Cochlear implantation (CI) is a surgical alternative to traditional amplification (hearing aids) that can facilitate spoken language development in young children with severe-to-profound sensorineural hearing loss (SNHL).
To prospectively assess spoken language acquisition following CI in young children with adjustment of co-variates.
Design, Setting, and Participants
Prospective, longitudinal, and multidimensional assessment of spoken language growth over a 3-year period following CI. Prospective cohort study of children who underwent CI before 5 years of age (n=188) from 6 US centers and hearing children of similar ages (n=97) from 2 preschools recruited between November, 2002 and December, 2004. Follow-up completed between November, 2005 and May, 2008.
Main Outcome Measures
Performance on measures of spoken language comprehension and expression.
Children undergoing CI showed greater growth in spoken language performance (10.4;[95% confidence interval: 9.6–11.2] points/year in comprehension; 8.4;[7.8–9.0] in expression) than would be predicted by their pre-CI baseline scores (5.4;[4.1–6.7] comprehension; 5.8;[4.6–7.0] expression). Although mean scores were not restored to age-appropriate levels after 3 years, significantly greater annual rates of language acquisition were observed in children who were younger at CI (1.1;[0.5–1.7] points in comprehension per year younger; 1.0;[0.6–1.5] in expression), and in children with shorter histories of hearing deficit (0.8;[0.2,1.2] points in comprehension per year shorter; 0.6;[0.2–1.0] for expression). In multivariable analyses, greater residual hearing prior to CI, higher ratings of parent-child interactions, and higher SES associated with greater rates of growth in comprehension and expression.
The use of cochlear implants in young children was associated with better spoken language learning than would be predicted from their pre-implantation scores. However, discrepancies between participants’ chronologic and language age persisted after CI, underscoring the importance of early CI in appropriately selected candidates.