The Effect of Differential Listening Experience on the Development of Expressive and Receptive Language in Children With Bilateral Cochlear Implants

Abstract

Objectives Growing evidence suggests that children who are deaf and use cochlear implants (CIs) can communicate effectively using spoken language. Research has reported that age of implantation and length of experience with the CI play an important role in a predicting a child’s linguistic development. In recent years, the increase in the number of children receiving bilateral CIs (BiCIs) has led to interest in new variables that may also influence the development of hearing, speech, and language abilities, such as length of bilateral listening experience and the length of time between the implantation of the two CIs. One goal of the present study was to determine how a cohort of children with BiCIs performed on standardized measures of language and nonverbal cognition. This study examined the relationship between performance on language and nonverbal intelligence quotient (IQ) tests and the ages at implantation of the first CI and second CI. This study also examined whether early bilateral activation is related to better language scores. Design Children with BiCIs (n = 39; ages 4 to 9 years) were tested on two standardized measures, the Test of Language Development and the Leiter International Performance Scale-Revised, to evaluate their expressive/receptive language skills and nonverbal IQ/memory. Hierarchical regression analyses were used to evaluate whether BiCI hearing experience predicts language performance. Results While large intersubject variability existed, on average, almost all the children with BiCIs scored within or above normal limits on measures of nonverbal cognition. Expressive and receptive language scores were highly variable, less likely to be above the normative mean, and did not correlate with Length of first CI Use, defined as length of auditory experience with one cochlear implant, or Length of second CI Use, defined as length of auditory experience with two cochlear implants. Conclusions All children in the present study had BiCIs. Most IQ scores were either at or above that found in the general population of typically hearing children. However, there was greater variability in their performance on a standardized test of expressive and receptive language. This cohort of children, who are mainstreamed in schools at age-appropriate grades, whose mothers’ education is high, and whose families’ socioecononomic status is high, had, as a group, on average, language scores within the same range as the normative sample of hearing children. Further research identifying the predictors that contribute to the high variability in both expressive and receptive language scores in children with BiCIs will provide useful information that can aid in clinical management and decision making.

The Acoustics of Word-Initial Fricatives and Their Effect on Word-Level Intelligibility in Children With Bilateral Cochlear Implants

“…These participants were recruited throughout the United States and tested at the University of Wisconsin–Madison. The speech and language skills of some of these children have been previously reported in Hess et al (2014) and Todd et al (2011), and the speech perception skills of some of these children have been reported in Misurelli and Litovsky (2012, 2015). Prior to testing, parents were asked about their child's speech, language, and developmental history.…”

Persistent Language Delay Versus Late Language Emergence in Children With Early Cochlear Implantation

“…In addition, more children are receiving a second CI, and recent evidence suggests that bilateral implantation promotes vocabulary and overall language development in children (Sarant, Harris, Bennet, & Bant, 2014). However, length of second CI use (i.e., duration of bilateral experience) did not predict language levels in a group of 39 children with two CIs (Hess et al, 2014).…”

What can we expect of normally-developing children implanted at a young age with respect to their auditory, linguistic and cognitive skills?

“…Although some children achieve adequate language levels, others lag behind (e.g. Svirsky et al, 2000;Niparko et al, 2010;Peterson et al, 2010;Ching et al, 2013;Hess et al, 2014). Many of the 'good' performers do not achieve normal speech perception levels and most CI users experience severe difficulties when performing more challenging listening tasks.…”