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General clinical and outcome profile
The demographical, hearing loss and CI profile of the study sample are presented in Table 4.1. CAP and SIR scores were obtained for 240 children at the time of the study (240/301 or 79.7%). Overall, most children (164/240 or 68.3%) achieved high CAP scores (category 5‐8), hile 76 children (76/240 or 31.7%) achieved low CAP scores (category 0‐4). For the total sample, high SIR scores (category 3‐5) were attained by 171 children (171/240 or 71.2%), with 69 children (69/240 or 28.8%) attaining low SIR scores (category 1‐2). Average hearing age at CAP/SIR for this study sample was 67.4 months (range: 6 ‐ 88 months; 43.6 SD; n=236). This hearing age at CAP/SIR was divided into two groups: children with a hearing age with CI of ≤36 months (73/236 or 30.9%) and children with a hearing age with CI ≥37 months (163/236 or 69.1%). Taking this hearing age with CI into account, for children wearing their implants ≥37 months, high CAP scores (128/163 or 78%) and high SIR scores (128/163 or 78%) were achieved for even more children.
Data on children’s current mode of communication were obtained for 96.3% (290/301) of the total sample. Most children (74.5%, 216/290) were oral communicators, while 13.1% (38/290) utilized TC and 6.2% (18/290) used SASL. The remaining 6.2% (18/290) were using other alternative modes of manual communication. All children who were not oral communicators were grouped together as non‐oral communicators (25.5%, 74/290).
For almost the entire sample (99%, 298/301), data were available on the educational placement of children. Just more than half of the children were in mainstream schools (52.3%, 156/298), while 15.1% (45/298) were in schools for the deaf (SASL mode of communication) and 7.4% (22/298) were in schools for the hard‐of‐hearing (oral mode of communication). A significant proportion of children (17.4%, 52/298) attended special schools where in half of the cases (50%, 26/52) a mainstream syllabus was followed and the other half of the cases (50%, 26/52) an adapted special syllabus was followed. Fourteen children (4.7%, 14/298) did not go to school, and another 9 children (3%, 9/298) were home‐schooled. All children not attending mainstream schools were grouped together as being placed in non‐mainstream education (47.7%, 142/298).
Linear regression analysis: auditory performance (CAP scores) and speech production (SIR scores)
Only the predictor variables that appeared to be associated with the outcome variables in the bivariate analysis were included in the regression models (Table 4.4). For the linear regression models, all associated predictor variables with a significance level of p < 0.1, as well as the two forced factors, were randomly fed into the model. During the model building process, the best predictors of the two continuous outcome variables (CAP and SIR scores) were identified.
The two resulting linear regression models showing the best predictors of outcomes in terms of auditory performance (model 1) and speech production (model 2) are presented in Table 4.5.
CHAPTER 1: INTRODUCTION
1.1 Background
1.2 Profound childhood hearing loss in South Africa
1.3 Predictors of pediatric cochlear implant outcome
1.4 Predictors of adult cochlear implant outcomes
1.5 Cochlear implantation in South Africa
1.6 Rationale .
CHAPTER 2: METHODOLOGY
2.1 Research objectives
2.2 Research design and procedures
2.3 Research context
2.4 Ethical considerations
2.5 Statistical analysis
CHAPTER 3: PROFOUND CHILDHOOD HEARING LOSS IN A SOUTH AFRICAN COHORT: RISK PROFILE,DIAGNOSIS AND AGE OF INTERVENTION
3.1 Abstract
3.2 Introduction
3.3 Method
3.3.1 Study population
3.3.2 Procedures
3.3.3 Data processing and analysis .
3.4 Results
3.4.1 Demographics
3.4.2 Risk profile .
3.4.3 Diagnosis and degree of permanent childhood hearing
3.4.4 Age of hearing loss suspicion and diagnosis
3.4.5 Age of intervention
3.5 Discussion
3.6 Conclusion
3.7 Acknowledgements .
CHAPTER 4: PREDICTORS OF PEDIATRIC COCHLEAR IMPLANTATION OUTCOMES IN SOUTH AFRICA
4.1 Abstrac
4.2 Introduction .
4.3 Materials and methods
4.3.1 Study population .
4.3.2 Description of variables
4.3.3 Data collection
4.3.4 Statistical analysis
4.4 Results
4.4.1 General clinical and outcome profile
4.4.2 Linear regression analysis: auditory performance (CAP scores) and speech production
(SIR scores)
4.4.3 Log linear analysis: non‐oral mode of communication and non‐mainstream
educational setting
4.5 Discussion
4.6 Conclusion
4.7 Acknowledgements .
CHAPTER 5: PREDICTORS OF HEALTH‐RELATED QUALITY OF LIFE IN ADULT COCHLEAR IMPLANRECIPIENTS IN SOUTH AFRICA
CAPTER 6: GENERAL DISCUSSION, CLINICAL IMPLICATIONS AND CONCLUSION
REFERENCES
