Comparison of Expressive Spoken Language Skills in Children With Cochlear Implants and Children With Typical Hearing

Abstract

When children start formal education, they are expected to be able to express complex thoughts. However, in order to do so, they need to be able to use both complex grammatical structures and a variety of words. One group that is at risk of having a delay in terms of their expressive language ability is children with cochlear implants (CI). In this study, we evaluated whether children with CI perform comparably to children with typical hearing (TH) on a standard expressive spoken grammar and a standard expressive spoken vocabulary task when the groups were matched on non-verbal intelligence and working memory capacity. It was found that the children with CI in this study performed more poorly on a standard expressive spoken vocabulary task but not on a standard expressive spoken grammar task when compared to the children with TH. Differences in terms of expressive spoken vocabulary do not seem to be explained by differences in cognitive ability. In addition, the variation in terms of expressive spoken language ability was larger in the children with CI compared to the children with TH. This might be explained by additional confounding factors, like the time of language deprivation or by a greater influence of cognitive differences for the acquisition of spoken language for children with CI.

Longitudinal Development of Verbal and Nonverbal Intelligence After Cochlear Implantation According to Wechsler Tests in German-speaking Children: A Preliminary Study

“…Our results support the position that early implantation alone does not lead to “normal” language development, as has been stated many times in previous studies (Hintermair et al 2014; Edwards & Isquith 2020; Socher, Ellis et al 2020; Wie et al 2020). A controversial review of the influence of age at implantation on language development was published by Hintermair et al (2020) who point out that with increasing hearing experience, the initial gaps between early and later age of implantation tend to disappear, and that early implantation was no longer a prerequisite for successful cognitive performance later on.…”

“…In line with this reasoning, in our study sample, the majority of children also received their CI at an early age that is before their first birthday. Therefore, the age distribution of implantation in our study population tends to be younger and more leftward distributed compared with other studies that investigated intelligence development (Wu et al 2008;Park et al Our results support the position that early implantation alone does not lead to "normal" language development, as has been stated many times in previous studies (Hintermair et al 2014;Edwards & Isquith 2020;Socher, Ellis et al 2020;Wie et al 2020). A controversial review of the influence of age at implantation on language development was published by Hintermair et al (2020) who point out that with increasing hearing experience, the initial gaps between early and later age of implantation tend to disappear, and that early implantation was no longer a prerequisite for successful cognitive performance later on.…”

“…This ambiguity is essentially rooted in the interdependence of the two (verbal and nonverbal) domains. A study including samples parallelized by linguistic abilities and a normal-hearing control group, such as that found in Socher et al (2020), ideally involving a larger sample and including a comprehensive neuropsychological profile, would be valuable to help address this issue.…”

Spoken Sentence Complexity and Grammar Use in Children with CIs

“…There is some indication that the standard procedure of scoring for the Formulated Sentences Test ( Semel et al., 2004 ) may not accurately represent differences in the language profile of children with CIs and children with TH. The current study is an extension of a published study ( Socher et al, 2020 ) comparing the expressive grammar skills of children with CIs and children with TH using the Swedish version of the Formulated Sentences Test ( Semel et al., 2004 ). The current study is exploratory and investigates the language profiles in terms of sentence complexity, sentence length, and severity of grammatical errors of children with CIs and children with TH matched on their score on the Formulated Sentences Test ( Semel et al., 2004 ) and expressive vocabulary (CELF-IV; Expressive vocabulary, Semel et al., 2004 ).…”

“…Children with cochlear implants (CIs) have been claimed to be at risk for delays in spoken expressive grammar ability ( Boons et al., 2013a , 2013b ; Inscoe et al., 2009 ; Wie et al., 2020 ; but see Socher et al., 2020 for contradicting results). As many children with CIs are born to hearing parents ( Mitchell & Karchmer, 2004 ) and grow up with oral language as their main communication mode, delays in spoken expressive grammar might have negative effects on their ability to communicate (but see Hall & De Anda, 2021 for information on different language access profiles).…”