Early intervention and assessment of speech and language development in young children with cochlear implants.

OBJECTIVE Age is one of the most important determinants of the benefit achieved in the cochlear implantation of pre-lingually deafened children. Earlier age at implantation increases the exposure of children with a hearing impairment to auditory stimuli. Earlier auditory stimulation enables children to better understand spoken language and to use spoken language themselves. Furthermore, there appears to be critical period under 2 years of age during which access to spoken language is essential in order for language development to proceed appropriately. The present study aimed to assess the impact of cochlear implantation under 2 years of age on subsequent speech and language development. METHODS 28 children implanted with a cochlear implant prior to 2 years of age were included in this study and the effects of age at implantation were determined using a reception of grammar test, active vocabulary test and speech development test. Demographic features were described using descriptive statistics and data were compared to the normative values (T-values) of their hearing peers by t-test or Mann-Whitney U-test. RESULTS The present data indicates that overall children with a hearing impairment implanted at less than 2 years of age perform as well as or better than their hearing peers in speech and grammar development. Word Comprehension was significantly greater in children with a cochlear implant compared to their normative peers (p=0.003), whereas Phonological Working Memory for Nonsense Words was poorer (p=0.031). An effect of age on grammatical and speech development could be found for younger implanted children (<12 months), who reached higher scores than children implanted after 12 months of age. CONCLUSIONS The data suggests that early hearing loss intervention via cochlear implantation in children benefits the speech and language development of children. A potential sensitive period exists for implantation before 12 months of age. These outcomes support the recent trend toward early cochlear implantation in pre-lingually deaf children.