title: Development of spoken language grammar following cochlear implantation in prelingually deaf children.
abstract: OBJECTIVE
  To assess the development of grammar comprehension in spoken language in prelingually deaf children following cochlear implantation and compare their grammatical abilities with those of their hearing peers.
  
  
  METHODS
  A prospective study of 82 consecutive prelingually deaf children up to 5 years following implantation. The children were less than 7 years old at the time of implantation (mean age +/- SD, 4.2 +/- 1.3 years). All received the same multichannel cochlear implant system. No child was lost to follow-up and there were no exclusions from the study.
  
  
  METHODS
  Tertiary referral cochlear implant center.
  
  
  METHODS
  The children were assessed using the Test for Reception of Grammar. This individually administered, multiple-choice test designed to assess the understanding of grammatical contrasts in the English language also allows direct comparison of grammar comprehension between test subjects and their normal-hearing peers.
  
  
  RESULTS
  Before implantation, only a small proportion (2%) of prelingually deaf children were above the first percentile of their normal-hearing peers. This percentage increased to 40% and 67%, respectively, 3 and 5 years after implantation; and 5 years after implantation, 20% of the children performed between the 25th and the 75th percentile or better. In the subgroup of children who received their cochlear device before the age of 4 years, this percentage reached 36%.
  
  
  CONCLUSIONS
  Spoken language grammar acquisition in prelingually deaf children with a cochlear implant was found to be considerably delayed. However, there was a clear trend toward the development of grammar skills following cochlear implantation, and the greatest advance was made by children who received their implant at a younger age. These findings support the present trend toward early implantation.
authors.affiliation: Department of Otorhinolaryngology, Ippokration Hospital, Athens University, Athens, Greece. Thomas.Nikolopoulos@Nottingham.ac.uk
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Nikolopoulos
authors.forename: Dee
authors.initials: D
authors.lastname: Dyar
authors.forename: Sue
authors.initials: S
authors.lastname: Archbold
authors.forename: Gerard M
authors.initials: GM
authors.lastname: O'Donoghue
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation; D005260:Female; D006801:Humans; D007804:Language Development; D007807:Language Tests; D008297:Male; D019986:Persons with Hearing Disabilities / Q000523:psychology*; D011446:Prospective Studies