Comprehensive evaluation of a child with an auditory brainstem implant.
OBJECTIVE
We had an opportunity to evaluate an American child whose family traveled to Italy to receive an auditory brainstem implant (ABI). The goal of this evaluation was to obtain insight into possible benefits derived from the ABI and to begin developing assessment protocols for pediatric clinical trials.


METHODS
Case study.


METHODS
Tertiary referral center.


METHODS
Pediatric ABI Patient 1 was born with auditory nerve agenesis. Auditory brainstem implant surgery was performed in December, 2005, in Verona, Italy. The child was assessed at the House Ear Institute, Los Angeles, in July 2006 at the age of 3 years 11 months. Follow-up assessment has continued at the HEAR Center in Birmingham, Alabama.


METHODS
Auditory brainstem implant.


METHODS
Performance was assessed for the domains of audition, speech and language, intelligence and behavior, quality of life, and parental factors.


RESULTS
Patient 1 demonstrated detection of sound, speech pattern perception with visual cues, and inconsistent auditory-only vowel discrimination. Language age with signs was approximately 2 years, and vocalizations were increasing. Of normal intelligence, he exhibited attention deficits with difficulty completing structured tasks. Twelve months later, this child was able to identify speech patterns consistently; closed-set word identification was emerging. These results were within the range of performance for a small sample of similarly aged pediatric cochlear implant users.


CONCLUSIONS
Pediatric ABI assessment with a group of well-selected children is needed to examine risk versus benefit in this population and to analyze whether open-set speech recognition is achievable.
Eisenberg
Laurie S
LS
House Ear Institute, Los Angeles, California 90057, USA. leisenberg@hei.org
Johnson
Karen C
KC
Martinez
Amy S
AS
DesJardin
Jean L
JL
Stika
Carren J
CJ
Dzubak
Danielle
D
Mahalak
Mandy Lutz
ML
Rector
Emily P
EP
D000328:Adult; D038262:Auditory Brain Stem Implants; D002648:Child; D002652:Child Behavior; D003056:Cochlear Nerve / Q000002:abnormalities; D003142:Communication; D003463:Cues; D003638:Deafness / Q000209:etiology / Q000523:psychology / Q000628:therapy; D006309:Hearing / Q000502:physiology; D006801:Humans; D007361:Intelligence Tests; D007804:Language Development; D008297:Male; D010290:Parents / Q000523:psychology; D010775:Photic Stimulation; D019919:Prosthesis Implantation; D011788:Quality of Life; D013060:Speech / Q000502:physiology; D013067:Speech Perception / Q000502:physiology; D013315:Stress, Psychological / Q000523:psychology