The Effect of Age at Cochlear Implant Initial Stimulation on Expressive Language Growth in Infants and Toddlers

Abstract

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...

Narrative skills following early confirmation of permanent childhood hearing impairment

“…9 The assessment of these skills is tried and tested with groups of typically developing children and with children who have other developmental disabilities. [9][10][11][12][13] Although less is known about the development of spoken narrative in children with PCHI, it is thought to follow a similar but delayed developmental pattern. 7 The prospect of better speech and language outcomes for children with PCHI, and of reducing the gap between them and normally hearing peers, has recently improved with the development of Universal Newborn Hearing Screening (UNHS) programmes, leading to early confirmation of PCHI in a higher proportion of cases, improvements in digital hearing aids, and increased access to cochlear implantation.…”

Pediatric Cochlear Implantation—Why the Delay

“…Earlier implantation prepares the brain systems for better language learning during infancy and therefore provide an earlier start in language learning [23][24][25]. Neural plasticity is believed to make significant contributions during sensitive periods in the maturation of the auditory system, in barn owls [26] and this has also been demonstrated in human [9,10,27,28].…”

“…This is reflected in all the areas of speech and language development. These children can achieve performance comparable to their normal hearing counter parts if implanted within 2 years of age [4,5,[36][37][38]. Early identification of hearing deficit is the most important and key factor for timely intervention in the management of congenitally hearing impaired population.…”

Cross-modal plasticity in cuban visually-impaired child cochlear implant candidates: topography of somatosensory evoked potentials

“…[24][25][26] Hearing and vision loss was detected early in all cases, at birth or around the age of three months when they were assessed by Cuba's Hearing Screening Program. Only two children became deaf after three months of age, both before three years, thus before language development was completed.…”