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Examining the impact of cochlear implantation on the early gross motor development of children with a hearing loss

Alexandra De Kegel (UGent) , Leen Maes (UGent) , Hilde Van Waelvelde (UGent) and Ingeborg Dhooge (UGent)
(2015) EAR AND HEARING. 36(3). p.e113-e121
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Organization
Abstract
Objective: As deaf children are now implanted at a very early age, the influence of a cochlear implant (CI) on the early motor development of children with a hearing loss becomes relevant. Design: Forty-eight children with a hearing loss were included in this controlled prospective follow-up study and were subdivided into a CI group (n = 23) receiving a CI during the follow-up period and a control group (n = 25) receiving no CI during the follow-up period. All children were assessed around the ages of 6 (T1), 12 (T2), 18 (T3), and 24 (T4) months with a motor test battery consisting of the Peabody Developmental Motor Scales-2 (PDMS-2), Alberta Infant Motor Scales (AIMS) (only at T1 and T2), and Ghent Developmental Balance Test (GDBT) (only at T3 and T4). In addition, collic vestibular-evoked myogenic potential testing was performed in all children. Group differences in PDMS-2 Gross Motor Quotient (GMQ), Fine Motor Quotient, AIMS z score, and GDBT z score were analyzed using Linear Mixed Model (LMM) analysis for repeated measures. Results: For PDMS-2 GMQ, the LMM revealed significant effects for group (p = 0.04), test moment (p < 0.001), and for the interaction between these two factors (p = 0.035). Contrasts indicated that the CI group showed a greater deterioration in PDMS-2 GMQ between T2 and T3 compared with that showed by the control group (p = 0.002). The LMM for PDMS-2 Fine Motor Quotient and AIMS z score showed no significant effects. For GDBT z score, the LMM pointed out significant effects for group (p = 0.013) and test moment (p < 0.001), but no significant interaction between these two factors. Contrasts indicated that the CI group performed significantly weaker than the control group at both test moments (T3 and T4; all p < 0.012) and that both groups showed a significant recovery in GDBTz scores between T3 and T4 (all p < 0.012). Conclusions: This study shows that the trajectory of gross motor development can be changed in children with a hearing loss after a cochlear implantation. Implanted children show a drop in their gross motor performance within the age range of 6 to 18 months, at which period the majority of the implantations took place, with a tendency of recovery toward the age of 2 years. However, longer follow-up will be necessary to trace whether the implanted children catch up their motor delay in comparison with nonimplanted children with a hearing loss at later age.
Keywords
Motor development, Cochlear implants, Vestibular disorders, EVOKED MYOGENIC POTENTIALS, CONGENITAL CYTOMEGALOVIRUS-INFECTION, VESTIBULAR FUNCTION, DEAF-CHILDREN, IMPAIRED CHILDREN, SACCULAR FUNCTION, DYSFUNCTION, INFANTS, RELIABILITY, DEFICITS

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Chicago
De Kegel, Alexandra, Leen Maes, Hilde Van Waelvelde, and Ingeborg Dhooge. 2015. “Examining the Impact of Cochlear Implantation on the Early Gross Motor Development of Children with a Hearing Loss.” Ear and Hearing 36 (3): e113–e121.
APA
De Kegel, A., Maes, L., Van Waelvelde, H., & Dhooge, I. (2015). Examining the impact of cochlear implantation on the early gross motor development of children with a hearing loss. EAR AND HEARING, 36(3), e113–e121.
Vancouver
1.
De Kegel A, Maes L, Van Waelvelde H, Dhooge I. Examining the impact of cochlear implantation on the early gross motor development of children with a hearing loss. EAR AND HEARING. 2015;36(3):e113–e121.
MLA
De Kegel, Alexandra, Leen Maes, Hilde Van Waelvelde, et al. “Examining the Impact of Cochlear Implantation on the Early Gross Motor Development of Children with a Hearing Loss.” EAR AND HEARING 36.3 (2015): e113–e121. Print.
@article{5791560,
  abstract     = {Objective: As deaf children are now implanted at a very early age, the influence of a cochlear implant (CI) on the early motor development of children with a hearing loss becomes relevant. 
Design: Forty-eight children with a hearing loss were included in this controlled prospective follow-up study and were subdivided into a CI group (n = 23) receiving a CI during the follow-up period and a control group (n = 25) receiving no CI during the follow-up period. All children were assessed around the ages of 6 (T1), 12 (T2), 18 (T3), and 24 (T4) months with a motor test battery consisting of the Peabody Developmental Motor Scales-2 (PDMS-2), Alberta Infant Motor Scales (AIMS) (only at T1 and T2), and Ghent Developmental Balance Test (GDBT) (only at T3 and T4). In addition, collic vestibular-evoked myogenic potential testing was performed in all children. Group differences in PDMS-2 Gross Motor Quotient (GMQ), Fine Motor Quotient, AIMS z score, and GDBT z score were analyzed using Linear Mixed Model (LMM) analysis for repeated measures. 
Results: For PDMS-2 GMQ, the LMM revealed significant effects for group (p = 0.04), test moment (p {\textlangle} 0.001), and for the interaction between these two factors (p = 0.035). Contrasts indicated that the CI group showed a greater deterioration in PDMS-2 GMQ between T2 and T3 compared with that showed by the control group (p = 0.002). The LMM for PDMS-2 Fine Motor Quotient and AIMS z score showed no significant effects. For GDBT z score, the LMM pointed out significant effects for group (p = 0.013) and test moment (p {\textlangle} 0.001), but no significant interaction between these two factors. Contrasts indicated that the CI group performed significantly weaker than the control group at both test moments (T3 and T4; all p {\textlangle} 0.012) and that both groups showed a significant recovery in GDBTz scores between T3 and T4 (all p {\textlangle} 0.012). 
Conclusions: This study shows that the trajectory of gross motor development can be changed in children with a hearing loss after a cochlear implantation. Implanted children show a drop in their gross motor performance within the age range of 6 to 18 months, at which period the majority of the implantations took place, with a tendency of recovery toward the age of 2 years. However, longer follow-up will be necessary to trace whether the implanted children catch up their motor delay in comparison with nonimplanted children with a hearing loss at later age.},
  author       = {De Kegel, Alexandra and Maes, Leen and Van Waelvelde, Hilde and Dhooge, Ingeborg},
  issn         = {0196-0202},
  journal      = {EAR AND HEARING},
  keyword      = {Motor development,Cochlear implants,Vestibular disorders,EVOKED MYOGENIC POTENTIALS,CONGENITAL CYTOMEGALOVIRUS-INFECTION,VESTIBULAR FUNCTION,DEAF-CHILDREN,IMPAIRED CHILDREN,SACCULAR FUNCTION,DYSFUNCTION,INFANTS,RELIABILITY,DEFICITS},
  language     = {eng},
  number       = {3},
  pages        = {e113--e121},
  title        = {Examining the impact of cochlear implantation on the early gross motor development of children with a hearing loss},
  url          = {http://dx.doi.org/10.1097/AUD.0000000000000133},
  volume       = {36},
  year         = {2015},
}

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