This study examined the growth of expressive language skills in children who received cochlear implants (CIs) in infancy. Repeated language measures were gathered from 29 children who received CIs between 10 and 40 months of age. Both cross-sectional and growth curve analyses were used to assess the relationship between expressive language outcomes and CI experience. A beneficial effect of earlier implantation on expressive language growth was found. Growth curve analysis showed that growth was more rapid in children implanted as infants than those implanted as toddlers. Age at initial stimulation accounted for 14.6% of the variance of the individual differences in expressive language growth rates.Keywords cochlear implants; infants; language growth; yearly hearing detection and intervention; growth curve analysis Infants born with normal hearing thresholds possess a number of auditory skills crucial to fostering language growth; many of these proficiencies appear to be present as early as birth or beforehand (DeCasper & Fifer, 1980;DeCasper, Lecanuet, Busnel, & Granier-Deferre, 1994;Kuhl & Miller, 1982;Mehler et al., 1988;Moon, Panneton-Cooper, & Fifer, 1993). Neonates with bilateral sensorineural hearing loss (SNHL), however, do not have this benefit of early spoken language exposure. As a result, children with severe to profound SNHL who are born to hearing parents often demonstrate great lags in spoken language development due to limited linguistic input (Brasel & Quigley, 1977;Carney & Moeller, 1998; Lederberg & Spencer, 2001;Mayne, Yoshinaga-Itano, & Sedey, 2000a, 2000b PippSiegel, Sedey, VanLeeuwen, & Yoshinaga-Itano, 2003;Spencer & Meadow-Orlans, 1996). However, nearly 20 years ago, pediatric cochlear implantation emerged as a surgical option that could provide acoustic information to the auditory system by means of direct electrical stimulation of the auditory nerve. Despite the fact that the typical cochlear implant (CI) device provides frequency and temporal resolution information that is considerably different from that of acoustic hearing, the auditory information provided by the CI appears to improve the rate of spoken language development of children with severe to profound SNHL who are born to hearing parents (Blamey & Sarant, 2000;Geers & Moog, 1994;Geers, Nicholas, & Sedey, 2003;Svirsky, Robbins, Kirk, Pisoni, & Miyamoto, 2000;Tomblin, Spencer, Flock, Tyler, & Gantz, 1999). Indeed, studies have shown that the rate of language development in school-age children with CIs typically approaches that of children with normal hearing. Svirsky and colleagues (Svirsky, 2003;Svirsky et al., 2000) have NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscriptshown average postimplant-growth rates that match those of children with normal hearing, whereas others have reported rates that ranged from 45% to 67% of normal growth rates (Blamey, 2001;Connor, Hieber, Arts, & Zwolan, 2000). Yet, although these and further data Kirk et al., 2002;Ouellet, Le Normand, & Cohen, 2001;Robbins, Os...

Objective-The principal goal of this study was to investigate the relationship between language and literacy (i.e., reading and writing) skills in pediatric cochlear implant users. A peripheral objective was to identify the children's skills that were in need of remediation and subsequently to provide suggestions for remedial programming. It was predicted that the robust language skills often associated with children who have cochlear implant experience would facilitate the development of literacy skills. It was further proposed that the language and literacy skills of pediatric cochlear implant users would approximate the language and literacy skills of children with normal hearing.Design-Sixteen pediatric cochlear implant users' language and literacy skills were evaluated and then compared with a reference group of 16 age-matched, normal-hearing children. All 32 participants were educated in mainstream classes within the public school system in the Midwest. The "Sentence Formulation" and "Concepts and Directions" subtests of the Clinical Evaluation of Language Fundamentals-3 test were used to evaluate receptive and expressive language skills. Reading comprehension was evaluated with the "Paragraph Comprehension" subtest of the Woodcock Reading Mastery Test. Performance measures for the writing analyses included productivity, complexity and grammaticality measures.Results-Children with cochlear implants performed within 1 SD of the normal-hearing, agematched children on measures of language comprehension, reading comprehension and writing accuracy. However, the children with cochlear implants performed significantly poorer than the children with normal hearing on the expressive "Sentence Formulation" subtest. The cochlear implant users also produced fewer words on the written narrative task than did the normal-hearing children, although there was not a significant difference between groups with respect to total words per clause. Furthermore there was a strong correlation between language performance and reading performance, as well as language performance and total words produced on the written performance measure for the children using cochlear implants. Conclusions-The results of this study suggest that the language skills of pediatric cochlear implant users are related to and correlated with the development of literacy skills within these children. Consequently, the performance of the cochlear implant users, on various language and literacy measures, compared favorably to an age-matched group of children with normal hearing. There were significant differences in the ability of the cochlear implant users to correctly utilize grammatical structures such as conjunctions and correct verb forms when they were required to formulate written and oral sentences. Given this information, it would be appropriate for their Copyright © 2003 NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript educational or remedial language programs to emphasize the use and development of these structures....

English language achievement of 29 prelingually deaf children with 3 or more years of cochlear implant (CI) experience was compared to the achievement levels of prelingually deaf children who did not have such CI experience. Language achievement was measured by the Rhode Island Test of Language Structure (RITLS), a measure of signed and spoken sentence comprehension, and the Index of Productive Syntax (IPSyn), a measure of expressive (signed and spoken) English grammar. When the CI users were compared with their deaf age mates who contributed to the norms of the RITLS, it was found that CI users achieved significantly better scores. Likewise, we found that CI users performed better than 29 deaf children who used hearing aids (HAs) with respect to English grammar achievement as indexed by the IPSyn. Additionally, we found that chronological age highly correlated with IPSyn levels only among the non-CI users, whereas length of CI experience was significantly correlated with IPSyn scores for CI users. Finally, clear differences between those with and without CI experience were found by 2 years of post-implant experience. These data provide evidence that children who receive CIs benefit in the form of improved English language comprehension and production.Keywords cochlear implants; language development; prelingually deaf; children Multichannel Cochlear Implants (CIs) have been available to profoundly deaf children for over a decade. One of the primary benefits intended for children receiving CIs is an improvement in communication skills. More specifically, the selection of a CI for a child implies an obvious desire by the parents to have the child participate within, and use the language of, the hearing community. Therefore, one of the expected benefits in communication derived from CIs in an English speaking community is the acquisition of spoken English. These expected benefits have been questioned recently by some (Tyler, 1993). Lane (1992) and Crouch (1997) have voiced strong opposition to the use of CIs in congenitally deaf children. Lane (1992) stated It is highly unlikely that an impoverished auditory signal such as the implant provides will yield the same benefits for later language acquisition that normal hearing does; indeed, the coding carried out by the speech processor of the implant may work against the usefulness of the auditory input for language development, since the human nervous system did not evolve to acquire language from cochlear prostheses (pp. 224-225). NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptCrouch (1997) noted that it remains to be shown that children receiving CIs obtain sufficient linguistic benefit from these devices to permit them to be fully participating members of the hearing community.Similar skepticism is found concerning the effectiveness of CIs on speech perception and speech production (Tyler, Davis, & Lansing, 1987). However, several programs of research have demonstrated that children receiving CIs show improvements in speech perce...