الفهرس 
Cochlear Implant, Histopathological Considerations & Long term effects of Electric StimulationOnly 14 pages are availabe for public view
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Abstract
Hearing impairment has a high prevalence affecting approximately 1 in 1000 newborn children (Frei et al., 2005). The identification, assessment and management of hearing impairment in the pediatric population can be a challenging endeavor. Much evidence suggests that, early in life, auditory input and communication are essential for the normal development of language, cognition and behavior (Quittner et al., 2004).
Cochlear implants (CIs) have shown tremendous promise in restoring auditory information to deaf children and concomitant improvement in speech recognition and production (Horn et al., 2005). However their speech and language outcomes are quite varied. It is not yet clear whether CIs enable children to reduce or overcome cognitive deficits associated with hearing impairment (Khan et al., 2005).
The main objective of the current study was to explore the value of application of Computer-Assisted training on CI children in order to improve the auditory abilities and speech performance of these children. This Computer-Assisted training program consisted of training of Temporal Processing abilities (games I, II & III) and Phonemic Awareness abilities (games IV, V & VI).
The program was applied on 33 CI children (Nucleus 24) with a minimum of one year of device use together with regular speech & language therapy. Extra training for temporal processing and phonemic awareness abilities was conducted at the clinic using a computer-based training program. Each session lasted for 25-35 minutes, 2 sessions per week, for a period of maximum 3 months.
Twenty five CI children (out of 33 CI children) could proceed in the training program (all games at different levels) while eight CI children could not respond or understand the simplest tasks of the training program (all games).
Results of these 25 CI children showed significant improvement in auditory skills as measured by Arabic version of MAIS questionnaire, Arabic speech perception tests, auditory fusion test (subtest I). The neuroplastic changes following remediation was documented by changes in electrophysiological measures (an increase in MMN amplitude). Nevertheless, there was also improvement in the speech production of these children. However, Arabic language test for these children did not show any change.
The improved performance was retained to some degree for a period of 6months to 2 years after training was completed. These results suggest that moderate amount of auditory training of temporal processing and phonemic awareness using a computer-based auditory rehabilitation tool with minimal supervision can be effective in improving the performance of CI children. Booster training is also recommended.