Article/Report  |   August 2007
Will They Catch Up? The Role of Age at Cochlear Implantation in the Spoken Language Development of Children With Severe to Profound Hearing Loss
 
Author Notes
  • Contact author: Johanna Grant Nicholas, Central Institute for the Deaf at Washington University School of Medicine, Department of Otolaryngology, Box 8115, 660 South Euclid Avenue, St. Louis, Missouri 63110. E-mail: nicholasj@ent.wustl.edu.
Article Information
Development / Hearing & Speech Perception / Hearing Disorders / Hearing Aids, Cochlear Implants & Assistive Technology / Language
Article/Report   |   August 2007
Will They Catch Up? The Role of Age at Cochlear Implantation in the Spoken Language Development of Children With Severe to Profound Hearing Loss
Journal of Speech, Language, and Hearing Research, August 2007, Vol. 50, 1048-1062. doi:10.1044/1092-4388(2007/073)
History: Received June 21, 2006 , Revised October 6, 2006 , Accepted November 28, 2006
 
Journal of Speech, Language, and Hearing Research, August 2007, Vol. 50, 1048-1062. doi:10.1044/1092-4388(2007/073)
History: Received June 21, 2006; Revised October 6, 2006; Accepted November 28, 2006
Web of Science® Times Cited: 99

Purpose: The authors examined the benefits of younger cochlear implantation, longer cochlear implant use, and greater pre-implant aided hearing to spoken language at 3.5 and 4.5 years of age.

Method: Language samples were obtained at ages 3.5 and 4.5 years from 76 children who received an implant by their 3rd birthday. Hierarchical linear modeling was used to identify characteristics associated with spoken language outcomes at the 2 test ages. The Preschool Language Scale (I. L. Zimmerman, V. G. Steiner, & R. E. Pond, 1992) was used to compare the participants' skills with those of hearing age-mates at age 4.5 years.

Results: Expected language scores increased with younger age at implant and lower pre-implant thresholds, even when compared at the same duration of implant use. Expected Preschool Language Scale scores of the children who received the implant at the youngest ages reached those of hearing age-mates by 4.5 years, but those children implanted after 24 months of age did not catch up with hearing peers.

Conclusion: Children who received a cochlear implant before a substantial delay in spoken language developed (i.e., between 12 and 16 months) were more likely to achieve age-appropriate spoken language. These results favor cochlear implantation before 24 months of age, especially for children with aided pure-tone average thresholds greater than 65 dB prior to surgery.

Acknowledgments
This study was supported by Grant R1DC04168 from the National Institute on Deafness and Other Communication Disorders, awarded to the Central Institute for the Deaf at Washington University School of Medicine.
We thank the following people for their assistance: Michael Strube, for statistical consultation, and Christine Brenner, Sarah Fessenden, Heidi Geers, Heather L. Hayes, Melissa Truesdell, and Sallie Shiel Vanderhoof, and for data collection, transcription, and technical assistance. We also thank the many families and school/hospital/therapy programs that generously agreed to participate.
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