Will they catch up? The role of age at cochlear implantation in the spoken language development of children with severe to profound hearing loss.
OBJECTIVE
The authors examined the benefits of younger cochlear implantation, longer cochlear implant use, and greater pre-implant aided hearing to spoken language at 3.5 and 4.5 years of age.


METHODS
Language samples were obtained at ages 3.5 and 4.5 years from 76 children who received an implant by their 3rd birthday. Hierarchical linear modeling was used to identify characteristics associated with spoken language outcomes at the 2 test ages. The Preschool Language Scale (I. L. Zimmerman, V. G. Steiner, & R. E. Pond, 1992) was used to compare the participants' skills with those of hearing age-mates at age 4.5 years.


RESULTS
Expected language scores increased with younger age at implant and lower pre-implant thresholds, even when compared at the same duration of implant use. Expected Preschool Language Scale scores of the children who received the implant at the youngest ages reached those of hearing age-mates by 4.5 years, but those children implanted after 24 months of age did not catch up with hearing peers.


CONCLUSIONS
Children who received a cochlear implant before a substantial delay in spoken language developed (i.e., between 12 and 16 months) were more likely to achieve age-appropriate spoken language. These results favor cochlear implantation before 24 months of age, especially for children with aided pure-tone average thresholds greater than 65 dB prior to surgery.
Central Institute for the Deaf at Washington University School of Medicine, Department of Otolaryngology, Box 8115, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA. nicholasj@ent.wustl.edu
Johanna Grant
JG
Nicholas
Ann E
AE
Geers
D000367:Age Factors; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D002675:Child, Preschool; D003054:Cochlear Implants; D006310:Hearing Aids; D034381:Hearing Loss / Q000150:complications / Q000534:rehabilitation* / Q000601:surgery*; D006801:Humans; D007223:Infant; D007802:Language; D007805:Language Development Disorders / Q000209:etiology / Q000517:prevention & control* / Q000534:rehabilitation*; D016014:Linear Models; D012720:Severity of Illness Index