Browsing by Author "Castellanos, Irina"

Now showing 1 - 6 of 6
  • Thumbnail Image
    Item
    Executive Functioning Skills in Preschool-Age Children With Cochlear Implants
    (ASHA Publications, 2014-08) Beer, Jessica; Kronenberger, William G.; Castellanos, Irina; Colson, Bethany G.; Henning, Shirley C.; Pisoni, David B.; Department of Otolaryngology--Head & Neck Surgery, School of Medicine
    Purpose The purpose of this study was to determine whether deficits in executive functioning (EF) in children with cochlear implants (CIs) emerge as early as the preschool years. Method Two groups of children ages 3 to 6 years participated in this cross-sectional study: 24 preschoolers who had CIs prior to 36 months of age and 21 preschoolers with normal hearing (NH). All were tested on normed measures of working memory, inhibition-concentration, and organization-integration. Parents completed a normed rating scale of problem behaviors related to EF. Comparisons of EF skills of children with CIs were made to peers with NH and to published nationally representative norms. Results Preschoolers with CIs showed significantly poorer performance on inhibition-concentration and working memory compared with peers with NH and with national norms. No group differences were found in visual memory or organization-integration. When data were controlled for language, differences in performance measures of EF remained, whereas differences in parent-reported problems with EF were no longer significant. Hearing history was generally unrelated to EF. Conclusions This is the first study to demonstrate that EF deficits found in older children with CIs begin to emerge as early as preschool years. The ability to detect these deficits early has important implications for early intervention and habilitation after cochlear implantation.
  • Thumbnail Image
    Item
    Neurocognitive Risk in Children With Cochlear Implants
    (American Medical Association, 2014-07) Kronenberger, William G.; Beer, Jessica; Castellanos, Irina; Pisoni, David B.; Miyamoto, Richard T.; Psychiatry, School of Medicine
    IMPORTANCE Children who receive a cochlear implant (CI) for early severe to profound sensorineural hearing loss may achieve age-appropriate spoken language skills not possible before implantation. Despite these advances, reduced access to auditory experience may have downstream effects on fundamental neurocognitive processes for some children with CIs. OBJECTIVE To determine the relative risk (RR) of clinically significant executive functioning deficits in children with CIs compared with children with normal hearing (NH). DESIGN, SETTING, AND PARTICIPANTS In this prospective, cross-sectional study, 73 children at a hospital-based clinic who received their CIs before 7 years of age and 78 children with NH, with average to above average mean nonverbal IQ scores, were recruited in 2 age groups: preschool age (age range, 3–5 years) and school age (age range, 7–17 years). No children presented with other developmental, cognitive, or neurologic diagnoses. INTERVENTIONS Parent-reported checklist measures of executive functioning were completed during psychological testing sessions. MAIN OUTCOMES AND MEASURES Estimates of the RR of clinically significant deficits in executive functioning (≥ 1 SDs above the mean) for children with CIs compared with children with NH were obtained based on 2 parent-reported child behavior checklists of everyday problems with executive functioning. RESULTS In most domains of executive functioning, children with CIs were at 2 to 5 times greater risk of clinically significant deficits compared with children with NH. The RRs for preschoolers and school-aged children, respectively, were greatest in the areas of comprehension and conceptual learning (RR [95% CI], 3.56 [1.71–7.43] and 6.25 [2.64–14.77]), factual memory ( 4.88 [1.58–15.07] and 5.47 [2.03–14.77]), attention (3.38 [1.03–11.04] and 3.13 [1.56–6.26]), sequential processing (11.25 [1.55–81.54] and 2.44 [1.24–4.76]), working memory (4.13 [1.30–13.06] and 3.64 [1.61–8.25] for one checklist and 1.77 [0.82–3.83] and 2.78 [1.18–6.51] for another checklist), and novel problem-solving (3.93 [1.50–10.34] and 3.13 [1.46–6.67]). No difference between the CI and NH samples was found for visual-spatial organization (2.63 [0.76–9.03] and 1.04 [0.45–2.40] on one checklist and 2.86 [0.98–8.39] for school-aged children on the other checklist). CONCLUSIONS AND RELEVANCE A large proportion of children with CIs are at risk for clinically significant deficits across multiple domains of executive functioning, a rate averaging 2 to 5 times that of children with NH for most domains. Screening for risk of executive functioning deficits should be a routine part of the clinical evaluation of all children with deafness and CIs.
  • Thumbnail Image
    Item
    Psychosocial Outcomes in Long-Term Cochlear Implant Users
    (Wolters Kluwer, 2018-05) Castellanos, Irina; Kronenberger, William G.; Pisoni, David B.; Psychiatry, School of Medicine
    OBJECTIVES: The objectives of this study were to investigate psychosocial outcomes in a sample of prelingually deaf, early-implanted children, adolescents, and young adults who are long-term cochlear implant (CI) users and to examine the extent to which language and executive functioning predict psychosocial outcomes. DESIGN: Psychosocial outcomes were measured using two well-validated, parent-completed checklists: the Behavior Assessment System for Children and the Conduct Hyperactive Attention Problem Oppositional Symptom. Neurocognitive skills were measured using gold standard, performance-based assessments of language and executive functioning. RESULTS: CI users were at greater risk for clinically significant deficits in areas related to attention, oppositional behavior, hyperactivity-impulsivity, and social-adaptive skills compared with their normal-hearing peers, although the majority of CI users scored within average ranges relative to Behavior Assessment System for Children norms. Regression analyses revealed that language, visual-spatial working memory, and inhibition-concentration skills predicted psychosocial outcomes. CONCLUSIONS: Findings suggest that underlying delays and deficits in language and executive functioning may place some CI users at a risk for difficulties in psychosocial adjustment.
