title: Comparing the effect of auditory-only and auditory-visual modes in two groups of Persian children using cochlear implants: a randomized clinical trial.
abstract: OBJECTIVE
  Since the introduction of cochlear implantation, researchers have considered children's communication and educational success before and after implantation. Therefore, the present study aimed to compare auditory, speech, and language development scores following one-sided cochlear implantation between two groups of prelingual deaf children educated through either auditory-only (unisensory) or auditory-visual (bisensory) modes.
  
  
  METHODS
  A randomized controlled trial with a single-factor experimental design was used.
  
  
  METHODS
  The study was conducted in the Instruction and Rehabilitation Private Centre of Hearing Impaired Children and their Family, called Soroosh in Shiraz, Iran. We assessed 30 Persian deaf children for eligibility and 22 children qualified to enter the study. They were aged between 27 and 66 months old and had been implanted between the ages of 15 and 63 months. The sample of 22 children was randomly assigned to two groups: auditory-only mode and auditory-visual mode; 11 participants in each group were analyzed. In both groups, the development of auditory perception, receptive language, expressive language, speech, and speech intelligibility was assessed pre- and post-intervention by means of instruments which were validated and standardized in the Persian population.
  
  
  RESULTS
  No significant differences were found between the two groups. The children with cochlear implants who had been instructed using either the auditory-only or auditory-visual modes acquired auditory, receptive language, expressive language, and speech skills at the same rate.
  
  
  CONCLUSIONS
  Overall, spoken language significantly developed in both the unisensory group and the bisensory group. Thus, both the auditory-only mode and the auditory-visual mode were effective. Therefore, it is not essential to limit access to the visual modality and to rely solely on the auditory modality when instructing hearing, language, and speech in children with cochlear implants who are exposed to spoken language both at home and at school when communicating with their parents and educators prior to and after implantation. The trial has been registered at IRCT.ir, number IRCT201109267637N1.
authors.affiliation: Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
authors.forename: Mohammad Majid
authors.initials: MM
authors.lastname: Oryadi Zanjani
authors.forename: Saeid
authors.initials: S
authors.lastname: Hasanzadeh
authors.forename: Mehdi
authors.initials: M
authors.lastname: Rahgozar
authors.forename: Hashem
authors.initials: H
authors.lastname: Shemshadi
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: Purdy
authors.forename: Behrooz
authors.initials: B
authors.lastname: Mahmudi Bakhtiari
authors.forename: Maryam
authors.initials: M
authors.lastname: Vahab
mesh_terms: D000367:Age Factors; D001307:Auditory Perception / Q000502:physiology*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D003638:Deafness / Q000175:diagnosis / Q000534:rehabilitation* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007492:Iran; D007804:Language Development; D007807:Language Tests; D008297:Male; D015999:Multivariate Analysis; D018570:Risk Assessment; D013067:Speech Perception / Q000502:physiology; D013068:Speech Production Measurement; D018709:Statistics, Nonparametric; D014796:Visual Perception / Q000502:physiology*
keywords: Auditory-only mode; Auditory–visual mode; Cochlear implant; Hand cue technique; Oral language development; Persian children