A Systematic Review to Define the Speech and Language Benefit of Early (<12 Months) Pediatric Cochlear Implantation

Abstract

Objective: This review aimed to evaluate the additional benefit of pediatric cochlear implantation before 12 months of age considering improved speech and language development and auditory performance. Materials and Methods: We conducted a search in PubMed, EMBASE and CINAHL databases and included studies comparing groups with different ages at implantation and assessing speech perception and speech production, receptive language and/or auditory performance. We included studies with a high directness of evidence (DoE). Results: We retrieved 3,360 articles. Ten studies with a high DoE were included. Four articles with medium DoE were discussed in addition. Six studies compared infants implanted before 12 months with children implanted between 12 and 24 months. Follow-up ranged from 6 months to 9 years. Cochlear implantation before the age of 2 years is beneficial according to one speech perception score (phonetically balanced kindergarten combined with consonant-nucleus-consonant) but not on Glendonald auditory screening procedure scores. Implantation before 12 months resulted in better speech production (diagnostic evaluation of articulation and phonology and infant-toddler meaningful auditory integration scale), auditory performance (Categories of Auditory Performance-II score) and receptive language scores (2 out of 5; Preschool Language Scale combined with oral and written language skills and Peabody Picture Vocabulary Test). Conclusions: The current best evidence lacks level 1 evidence studies and consists mainly of cohort studies with a moderate to high risk of bias. Included studies showed consistent evidence that cochlear implantation should be performed early in life, but evidence is inconsistent on all speech and language outcome measures regarding the additional benefit of implantation before the age of 12 months. Long-term follow-up studies are necessary to provide insight on additional benefits of early pediatric cochlear implantation.

Evaluation of the Diagnostic Stability of the Early Autism Spectrum Disorder Phenotype in the General Population Starting at 12 Months

“…The human brain has an enormous capacity to resculpt and remodel, particularly during the first postnatal years. The few studies that have examined treatment during this transformative time window have found that toddlers with ASD, 26 , 27 , 29 , 30 cerebral palsy, 31 premature birth, 32 , 33 , 34 and severe hearing loss 35 experience significant positive changes, such as an increase in 15 IQ points 29 or improvements in speech perception and language ability. 36 The caveat, however, is that early-age diagnostic evaluations should be conducted by practitioners with considerable experience in early ASD development.…”

Prosodic Focus Acquisition in French Early Cochlear Implanted Children

“…It is in fact optimally beneficial to offer CI during the critical period of cortex neuroplasticity in which speech and language are acquired and mastered [18]- [20]. Cochlear implantation performed before the age of 2 and optimally before 12 to 18 months has shown better results in terms of hearing and language development [21].…”

Long-Term Language Development in Children With Early Simultaneous Bilateral Cochlear Implants

“…Cochlear implants (CIs) have become a common means to allow children with congenital profound deafness to access sound and develop spoken language. Especially, children who receive CIs early in life can attain spoken language skills similar to those of their normal-hearing (NH) peers ( Bruijnzeel et al 2016 ; Colletti et al 2012 ; Dettman et al 2016 ; Geers & Nicholas 2013 ; Leigh et al 2013 ; Niparko et al 2010 ). Moreover, it has been shown that bilateral simultaneous implantation, as opposed to unilateral or sequential implantation, further facilitates access to sound, development of the brain’s auditory pathways, and hence spoken language acquisition ( Gordon et al 2013 ; Kral et al 2016 ).…”