Rayes, Hanin Hassan H.; (2021) The Development and Evaluation of the Hearing Intervention Battery in Arabic (HIBA) for Auditory Perception in Children with Cochlear Implants. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

The Hearing Intervention Battery in Arabic (HIBA), is a multi-modal auditory training intervention, that was developed based on the recommendations from our published systematic review of the literature on the effectiveness of auditory training (AT) for children with cochlear implants (CIs). HIBA was primarily intended to help improve speech and pitch perception in Arabic-speaking children with CIs. Due to the lack of auditory and speech assessment tools for the Arabic language, the A-CAPT, an Arabic version of the English Chear Auditory Perception Test (CAPT) was developed. The A-CAPT was validated prior its use in this project with 26 children with typical hearing. There was a strong agreement between the test and retest measures and normative data and the critical difference values were calculated which were similar to the British English CAPT. A randomized control trial (RCT) to evaluate the HIBA training programme was conducted with 14, 5- to 13-year-old Arabic-speaking children with CIs. The control group received art training following step-by-step drawing and face-paint exercises while the HIBA multi-modal training group received games involving communication interactions (DiaPix), speech cue discrimination (Alefbata.com), and pitch discrimination (musical discrimination using a keyboard). All tasks were interactive and designed to be completed by the children together with their parents or caregivers. There was a double baseline measurement, followed by a 4-week intervention period before a post intervention assessment. There was a significant improvement in consonant perception for children who received the HIBA multi-modal training intervention but this was not observed in the active control group. There was some evidence of generalization of learning, as observed by improvements in the non-trained task (phoneme discrimination) for the intervention group but not for controls. It was unclear if one particular element of the HIBA led to these improvements. Parents were actively involved in the multi-modal training group and their feedback indicated that the most preferred part of multi-modal training was the communication interaction tasks using the Diapix. To understand which element of the HIBA led to improvements in speech perception and whether the duration of training and sample size masked any gains, a trial forward in a larger scale should be conducted. In addition, to improve the quality of evidence of the study, collaboration is need to achieve a double blinded study and minimize bias. Findings of this project may suggest that children with CIs and their parents can benefit from regular and sustained access to age-appropriate auditory training materials and activities. In addition, findings would extend the current understanding of the impact of auditory training on CI outcomes in children and provide inspiration for a more comprehensive rehabilitation scheme for CI users.

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