Spoken language development in children following cochlear implantation

John K. Niparko, Emily A. Tobey, Donna J. Thal, Laurie S. Eisenberg, Nae Yuh Wang, Alexandra L. Quittner, Nancy E. Fink

Research output: Contribution to journalArticle

523 Scopus citations

Abstract

Context: Cochlear implantation is a surgical alternative to traditional amplification (hearing aids) that can facilitate spoken language development in young children with severe to profound sensorineural hearing loss (SNHL). Objective: To prospectively assess spoken language acquisition following cochlear implantation in young children. Design, Setting, and Participants: Prospective, longitudinal, and multidimensional assessment of spoken language development over a 3-year period in children who underwent cochlear implantation before 5 years of age (n=188) from 6 US centers and hearing children of similar ages (n=97) from 2 preschools recruited between November 2002 and December 2004. Follow-up completed between November 2005 and May 2008. Main Outcome Measures: Performance on measures of spoken language comprehension and expression (Reynell Developmental Language Scales). Results: Children undergoing cochlear implantation showed greater improvement in spoken language performance (10.4; 95% confidence interval [CI], 9.6-11.2 points per year in comprehension; 8.4; 95% CI, 7.8-9.0 in expression) than would be predicted by their preimplantation baseline scores (5.4; 95% CI, 4.1-6.7, comprehension; 5.8; 95% CI, 4.6-7.0, expression), although mean scores were not restored to age-appropriate levels after 3 years. Younger age at cochlear implantation was associated with significantly steeper rate increases in comprehension (1.1; 95% CI, 0.5-1.7 points per year younger) and expression (1.0; 95% CI, 0.6-1.5 points per year younger). Similarly, each 1-year shorter history of hearing deficit was associated with steeper rate increases in comprehension (0.8; 95% CI, 0.2-1.2 points per year shorter) and expression (0.6; 95% CI, 0.2-1.0 points per year shorter). In multivariable analyses, greater residual hearing prior to cochlear implantation, higher ratings of parent-child interactions, and higher socioeconomic status were associated with greater rates of improvement in comprehension and expression. Conclusion: The use of cochlear implants in young children was associated with better spoken language learning than would be predicted from their preimplantation scores.

Original languageEnglish (US)
Pages (from-to)1498-1506
Number of pages9
JournalJAMA - Journal of the American Medical Association
Volume303
Issue number15
DOIs
StatePublished - Apr 21 2010

ASJC Scopus subject areas

  • Medicine(all)

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    Niparko, J. K., Tobey, E. A., Thal, D. J., Eisenberg, L. S., Wang, N. Y., Quittner, A. L., & Fink, N. E. (2010). Spoken language development in children following cochlear implantation. JAMA - Journal of the American Medical Association, 303(15), 1498-1506. https://doi.org/10.1001/jama.2010.451