Developmental Effects of Concurrent Vestibular and Auditory Impairments in Childhood
Bibliographic record
Abstract
This thesis aimed to examine how hearing loss, vestibular dysfunction, and socioeconomic factors influence the development of balance, spatial learning, and cognitive outcomes in children with cochlear implants. While children with hearing loss are known to experience delays in motor and cognitive domains, the extent to which these delays relate to underlying vestibular dysfunction, reduced auditory experience, or environmental factors remains unclear. It was hypothesized that poor balance and spatial difficulties would be more prevalent in children with cochlear implants, but that learning could occur with repeated exposure and experience.To explore this, three complementary studies were conducted. The first study analyzed clinical data from 334 children with and without hearing loss and found that balance problems were significantly more common in children with hearing loss, particularly when vestibulo-ocular reflex (VOR) function was impaired. These results support the importance of VOR assessments in identifying children at risk for motor delays. The second study evaluated language, working memory, and academic performance in 96 children, 66 with bilateral cochlear implants compared to 30 typically developing peers. Although all children improved with age, those with cochlear implants demonstrated persistent deficits across all domains. Analyses revealed that developmental outcomes were most strongly associated with duration and quality of auditory experience, rather than vestibular or socioeconomic factors alone. Children with specific etiologies such as congenital cytomegalovirus and structural inner ear anomalies were particularly affected. The final study assessed spatial learning in 54 children during a 5-day camp using novel, mobile tasks of balance, auditory localization, and visuospatial memory. Children with cochlear implants (n=21) performed more poorly than their peers (n=19) across all tasks but demonstrated learning over time in visuospatial and balance domains, suggesting that these abilities are malleable with experience. Auditory spatial performance was more limited but showed improvement in reaction time for children with greater auditory experience. Taken together, these findings highlight the complex interplay between sensory input, neural development, and experience. While delays are evident in children with cochlear implants, the capacity for improvement underscores the importance of early intervention, balance screening, and individualized supports that promote spatial and cognitive development in this high-risk population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".