Saying that the study validates their hypothesis that pre-implant cortical activation patterns during infancy correlate with language performance two years after implantation, Dr. Lu emphasized that the two regions of the brain with elevated activity in the children who underwent cochlear implantation indicate two biomarkers that may predict outcomes of cochlear implants.
“Based on this preliminary result, we are optimistic that a reliable machine learning model based on a larger training set can eventually be applied in the clinical setting to provide specific prognosis information to patients considering cochlear implantation,” he said. The aim now, he added, is to test the model in a larger sample so that eventually may become a useful tool for clinicians.
Beyond Speech and Language Skills
For Nancy M. Young, MD, head of the section of otology/neurotolgy and medical director of the audiology and cochlear implant programs at the Ann & Robert H. Lurie Children’s Hospital of Chicago, these findings should be used to further research to improve cochlear implantation in children, but she emphasized that they should not be used to exclude children from receiving cochlear implants.
“I think it is very important to learn about how brain structure affects speech and language outcomes, but the goal should be to use that knowledge to then individualize therapy to improve the outcome and to better counsel the family about outcomes as well,” she said.
Dr. Young, who also is engaged in research using functional imaging to better understand hearing loss in children, disagrees with what she sees as an underlying premise of the study that suggests the only children who can achieve excellent spoken language skills should be treated with cochlear implants.
“There are benefits of hearing that go beyond speech,” she emphasized, saying, among other things, that hearing permits a better and needed understanding of our environment and helps us engage with other people.
She also cited research showing that cochlear implants in children not only have a powerful impact on spoken language development, but also on the ability to use sign language.
Clarifying that speech and language are the ultimate benefits of cochlear implants, Dr. Lu agreed that there are other benefits to hearing such as hearing an oncoming car when crossing the street or responding when your name is called.
“These processes do not involve speech or even language but can be life changing and life saving,” he said, adding that their model may provide some pre-operative counseling to patients considering cochlear implantation even if it doesn’t exclude ineffective users of cognitive implants from this surgery.