  • Thumbnail Image
    Item
    Questionnaire-based assessment of executive functioning: Case studies
    (Taylor & Francis, 2018-01) Kronenberger, William G.; Castellanos, Irina; Pisoni, David B.; Psychiatry, School of Medicine
    Delays in the development of executive functioning skills are frequently observed in pediatric neuropsychology populations and can have a broad and significant impact on quality of life. As a result, assessment of executive functioning is often relevant for the development of formulations and recommendations in pediatric neuropsychology clinical work. Questionnaire-based measures of executive functioning behaviors in everyday life have unique advantages and complement traditional neuropsychological measures of executive functioning. Two case studies of children with spina bifida are presented to illustrate the clinical use of a new questionnaire measure of executive and learning-related functioning, the Learning, Executive, and Attention Functioning Scale (LEAF). The LEAF emphasizes clinical utility in assessment by incorporating four characteristics: brevity in administration, breadth of additional relevant content, efficiency of scoring and interpretation, and ease of availability for use. LEAF results were consistent with another executive functioning checklist in documenting everyday behavior problems related to working memory, planning, and organization while offering additional breadth of assessment of domains such as attention, processing speed, and novel problem-solving. These case study results demonstrate the clinical utility of questionnaire-based measurement of executive functioning in pediatric neuropsychology and provide a new measure for accomplishing this goal.
  • Thumbnail Image
    Item
    Temperament in Toddlers With and Without Prelingual Hearing Loss
    (American Speech-Language-Hearing Association, 2024) Castellanos, Irina; Houston, Derek M.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Purpose: The purpose of this study is to examine parent-reported ratings of temperament in toddlers with and without prelingual hearing loss. Method: The parent-completed Early Childhood Behavior Questionnaire (ECBQ) was used to assess temperament in toddlers aged 18-36 months. Three dimensions of temperament were examined: surgency, negative affectivity, and effortful control. Analyses were conducted to (a) examine differences in temperament across toddlers with and without prelingual hearing loss; (b) examine possible associations between temperament, demographic, and communication factors; and (c) determine if the ECBQ is sensitive to differences in hearing, communication, and listening skills among toddlers with prelingual hearing loss. Results: The parent-completed ECBQ revealed that toddlers with prelingual hearing loss differed from their hearing peers on some but not all dimensions of temperament. Specifically, children with prelingual hearing loss were rated as displaying higher levels of surgency and lower levels of effortful control but comparable levels of negative affectivity when compared to their hearing peers. Regression analyses revealed that chronological age and communication strategy predicted scores of effortful control in toddlers with prelingual hearing loss, whereas chronological age alone predicted scores of effortful control in toddlers with hearing. Finally, the ECBQ appears to contain "listening" items that skew (lower) levels of effortful control in toddlers with prelingual hearing loss, such that only the group effect of higher levels of surgency remained after removing these "listening" items. Correlations between the original and our modified ECBQ (removing the "listening" items) revealed strong associations, reflective of high construct validity. Conclusions: This was the first study to measure temperament in toddlers with prelingual hearing loss using the ECBQ. Our results revealed differences between children with and without prelingual hearing loss centering on the dimension of surgency. Examining differences in temperament during the toddler period of development may be particularly important and useful for predicting functional outcomes following prelingual hearing loss.
  • Thumbnail Image
    Item
    Verbal Learning and Memory After Cochlear Implantation in Postlingually Deaf Adults: Some New Findings with the CVLT-II
    (Wolters Kluwer, 2018) Pisoni, David B.; Broadstock, Arthur; Wucinich, Taylor; Safdar, Natalie; Miller, Kelly; Hernandez, Luis R.; Vasil, Kara; Boyce, Lauren; Davies, Alexandra; Harris, Michael S.; Castellanos, Irina; Xu, Huiping; Kronenberger, William G.; Moberly, Aaron C.; Biostatistics, IU School of Medicine
    OBJECTIVES: Despite the importance of verbal learning and memory in speech and language processing, this domain of cognitive functioning has been virtually ignored in clinical studies of hearing loss and cochlear implants in both adults and children. In this article, we report the results of two studies that used a newly developed visually based version of the California Verbal Learning Test-Second Edition (CVLT-II), a well-known normed neuropsychological measure of verbal learning and memory. DESIGN: The first study established the validity and feasibility of a computer-controlled visual version of the CVLT-II, which eliminates the effects of audibility of spoken stimuli, in groups of young normal-hearing and older normal-hearing (ONH) adults. A second study was then carried out using the visual CVLT-II format with a group of older postlingually deaf experienced cochlear implant (ECI) users (N = 25) and a group of ONH controls (N = 25) who were matched to ECI users for age, socioeconomic status, and nonverbal IQ. In addition to the visual CVLT-II, subjects provided data on demographics, hearing history, nonverbal IQ, reading fluency, vocabulary, and short-term memory span for visually presented digits. ECI participants were also tested for speech recognition in quiet. RESULTS: The ECI and ONH groups did not differ on most measures of verbal learning and memory obtained with the visual CVLT-II, but deficits were identified in ECI participants that were related to recency recall, the buildup of proactive interference, and retrieval-induced forgetting. Within the ECI group, nonverbal fluid IQ, reading fluency, and resistance to the buildup of proactive interference from the CVLT-II consistently predicted better speech recognition outcomes. CONCLUSIONS: Results from this study suggest that several underlying foundational neurocognitive abilities are related to core speech perception outcomes after implantation in older adults. Implications of these findings for explaining individual differences and variability and predicting speech recognition outcomes after implantation are discussed.