Comparison of sustained auditory attention between children with cochlear implant and normal children
Background and Aim: Cochlear Implants (CIs) bypass a non-functional inner ear by a direct electrical stimulation of the auditory nerve. Compared to normal acoustic hearing, sounds transmitted through the CI are degraded and this electrical signal may change the attention capacity of children with CI. According to Kahneman’s model, the presence of CI input might trigger the allocation of limited-capacity central resources for attentional processing of this degraded input and lead to attentional deficiencies. The aim of this study was to compare sustained auditory attention between children with CI and normal children.
Methods: Eighteen children with unilateral CI in right ear and profound hearing loss in left ear with age of implantation under two years, and 40 normal hearing children were selected for this study. The age range of all the children was between 8 and 11 years. Each child in the normal group was tested twice; once binaural and once with left ear plugged. In order to compare sustained auditory attention between the groups, we used sustained auditory attention capacity test (SAACT) and calculated inattention, impulsive, reduction index, and total errors for each child.
Results: In the normal group, all mentioned test variables in binaural versus monaural were not significantly different. In CI group, the values of inattention, impulsive, and total errors were more than these errors in the normal group whether bilateral or unilateral (p<0.05).
Conclusion: There is a statistically significant difference in all SAAC test variables (inattention, impulsive, reduction index, and total errors) between normal and implant groups.
2. Gianvecchio L, French L. Sustained attention, inattention, receptive language, and story interruptions in preschool head start story time. J Appl Dev Psychol. 2002;23(4):393-407. doi: 10.1016/S0193-3973(02)00125-9
3. Richards JE. The development of sustained attention in infants. In: Posner MI, editor. Cognitive neuroscience of attention. 1st ed. New York: The Guilford Press; 2004. p. 342-56.
4. Salamat MT, McPherson DL. Interactions among variables in the P300 response to a continuous performance task. J Am Acad Audiol. 1999;10(7):379-87.
5. Feniman MR, Ortelan RR, Lauris JR, Campos CF, Cruz MS. A proposed behavioral tool to assess sustained auditory attention. Braz J Otorhinolaryngol. 2007;73(4):523-7.
6. Beer J, Kronenberger WG, Castellanos I, Colson BG, Henning SC, Pisoni DB. Executive functioning skills in preschool-age children with cochlear implants. J Speech Lang Hear Res. 2014;57(4):1521-34. doi: 10.1044/2014_JSLHR-H-13-0054
7. Moberly AC, Lowenstein JH, Nittrouer S. Word recognition variability with cochlear implants: "perceptual attention" versus "auditory sensitivity". Ear Hear. 2016;37(1):14-26. doi: 10.1097/AUD.0000000000000204
8. Drennan WR, Rubinstein JT. Music perception in cochlear implant users and its relationship with psychophysical capabilities. J Rehabil Res Dev. 2008;45(5):779-89.
9. Raine C, Atkinson H, Strachan DR, Martin JM. Access to cochlear implants: Time to reflect. Cochlear Implants Int. 2016;17 Suppl 1:42-6. doi: 10.1080/14670100.2016.1155808
10. Cosetti MK, Waltzman SB. Cochlear implants: current status and future potential. Expert Rev Med Devices. 2011;8(3):389-401. doi: 10.1586/erd.11.12
11. Wilson BS, Dorman MF. Cochlear implants: a rem¬arkable past and a brilliant future. Hear Res. 2008;242(1-2):3-21. doi: 10.1016/j.heares.2008.06.005
12. Caldwell MT, Jiam NT, Limb CJ. Assessment and improvement of sound quality in cochlear implant users. Laryngoscope Investig Otolaryngol. 2017;2(3):119-124. doi: 10.1002/lio2.71
13. Kahneman D. Attention and effort. 1st ed. Englewood Cliffs, NJ: Prentice-Hall; 1973.
14. Finke M, Sandmann P, Kopp B, Lenarz T, Büchner A. Auditory distraction transmitted by a cochlear implant alters allocation of attentional resources. Front Neurosci. 2015;9:68. doi: 10.3389/fnins.2015.00068
15. Soltanparast S, Jafari Z, Sameni SJ, Salehi M. Psychometric properties of Persian version of the sustained auditory attention capacity Test in children with attention deficit-hyperactivity disorder. Med J Islam Repub Iran. 2014;28(1):14.
16. Schlauch RS, Nelson P. Puretone evaluation. In: Katz J, Medwetsky L, Burkard R, Hood L, editors. Handbook of clinical audiology. 6th ed. Baltimore: Lippincott Williams & Wilkins; 2009. p. 30-49.
17. Manrique M, Cervera-Paz FJ, Huarte A, Molina M. Advantages of cochlear implantation in prelingual deaf children before 2 years of age when compared with later implantation. Laryngoscope. 2004;114(8):1462-9. doi: 10.1097/00005537-200408000-00027
18. Kral A, Sharma A. Developmental neuroplasticity after cochlear implantation. Trends Neurosci. 2012;35(2):111-22. doi: 10.1016/j.tins.2011.09.004
19. Jiwani S, Papsin BC, Gordon KA. Early unilateral cochlear implantation promotes mature cortical asymmetries in adolescents who are deaf. Hum Brain Mapp. 2016;37(1):135-52. doi: 10.1002/hbm.23019
20. Fuster JM. The prefrontal cortex--an update: time is of the essence. Neuron. 2001;30(2):319-33. doi: 10.1016/S0896-6273(01)00285-9
21. Silva LAF, Couto MIV, Magliaro FCL, Tsuji RK, Bento RF, de Carvalho ACM, et al. Correction: Cortical maturation in children with cochlear implants: Correlation between electrophysiological and behavioral measurement. PLoS One. 2017;12(6):e0178341. doi: 10.1371/journal.pone.0178341
22. Emmorey K, Allen JS, Bruss J, Schenker N, Damasio H. A morphometric analysis of auditory brain regions in congenitally deaf adults. Proc Natl Acad Sci U S A. 2003;100(17):10049-54. doi: 10.1073/pnas.1730169100
23. Conway CM, Pisoni DB, Kronenberger WG. The importance of sound for cognitive sequencing abilities: the auditory scaffolding hypothesis. Curr Dir Psychol Sci. 2009;18(5):275-9. doi: 10.1111/j.1467-8721.2009.01651.x
24. Mondelli MF, Carvalho FR, Feniman MR, Lauris JR. Mild hearing loss: performance in the Sustained Auditory Attention Ability Test. Pro Fono. 2010;22(3):245-50. doi: 10.1590/S0104-56872010000300015
25. Seidel WT, Joschko M. Evidence of difficulties in sustained attention in children with ADDH. J Abnorm Child Psychol. 1990;18(2):217-29.