title: Long-term Communication Outcomes for Children Receiving Cochlear Implants Younger Than 12 Months: A Multicenter Study.
abstract: OBJECTIVE
  Examine the influence of age at implant on speech perception, language, and speech production outcomes in a large unselected paediatric cohort.
  
  
  METHODS
  This study pools available assessment data (collected prospectively and entered into respective databases from 1990 to 2014) from three Australian centers.
  
  
  METHODS
  Children (n = 403) with congenital bilateral severe to profound hearing loss who received cochlear implants under 6 years of age (excluding those with acquired onset of profound hearing loss after 12 mo, those with progressive hearing loss and those with mild/moderate/severe additional cognitive delay/disability).
  
  
  METHODS
  Speech perception; open-set words (scored for words and phonemes correct) and sentence understanding at school entry and late primary school time points. Language; PLS and PPVT standard score equivalents at school entry, CELF standard scores. Speech Production; DEAP percentage accuracy of vowels, consonants, phonemes-total and clusters, and percentage word-intelligibility at school entry.
  
  
  RESULTS
  Regression analysis indicated a significant effect for age-at-implant for all outcome measures. Cognitive skills also accounted for significant variance in all outcome measures except open-set phoneme scores. ANOVA with Tukey pairwise comparisons examined group differences for children implanted younger than 12 months (Group 1), between 13 and 18 months (Group 2), between 19 and 24 months (Group 3), between 25 and 42 months (Group 4), and between 43 and 72 months (Group 5). Open-set speech perception scores for Groups 1, 2, and 3 were significantly higher than Groups 4 and 5. Language standard scores for Group 1 were significantly higher than Groups 2, 3, 4, and 5. Speech production outcomes for Group 1 were significantly higher than scores obtained for Groups 2, 3, and 4 combined. Cross tabulation and χ2 tests supported the hypothesis that a greater percentage of Group 1 children (than Groups 2, 3, 4, or 5) demonstrated language performance within the normative range by school entry.
  
  
  CONCLUSIONS
  Results support provision of cochlear implants younger than 12 months of age for children with severe to profound hearing loss to optimize speech perception and subsequent language acquisition and speech production accuracy.
authors.affiliation: *University of Melbourne, HEARing CRC, Cochlear Implant Clinic, Royal Victorian Eye and Ear Hospital †University of Melbourne, HEARing CRC ‡Hear and Say Centre §The Shepherd Centre ||Cochlear Implant Clinic, Royal Victorian Eye and Ear Hospital ¶University of Melbourne, HEARing CRC #University of Melbourne, HEARing CRC, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
authors.forename: Shani Joy
authors.initials: SJ
authors.lastname: Dettman
authors.forename: Richard Charles
authors.initials: RC
authors.lastname: Dowell
authors.forename: Dawn
authors.initials: D
authors.lastname: Choo
authors.forename: Wendy
authors.initials: W
authors.lastname: Arnott
authors.forename: Yetta
authors.initials: Y
authors.lastname: Abrahams
authors.forename: Aleisha
authors.initials: A
authors.lastname: Davis
authors.forename: Dimity
authors.initials: D
authors.lastname: Dornan
authors.forename: Jaime
authors.initials: J
authors.lastname: Leigh
authors.forename: Gabriella
authors.initials: G
authors.lastname: Constantinescu
authors.forename: Robert
authors.initials: R
authors.lastname: Cowan
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Briggs
mesh_terms: D000367:Age Factors; D001315:Australia; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D003638:Deafness / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007802:Language; D007804:Language Development; D008297:Male; D013067:Speech Perception; D013068:Speech Production Measurement; D016896:Treatment Outcome