title: Enduring advantages of early cochlear implantation for spoken language development.
abstract: OBJECTIVE
  In this article, the authors sought to determine whether the precise age of implantation (AOI) remains an important predictor of spoken language outcomes in later childhood for those who received a cochlear implant (CI) between 12 and 38 months of age. Relative advantages of receiving a bilateral CI after age 4.5 years, better pre-CI-aided hearing, and longer CI experience were also examined.
  
  
  METHODS
  Sixty children participated in a prospective longitudinal study of outcomes at 4.5 and 10.5 years of age. Twenty-nine children received a sequential second CI. Test scores were compared with normative samples of hearing age mates, and predictors of outcomes were identified.
  
  
  RESULTS
  Standard scores on language tests at 10.5 years of age remained significantly correlated with age of first cochlear implantation. Scores were not associated with receipt of a second, sequentially acquired CI. Significantly higher scores were achieved for vocabulary as compared with overall language, a finding not evident when the children were tested at younger ages.
  
  
  CONCLUSIONS
  Age-appropriate spoken language skills continued to be more likely with younger AOI, even after an average of 8.6 years of additional CI use. Receipt of a second implant between ages 4 and 10 years and longer duration of device use did not provide significant added benefit.
authors.affiliation: University of Texas at Dallas, TX, USA. ageers@utdallas.edu
authors.forename: Ann E
authors.initials: AE
authors.lastname: Geers
authors.forename: Johanna G
authors.initials: JG
authors.lastname: Nicholas
mesh_terms: D000367:Age Factors; D002648:Child; D002663:Child Language; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods / Q000534:rehabilitation*; D012048:Correction of Hearing Impairment; D003638:Deafness / Q000534:rehabilitation* / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007804:Language Development; D007807:Language Tests; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D013060:Speech; D014825:Vocabulary