title: Auditory performance and speech intelligibility of Mandarin-speaking children implanted before age 5.
abstract: OBJECTIVE
  (1) To report the auditory performance and speech intelligibility of 84 Mandarin-speaking prelingually deaf children after using cochlear implants (CIs) for one, two, three, four, and five years to understand how many years of implant use were needed for them to reach a plateau-level performance; (2) to investigate the relation between subjective rating scales and objective measurements (i.e., speech perception tests); (3) to understand the effect of age at implantation on auditory and speech development.
  
  
  METHODS
  Eighty-four children with CIs participated in this study. Their auditory performance and speech intelligibility were rated using the Categorical Auditory Performance (CAP) and the Speech Intelligibility Rating (SIR) scales, respectively. The evaluations were made before implantation and six months, one, two, three, four, and five years after implantation. At the fifth year after implantation, monosyllabic-word, easy-sentence, and difficult-sentence perception tests were administered.
  
  
  RESULTS
  The median CAP score reached a plateau at category 6 after three years of implant use. The median SIR arrived at the highest level after five years of use. With five years of CI experiences, 86% of the subjects understood conversation without lip-reading, and 58% were fully intelligible to all listeners. The three speech perception tests had a moderate-to-strong correlation with the CAP and SIR scores. The children implanted before the age of three years had significantly better CAP and monosyllabic word perception test scores.
  
  
  CONCLUSIONS
  Five years of follow-up are needed for assessing the post-implantation development of communication ability of prelingually deafened children. It is recommended that hearing-impaired children receive cochlear implantation at a younger age to acquire better auditory ability for developing language skills. Constant postoperative aural-verbal rehabilitation and speech and language therapy are most likely required for the patients to reach the highest level on the CAP and SIR scales.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Chang-Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
authors.forename: Hsuan-Yeh
authors.initials: HY
authors.lastname: Fang
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Chang-Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
authors.forename: Hui-Chen
authors.initials: HC
authors.lastname: Ko
authors.affiliation: School of Speech Language Pathology and Audiology, Chung Shan Medical University, Taichung City, Taiwan.
authors.forename: Nan-Mai
authors.initials: NM
authors.lastname: Wang
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Chang-Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
authors.forename: Tuan-Jen
authors.initials: TJ
authors.lastname: Fang
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Chang-Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
authors.forename: Wei-Chieh
authors.initials: WC
authors.lastname: Chao
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Chang-Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
authors.forename: Yung-Ting
authors.initials: YT
authors.lastname: Tsou
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Chang-Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang-Gung University, Taoyuan, Taiwan. Electronic address: bobwu506@hotmail.com.
authors.forename: Che-Ming
authors.initials: CM
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001307:Auditory Perception / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D015331:Cohort Studies; D003638:Deafness / Q000151:congenital / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007802:Language; D007804:Language Development; D016014:Linear Models; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013065:Speech Intelligibility; D013067:Speech Perception / Q000502:physiology; D018709:Statistics, Nonparametric; D013624:Taiwan; D013997:Time Factors
keywords: Categorical auditory performance; Cochlear implantation; Mandarin children; Speech intelligibility