implants. METHODS: Quantile regression was used to develop growth curves from the FAPCI scores of a cross-sectional sample of 82 normal hearing children (age range 7 months-5 years). Trajectories of FAPCI scores from a longitudinal cohort of 75 children with cochlear implants (age range 1-5 years) were compared to these growth curves. RESULTS: FAPCI scores were positively associated with increasing age in normal hearing children with a rapid increase in scores observed at earlier ages followed by a plateau at age 3 years. FAPCI trajectories for cochlear-implanted children varied with age at implantation and did not reach a plateau until age 5-6 years. CONCLUSION: Normal hearing children demonstrated increasing FAPCI scores with age, and these preliminary growth curves allow for the interpretation of a cochlear-implanted child's FAPCI scores in comparison to normal hearing children. Additional research using a larger, longitudinal cohort of normal hearing children will be needed to develop definitive normative FAPCI trajectories.

12 Article Spoken language development in children following cochlear implantation. 2010

Niparko, John K / Tobey, Emily A / Thal, Donna J / Eisenberg, Laurie S / Wang, Nae-Yuh / Quittner, Alexandra L / Fink, Nancy E / Anonymous5180658. ·Department of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. jnipark1@jhmi.edu ·JAMA · Pubmed #20407059.

ABSTRACT: CONTEXT: Cochlear implantation is a surgical alternative to traditional amplification (hearing aids) that can facilitate spoken language development in young children with severe to profound sensorineural hearing loss (SNHL). OBJECTIVE: To prospectively assess spoken language acquisition following cochlear implantation in young children. DESIGN, SETTING, AND PARTICIPANTS: Prospective, longitudinal, and multidimensional assessment of spoken language development over a 3-year period in children who underwent cochlear implantation before 5 years of age (n = 188) from 6 US centers and hearing children of similar ages (n = 97) from 2 preschools recruited between November 2002 and December 2004. Follow-up completed between November 2005 and May 2008. MAIN OUTCOME MEASURES: Performance on measures of spoken language comprehension and expression (Reynell Developmental Language Scales). RESULTS: Children undergoing cochlear implantation showed greater improvement in spoken language performance (10.4; 95% confidence interval [CI], 9.6-11.2 points per year in comprehension; 8.4; 95% CI, 7.8-9.0 in expression) than would be predicted by their preimplantation baseline scores (5.4; 95% CI, 4.1-6.7, comprehension; 5.8; 95% CI, 4.6-7.0, expression), although mean scores were not restored to age-appropriate levels after 3 years. Younger age at cochlear implantation was associated with significantly steeper rate increases in comprehension (1.1; 95% CI, 0.5-1.7 points per year younger) and expression (1.0; 95% CI, 0.6-1.5 points per year younger). Similarly, each 1-year shorter history of hearing deficit was associated with steeper rate increases in comprehension (0.8; 95% CI, 0.2-1.2 points per year shorter) and expression (0.6; 95% CI, 0.2-1.0 points per year shorter). In multivariable analyses, greater residual hearing prior to cochlear implantation, higher ratings of parent-child interactions, and higher socioeconomic status were associated with greater rates of improvement in comprehension and expression. CONCLUSION: The use of cochlear implants in young children was associated with better spoken language learning than would be predicted from their preimplantation scores.

13 Minor Representativeness in studies of early cochlear implantation. 2012

Wang, Nae-Yuh / Carson, Christine M / Niparko, John K / Anonymous7810736. · ·Am Ann Deaf · Pubmed #22978200.

ABSTRACT: -- No abstract --