title: CENTRAL AUDTIORY DEVELOPMENT IN CHILDREN WITH HEARING LOSS: CLINICAL RELEVANCE OF THE P1 CAEP BIOMARKER IN HEARING-IMPAIRED CHILDREN WITH MULTIPLE DISABILITIES.
abstract: OBJECTIVE
  First, we review the development and plasticity of the central auditory pathways in infants and children with hearing loss who are fitted with cochlear implants (CIs). Second, we describe case studies demonstrating the clinical utility of the P1 central auditory evoked potential (CAEP) for evaluating cortical auditory maturation in the rapidly increasing number of cochlear-implanted children who have multiple disabilities.
  
  
  METHODS
  Children who receive CIs provide a platform to examine the trajectories of deprivation-induced and experience-dependent plasticity in the central auditory system. We review the evidence for, and time limits of sensitive periods for cortical auditory maturation framing an optimal period for cochlear implantation. Finally, we evaluate the use of the P1 biomarker as an objective assessment tool in the special case of children with multiple disabilities.
  
  
  RESULTS
  The P1 response was useful in assessing central auditory maturation in patients with CHARGE association, ANSD, and Pallister-Killian Syndrome concomitant with hearing loss.
  
  
  CONCLUSIONS
  The presence of co-existing disabilities in addition to hearing loss poses unique challenges regarding both pre-intervention evaluation and post-intervention rehabilitation for children with multiple disabilities. When combined with a standard audiological test battery, the P1 CAEP biomarker has a useful role in objectively evaluating the maturation of central auditory pathways to determine the effectiveness of various intervention strategies in hearing-impaired children with multiple disabilities.
authors.affiliation: Dept. of Speech, Language and Hearing Sciences, University of Colorado at Boulder, 2501 Kittredge Loop Road 409 UCB Boulder, CO 80309.
authors.forename: Anu
authors.initials: A
authors.lastname: Sharma
authors.forename: Hannah
authors.initials: H
authors.lastname: Glick
authors.forename: Julia
authors.initials: J
authors.lastname: Campbell
authors.forename: Allison
authors.initials: A
authors.lastname: Biever
keywords: P1 Cortical auditory evoked potential; cochlear implant; multiple disabilities; sensitive period