Trajectory of auditory and language development in the early stages of pre-lingual children post cochlear implantation: A longitudinal follow up study

Abstract

Objectives: The aim of this longitudinal follow-up study was to explore the trajectories of early auditory and language development in Mandarin speaking children younger than 3 years of age following switch-on of their cochlear implants (CIs). Methods: Early auditory and language development was measured longitudinally using the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS), which is a commonly used tool for assessing early prelingual auditory development (EPLAD) in children, and the subtest (Words and Gestures, W&G) of the simplified short form version of the Mandarin Communicative Development Inventory (SSF-MCDI) to assess receptive and expressive vocabulary growths of children in 24 pediatric cochlea implant recipients at baseline, 3, 6, and 12 months following switch-on. Age at switch-on ranged from 1 to 3 years of age. Participants were divided into two groups based on age at switch-on. The IT-MAIS and SSF-MCDI (W&G) scores were analyzed with comparison to normal children, unaided hearing-impaired children, and CI children. Results: Significant improvements in IT-MAIS and SSF-MCDI (W&G) scores from baseline to 12 months were seen after switch-on in both CI groups and were comparable to the normal hearing children in the first year of age. The IT-MAIS scores of CI children in both groups at 12 months after switch-on surpassed the average level of unaided peers with profound hearing loss and were similar to the average level of unaided peers with mild hearing loss. SSF-MCDI (W&G) scores in word comprehension and expression were significantly different between groups at some intervals. Conclusions: Children younger than 3 years of age with cochlear implants have similar trajectories in early auditory and language developments to normally hearing children. Moreover, early implantation is an important factor for the early auditory development when comparing EPLAD results between CI children and unaided peers with different hearing loss. Finally, it is noteworthy that CI children master the skill of word comprehension before the skill of word expression, and that word comprehension may be the basis of word expression.

A Review of Speech Perception of Mandarin-Speaking Children With Cochlear Implantation

“…Data showed no or very low level of auditory skills preimplant. After 6 months of CI use, these children could achieve a score of about 50∼60% on the IT-MAIS/MAIS (Chen Y. et al, 2016;Lu and Qin, 2018;Li G. et al, 2020) and reach (Chen Y. et al, 2016Lu and Qin, 2018;Li G. et al, 2020) and reach category 4 (i.e., discriminates at least two speech sounds) on the CAPQ (Lyu et al, 2019;Jiang et al, 2020). More than half of the children could achieve category 4 (i.e., vowel perception) and category 5 (i.e., consonant perception) on the MESP test (Zheng et al, 2011;Chen Y. et al, 2016;Guo et al, 2016;Lu and Qin, 2018).…”

“…Data showed no or very low level of auditory skills pre-implant. After 6 months of CI use, these children could achieve a score of about 50∼60% on the IT-MAIS/MAIS ( Chen Y. et al, 2016 ; Lu and Qin, 2018 ; Li G. et al, 2020 ) and reach category 3 (i.e., recognizes environmental sounds) on the CAPQ ( Lyu et al, 2019 ; Chen Y. et al, 2020 ; Jiang et al, 2020 ). About 40∼88% of children reached category 2 (i.e., speech pattern perception) or higher on the MESP test ( Zheng et al, 2011 ; Chen Y. et al, 2016 ; Guo et al, 2016 ; Lu and Qin, 2018 ).…”

“…These results suggest that at 6 months post CI, children begin to develop closed-set word recognition and sentence recognition in quiet, as well as open-set word recognition in quiet. At 12 months post CI, children could obtain scores of about 70∼80% on the IT-MAIS/MAIS ( Chen Y. et al, 2016 , 2020 ; Lu and Qin, 2018 ; Li G. et al, 2020 ) and reach category 4 (i.e., discriminates at least two speech sounds) on the CAPQ ( Lyu et al, 2019 ; Chen Y. et al, 2020 ; Jiang et al, 2020 ). More than half of the children could achieve category 4 (i.e., vowel perception) and category 5 (i.e., consonant perception) on the MESP test ( Zheng et al, 2011 ; Chen Y. et al, 2016 ; Guo et al, 2016 ; Lu and Qin, 2018 ).…”

Speech production in Mandarin-speaking children with cochlear implants: a systematic review

“…Speech production constitutes an essential outcome measure in the assessment of children with CIs. However, there are few studies that have examined speech production in Mandarin-speaking children with CIs, with most published work focussing on expressive vocabulary development and speech intelligibility (Han et al 2007;Li et al 2020). Where studies do report speech production measures in Mandarinspeaking children with CIs, they often show conflicting results and are based on different materials and methods (Chuang et al 2012;Deroche et al 2019;Han et al 2007;Mao, Chen, and Xu 2017;Tseng, Kuei, and Tsou 2011).…”

Do Acoustic Environment Characteristics Affect the Lexical Development of Children With Cochlear Implants? A Longitudinal Study Before and After Cochlear Implant Activation

“…everal studies have shown that the use of cochlear implants (CIs) improves the speech perception and language skills of children with hearing loss (Quittner et al, 2004;Spencer & Marschark, 2010;Tomblin et al, 2008;Uhler et al, 2011). After implantation, young children substantially expand their expressive vocabulary (Ertmer & Inniger, 2009;Majorano, Brondino, et al, 2020) and show word acquisition trajectories that are similar to those shown by children with normal hearing within the first year of life (Li et al, 2020). In some cases, this rapid vocabulary growth after implantation results in spoken abilities that are within the normative range not only by the time the children with CIs reach 10 years of age but also after only a few years of CI use (Cuda et al, 2014;Guerzoni et al, 2016;Murri et al 2015;Nicholas & Geers, 2007Niparko et al, 2010).…”