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Multicenter Study
. 2013 Apr;52(4):219-29.
doi: 10.3109/14992027.2012.759666. Epub 2013 Feb 28.

Influence of implantation age on school-age language performance in pediatric cochlear implant users

Emily A Tobey  1 , Donna Thal, John K Niparko, Laurie S Eisenberg, Alexandra L Quittner, Nae-Yuh Wang; CDaCI Investigative Team
Affiliations
Multicenter Study

Influence of implantation age on school-age language performance in pediatric cochlear implant users

Emily A Tobey et al. Int J Audiol. 2013 Apr.

Abstract

Objective: This study examined specific spoken language abilities of 160 children with severe-to-profound sensorineural hearing loss followed prospectively 4, 5, or 6 years after cochlear implantation.

Study sample: Ninety-eight children received implants before 2.5 years, and 62 children received implants between 2.5 and 5 years of age.

Design: Language was assessed using four subtests of the Comprehensive Assessment of Spoken Language (CASL). Standard scores were evaluated by contrasting age of implantation and follow-up test time.

Results: Children implanted under 2.5 years of age achieved higher standard scores than children with older ages of implantation for expressive vocabulary, expressive syntax, and pragmatic judgments. However, in both groups, some children performed more than two standard deviations below the standardization group mean, while some scored at or well above the mean.

Conclusions: Younger ages of implantation are associated with higher levels of performance, while later ages of implantation are associated with higher probabilities of continued language delays, particularly within subdomains of grammar and pragmatics. Longitudinal data from this cohort study demonstrate that after 6 years of implant experience, there is large variability in language outcomes associated with modifiers of rates of language learning that differ as children with implants age.

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Conflict of interest statement

Declaration of interest: The authors report no declarations of interest. This work was sponsored, in part, by the National Institutes of Health, NIDCD R01DC04797 (J.K. Niparko, Principal Investigator).

Figures

Figure 1
Figure 1
In the top panel, the mean trajectories for CASL core composite scores as a function of age of implantation are shown for the 4-, 5- or 6-year follow-up visits after implantation. The dashed lines represent the 95% confidence limits for the trajectories acquired at the 6-year follow-up. The bottom panel depicts the means and standard deviations for the five quintiles for each test period.
Figure 2
Figure 2
In the top panel, the mean trajectories for CASL receptive syntax standard scores as a function of age of implantation are shown for the 4-, 5- and 6-year follow-up visits after implantation. The dashed lines represent the 95% confidence limits for the trajectories acquired at the 6-year follow-up. The bottom panel depicts the mean and standard deviations for the five quintiles for each test period.
Figure 3
Figure 3
In the top panel, the mean trajectories for CASL expressive syntax standard scores as a function of age of implantation are shown for the 4-, 5- and 6-year follow-up visits after implantation. The dashed lines represent the 95% confidence limits for the trajectories acquired at the 6-year follow-up. The bottom panel depicts the mean and standard deviations for the five quintiles for each test period.
Figure 4
Figure 4
In the top panel, the mean trajectories for CASL pragmatics standard scores as a function of age of implantation are shown for the 4-, 5- and 6-year follow-up visits after implantation. The dashed lines represent the 95% confidence limits for the trajectories acquired at the 6-year follow-up. The bottom panel depicts the mean and standard deviations for the five quintiles for each test period.
Figure 5
Figure 5
In the top panel, the mean trajectories for CASL antonym scores as a function of age of implantation are shown for the 4-, 5- and 6-year follow-up visits after implantation. The dashed lines represent the 95% confidence limits for the trajectories acquired at the 6-year follow-up. The bottom panel depicts the mean and standard deviations for the five quintiles for each test period.
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References

    1. Archbold S, Harris M, O’Donoghue G, Nikolopoulos T, White A, et al. Reading abilities after cochlear implantation: The effect of age at implantation on outcomes at 5 and 7 years after implantation. Int J Pediatr Otorhinolaryngol. 2008;72:1471–1478. - PubMed
    1. Bates E, Thal D, Finlay B, Clancy B. Early language development and its neural correlates. In: Segalowitz S, Rapin I, editors. Handbook of Neuropsychology. 2. New York: Elsevier; 2003. pp. 525–592. Part II. Child Neuropsychology.
    1. Bayley N. Bayley Scales of Infant Development. 2. San Antonio, USA: The Psychological Corporation; 1993.
    1. Bergeson TR, Houston DM, Miyamoto RT. Effects of congenital hearing loss and cochlear implantation on audiovisual speech perception in infants and children. Restor Neurol Neurosci. 2010;28:157–165. - PMC - PubMed
    1. Carrow-Woolfolk E. Comprehensive Assessment of Spoken Language. San Antonio, USA: American Guidance Services; 1999.

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