The present study is a systematic review on the effectiveness of Parent Training (PT) and coaching in deaf and hard of hearing (DHH) rehabilitation programs which reviews and synthesizes the existing body of evidence to assess the benefits of these programs in enhancing parents’ sensitivity, responsivity and promoting language development in DHH children during the first years after HA fitting or CI activation. Five published studies met the Population, Intervention, Comparison and Outcomes (PICO) inclusion criteria and were eligible to be included, but heterogeneity in terms of the study design, interventions and outcomes did not allow for performing a meta-analysis. All included studies shared the view that a parent’s learning is a circular (rather than frontal) process, and the results appear promising in terms of enhancing parents’ responsiveness and promoting DHH child language development. Nevertheless, the available evidence was judged to not be robust enough due to limitations in the studies’ designs. Further high-quality evidence is needed to evaluate the true degree of clinical value and the cost effectiveness of PT programs aimed at increasing parents’ responsiveness to their DHH children.
Objectives: The present study aimed to investigate in a group of elderly CI users working memory and attention, conventionally considered as predictors of better CI performance and to try to disentangle the effects of these cognitive domains on speech perception, finding potential markers of cognitive decline related to audiometric findings. Methods Thirty postlingually deafened CI users aged >60 underwent an audiological evaluation followed by a cognitive assessment of attention and verbal working memory. A correlation analysis was performed to evaluate the associations between cognitive variables while a simple regression investigated the relationships between cognitive and audiological variables. Comparative analysis was performed to compare variables on the basis of subjects’ attention performance. Results: Attention was found to play a significant role in sound field and speech perception. Univariate analysis found a significant difference between poor and high attention performers, while regression analysis showed that attention significantly predicted recognition of words presented at Signal/Noise +10. Further, the high attention performers showed significantly higher scores than low attentional performers for all working memory tasks. Conclusion: Overall findings confirmed that a better cognitive performance may positively contribute to better speech perception outcomes, especially in complex listening situations. WM may play a crucial role in storage and processing of auditory-verbal stimuli and a robust attention may lead to better performance for speech perception in noise. Implementation of cognitive training in auditory rehabilitation of CI users should be investigated in order to improve cognitive and audiological performance in elderly CI users.
This pilot study investigates the neurophysiological patterns of visual and auditory verbal working memory (VWM) in unilateral cochlear implant users (UCIs). We compared the task-related electroencephalogram (EEG) power spectral density of 7- to 13-year-old UCIs (n = 7) with a hearing control group (HC, n = 10) during the execution of a three-level n-back task with auditory and visual verbal (letters) stimuli. Performances improved as memory load decreased regardless of sensory modality (SM) and group factors. Theta EEG activation over the frontal area was proportionally influenced by task level; the left hemisphere (LH) showed greater activation in the gamma band, suggesting lateralization of VWM function regardless of SM. However, HCs showed stronger activation patterns in the LH than UCIs regardless of SM and in the parietal area (PA) during the most challenging audio condition. Linear regressions for gamma activation in the PA suggest the presence of a pattern-supporting auditory VWM only in HCs. Our findings seem to recognize gamma activation in the PA as the signature of effective auditory VWM. These results, although preliminary, highlight this EEG pattern as a possible cause of the variability found in VWM outcomes in deaf children, opening up new possibilities for interdisciplinary research and rehabilitation intervention.
1 January 2021 in Computational Intelligence and Neuroscience
Exploration of specific brain areas involved in verbal working memory (VWM) is a powerful but not widely used tool for the study of different sensory modalities, especially in children. In this study, for the first time, we used electroencephalography (EEG) to investigate neurophysiological similarities and differences in response to the same verbal stimuli, expressed in the auditory and visual modality during the n‐back task with varying memory load in children. Since VWM plays an important role in learning ability, we wanted to investigate whether children elaborated the verbal input from auditory and visual stimuli through the same neural patterns and if performance varies depending on the sensory modality. Performance in terms of reaction times was better in visual than auditory modality (p = 0.008) and worse as memory load increased regardless of the modality (p < 0.001). EEG activation was proportionally influenced by task level and was evidenced in theta band over the prefrontal cortex (p = 0.021), along the midline (p = 0.003), and on the left hemisphere (p = 0.003). Differences in the effects of the two modalities were seen only in gamma band in the parietal cortices (p = 0.009). The values of a brainwave‐based engagement index, innovatively used here to test children in a dual‐modality VWM paradigm, varied depending on n‐back task level (p = 0.001) and negatively correlated (p = 0.002) with performance, suggesting its computational effectiveness in detecting changes in mental state during memory tasks involving children. Overall, our findings suggest that auditory and visual VWM involved the same brain cortical areas (frontal, parietal, occipital, and midline) and that the significant differences in cortical activation in theta band were more related to memory load than sensory modality, suggesting that VWM function in the child’s brain involves a cross‐modal processing pattern.