title: Assessing the use of speech and language measures in relation to parental perceptions of development after early cochlear implantation.
abstract: OBJECTIVE
  Clinicians and investigators use multiple outcome measures after early cochlear implantation (CI) to assess auditory skills, speech, and language effects. Are certain outcome measures better associated with optimal childhood development from the perspective of parents? We studied the association between several commonly used outcome instruments and a measure of parental perceptions of development to gain insight into how our clinical tests reflect parental perceptions of a child's developmental status.
  
  
  METHODS
  Cross-sectional analysis.
  
  
  METHODS
  Six academic centers.
  
  
  METHODS
  One hundred eighty-eight deaf children (<6 yr) 1 year after CI activation enrolled in the longitudinal Childhood Development after CI study.
  
  
  METHODS
  Measures of auditory skills, speech, and language. Parental perceptions of development quantified with a visual analogue scale (visual analogue scale-development).
  
  
  METHODS
  Nonparametric and parametric regression methods were used to model the relationship between outcome measures and visual analogue scale-development scores.
  
  
  RESULTS
  All outcome measures were positively associated with parental perceptions of development, but more robust associations were observed with language measures and a parent-report scale of auditory skills than with a selected measure of closed-set speech. For speech and language data, differences were observed in the trajectories of associations among younger (2-3 yr) versus older (4-5 yr) children.
  
  
  CONCLUSIONS
  Our results demonstrate the importance of measuring multiple outcome measures after early pediatric CI. The degree to which an outcome measure reflects childhood development as perceived by parents may be affected by the child's age. Measures that are based on parental report and broader outcome measures focused on verbal language offer the potential for a fuller understanding of the true effectiveness of early implantation.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, John Hopkins School of Medicine, Baltimore, Maryland , USA. flin1@jhmi.edu
authors.forename: Frank R
authors.initials: FR
authors.lastname: Lin
authors.forename: Nae-Yuh
authors.initials: NY
authors.lastname: Wang
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Fink
authors.forename: Alexander L
authors.initials: AL
authors.lastname: Quittner
authors.forename: Laurie S
authors.initials: LS
authors.lastname: Eisenberg
authors.forename: Emily A
authors.initials: EA
authors.lastname: Tobey
authors.forename: John K
authors.initials: JK
authors.lastname: Niparko
mesh_terms: D001307:Auditory Perception / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D003054:Cochlear Implants; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D007804:Language Development; D007807:Language Tests; D008137:Longitudinal Studies; D008297:Male; D015233:Models, Statistical; D009483:Neuropsychological Tests; D010290:Parents; D012044:Regression Analysis; D013060:Speech / Q000502:physiology*; D013067:Speech Perception / Q000502:physiology*; D016896:Treatment Outcome