title: Influence of implantation age on school-age language performance in pediatric cochlear implant users.
abstract: OBJECTIVE
  This study examined specific spoken language abilities of 160 children with severe-to-profound sensorineural hearing loss followed prospectively 4, 5, or 6 years after cochlear implantation.
  
  
  METHODS
  Ninety-eight children received implants before 2.5 years, and 62 children received implants between 2.5 and 5 years of age.
  
  
  METHODS
  Language was assessed using four subtests of the Comprehensive Assessment of Spoken Language (CASL). Standard scores were evaluated by contrasting age of implantation and follow-up test time.
  
  
  RESULTS
  Children implanted under 2.5 years of age achieved higher standard scores than children with older ages of implantation for expressive vocabulary, expressive syntax, and pragmatic judgments. However, in both groups, some children performed more than two standard deviations below the standardization group mean, while some scored at or well above the mean.
  
  
  CONCLUSIONS
  Younger ages of implantation are associated with higher levels of performance, while later ages of implantation are associated with higher probabilities of continued language delays, particularly within subdomains of grammar and pragmatics. Longitudinal data from this cohort study demonstrate that after 6 years of implant experience, there is large variability in language outcomes associated with modifiers of rates of language learning that differ as children with implants age.
authors: Dallas Cochlear Implant Program, University of Texas at Dallas, Dallas, Texas, USA. etobey@utdallas.edu
authors: Emily A
authors: EA
authors: Tobey
authors: Donna
authors: D
authors: Thal
authors: John K
authors: JK
authors: Niparko
authors: Laurie S
authors: LS
authors: Eisenberg
authors: Alexandra L
authors: AL
authors: Quittner
authors: Nae-Yuh
authors: NY
authors: Wang
mesh_terms: D000367:Age Factors; D002648:Child; D002663:Child Language; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000295:instrumentation*; D003054:Cochlear Implants; D032882:Comprehension; D012048:Correction of Hearing Impairment / Q000295:instrumentation*; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D007223:Infant; D007805:Language Development Disorders / Q000517:prevention & control* / Q000523:psychology; D007807:Language Tests; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D019986:Persons with Hearing Disabilities / Q000523:psychology / Q000534:rehabilitation*; D011446:Prospective Studies; D012720:Severity of Illness Index; D014481:United States; D014825:Vocabulary