title: Pediatric cochlear implantation in Taiwan: long-term communication outcomes.
abstract: OBJECTIVE
  Cochlear implantation is an established method of auditory rehabilitation for severely and profoundly hearing impaired individuals. Although numerous studies have examined communication outcomes in pediatric cochlear implant (CI) recipients, data concerning the benefits of cochlear implantation in children who speak Mandarin Chinese are lacking. This study examined communication outcomes in 29 Mandarin-speaking children implanted at Chung Gung Memorial Hospital.
  
  
  METHODS
  A prospective between-groups design was used to compare communication outcomes as a function of age at time of implantation.
  
  
  METHODS
  Children in the Younger group were implanted before 3 years of age, whereas children in the Older group were implanted after 3 years of age. Outcome measures assessed auditory thresholds, speech perception, speech intelligibility, receptive and expressive language skills, communication barriers, and communication mode. Correlation analysis was used to examine the relationship between communication outcome and age at implantation.
  
  
  RESULTS
  Children in the Younger group demonstrated a significant level of difference on Mandarin vowels, consonants, tones, and open-set speech perception compared with the children in the Older group. Between-group differences were also shown on receptive and expressive language skills. But, no significant differences were noted on speech intelligibility or in self-ratings of communication barriers. A larger proportion of children in the Younger group used oral communication and were educated in mainstream classrooms. Communication mode change of the Younger group reached a significant level after cochlear implant. Speech perception performance was negatively correlated with age at implantation as well as chronological age. Mandarin-speaking children can obtain substantial communication benefits from cochlear implantation, with earlier implantation yielding superior results.
authors.affiliation: Department of Speech Language Pathology & Audiology, Chung Shan Medical University, No. 110 Chien Kuo North Road, Section 1, Taichung 402, Taiwan. frances@csmu.edu.tw
authors.forename: Nan Mai
authors.initials: NM
authors.lastname: Wang
authors.forename: Tsun Sheng
authors.initials: TS
authors.lastname: Huang
authors.forename: Che-Ming
authors.initials: CM
authors.lastname: Wu
authors.forename: Karen Iler
authors.initials: KI
authors.lastname: Kirk
mesh_terms: D000293:Adolescent; D001309:Auditory Threshold / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000706:statistics & numerical data*; D003147:Communication Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D003145:Communication Methods, Total; D003638:Deafness / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D004519:Education, Special / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008282:Mainstreaming, Education / Q000706:statistics & numerical data; D008297:Male; D013065:Speech Intelligibility; D013067:Speech Perception / Q000502:physiology; D013068:Speech Production Measurement; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome