Development and validation of the Nottingham Auditory Milestones (NAMES) profile for deaf children under 2 years old, using cochlear implants

Abstract

Objectives: Clinicians face considerable challenges in setting appropriate auditory goals for babies and young children who receive cochlear implants. This paper describes the rationale, organization, implementation, and validation of the Nottingham Auditory Milestones profile that was developed to address these challenges.

Methods: The use of the profile has been fully integrated into the postoperative pathway at the Nottingham Auditory Implant Programme since 2009. Data are presented on a cohort of 30 children who received bilateral cochlear implants under the age of 2 years and who have no other diagnosed difficulties. The data were used to validate the profile’s structure and characterize the expected development trajectory for this population of children.

Results: The analysis of routine data from the children confirmed that the profile’s structure reflected the typical order and rate at which skills emerged and were acquired over the first 3 years following cochlear implantation. The distribution of profile scores across five assessment time-points established a developmental trajectory for typically developing children. Three case studies describe the use of the profile to set consistent expectations for progress for a wide range of children.

Discussion: The development trajectory established using the profile provides a mechanism to identify children not making the expected progress, in order to support the need for a review of approach or a differential diagnosis.

Conclusion: The Nottingham Auditory Milestones profile is an accessible and practical tool for identifying, monitoring, and appraising the auditory achievements of deaf babies and young children in the first 3 years following cochlear implantation.

Keywords:

• Paediatric Cochlear Implantation
• Auditory Achievements
• Milestones
• Profile

Acknowledgements

The authors wish to thank all members of the team at NAIP, the families, and local professionals for their contributions. They would also like to thank Sandra Smith and Laura Lucas for their assistance with transcribing the data. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health.

Disclaimer statements

Contributors None.

Conflicts of interest None.

Ethics approval None.

ORCID

Pádraig T. Kitterick http://orcid.org/0000-0001-8383-5318

Notes

1 Staff who comprise the Outreach Support Team have professional backgrounds in auditory verbal therapy, deaf education, and speech and language therapy.

2 Twenty-one out of 30 children as a proportion (70%) has a confidence interval from 52% to 83%. Seventy per cent was used to signify a majority as it was the smallest proportion whose lower confidence interval was >50%; i.e. the smallest proportion statistically greater than 50%.

3 The Ling Sound test was developed by Dr. Daniel Ling in 1976 as a means to easily test sounds across the speech spectrum of hearing. The following 6 sounds are used: mm, oo, ah, ee, sh, s.

4 The materials are available on the NAIP website (www.nuh.nhs.uk/naip) and subsequent to their development, have been published by Advanced Bionics Ltd (advancedbionics.com).

Additional information

Funding

This study was supported by infrastructure funding from the National Institute for Health Research (NIHR), Nottingham University Hospitals NHS Trust, and the University of Nottingham.