title: Spoken language development in children following cochlear implantation.
abstract: BACKGROUND
  Cochlear implantation 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).
  
  
  OBJECTIVE
  To prospectively assess spoken language acquisition following cochlear implantation in young children.
  
  
  METHODS
  Prospective, longitudinal, and multidimensional assessment of spoken language development over a 3-year period in children who underwent cochlear implantation 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.
  
  
  METHODS
  Performance on measures of spoken language comprehension and expression (Reynell Developmental Language Scales).
  
  
  RESULTS
  Children undergoing cochlear implantation showed greater improvement in spoken language performance (10.4; 95% confidence interval [CI], 9.6-11.2 points per year in comprehension; 8.4; 95% CI, 7.8-9.0 in expression) than would be predicted by their preimplantation baseline scores (5.4; 95% CI, 4.1-6.7, comprehension; 5.8; 95% CI, 4.6-7.0, expression), although mean scores were not restored to age-appropriate levels after 3 years. Younger age at cochlear implantation was associated with significantly steeper rate increases in comprehension (1.1; 95% CI, 0.5-1.7 points per year younger) and expression (1.0; 95% CI, 0.6-1.5 points per year younger). Similarly, each 1-year shorter history of hearing deficit was associated with steeper rate increases in comprehension (0.8; 95% CI, 0.2-1.2 points per year shorter) and expression (0.6; 95% CI, 0.2-1.0 points per year shorter). In multivariable analyses, greater residual hearing prior to cochlear implantation, higher ratings of parent-child interactions, and higher socioeconomic status were associated with greater rates of improvement in comprehension and expression.
  
  
  CONCLUSIONS
  The use of cochlear implants in young children was associated with better spoken language learning than would be predicted from their preimplantation scores.
authors.affiliation: Department of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. jnipark1@jhmi.edu
authors.forename: John K
authors.initials: JK
authors.lastname: Niparko
authors.forename: Emily A
authors.initials: EA
authors.lastname: Tobey
authors.forename: Donna J
authors.initials: DJ
authors.lastname: Thal
authors.forename: Laurie S
authors.initials: LS
authors.lastname: Eisenberg
authors.forename: Nae-Yuh
authors.initials: NY
authors.lastname: Wang
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Quittner
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Fink
mesh_terms: D016022:Case-Control Studies; D002675:Child, Preschool; D003054:Cochlear Implants; D005260:Female; D006319:Hearing Loss, Sensorineural; D006801:Humans; D007223:Infant; D007804:Language Development; D008297:Male; D011446:Prospective Studies; D013060:Speech
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