Early speech changes in children with multichannel cochlear implants

Abstract

A number of studies have demonstrated that cochlear implants provide an improved auditory signal and enhance the development of speech-perception and production skills for profoundly deaf children. However, exactly when these early speech skills begin to develop remains unclear. To explore this issue, we observed, for a 1-year period, four prelingually deaf children who underwent implantation consecutively within 1 month of each other, and we paid particular attention to the first few months of rehabilitation. We found immediate speech scores as early as the first day of implant tune-up. Speech production continued to improve rapidly throughout the first 4 months but exhibited a generally slower rate of progress in some of the speech-production skills at 1 year. We also found vowel-production skills to be the easiest to achieve, with word-pattern recognition and consonant voicing of intermediate difficulty. Consonant placing and manner of consonant production were the hardest skills to achieve. Results of speech-perception tests 1 year after implantation were markedly improved over preimplantation levels in three of the four children. These early speech changes stress the need for maximization of the capability of the cochlear implant by institution of immediate and intensive speech rehabilitation efforts for prelingually deaf children.

Cochlear Implantation in Prelingually Deaf Children

“…Even if auditory performance is enhanced and objectively evaluated, language outcomes are more difficult to measure. The study of Te et al 1 shows very clearly that “… a slower rate of progress in speech production with even a few declining scores marked the evaluations 1 year after implantation.”…”

“…To be ethically acceptable, it must be scientifically proved that the implanted child not only has audiologic perception but also improves his or her communicating ability. Te et al 1 refer to the need for “… immediate and intensive speech therapy and the detection and correction of speech inadequacies early in rehabilitation” but do not answer the question of what educational setting is best for the development of these children.…”