Language Outcomes Improved Through Early Hearing Detection and Earlier Cochlear Implantation

Abstract

Hypothesis: Early identification and intervention, earlier cochlear implantation, and mother's level of education will directly and/or indirectly impact the language outcomes of children with cochlear implants (CIs). Background: Identifying factors that contribute to the wide range of language outcomes in children who use CIs will assist healthcare and rehabilitation professionals in optimizing service delivery for this population. Universal newborn hearing screening provides an opportunity to examine the relationship between meeting the early hearing detection and intervention (EHDI) 1-3-6 guidelines and child language outcomes. These guidelines recommend screening by 1 month, confirmation of hearing loss by 3 months, and intervention by 6 months of age. Methods: Participants were 125 children with CIs ranging from 13 to 39 months of age. Language ability was measured using the Child Development Inventory and MacArthur-Bates Communicative Development Inventories. Results: Meeting EHDI 1-3-6, higher levels of maternal education and earlier cochlear implant activation had a direct, positive impact on language outcomes. Meeting the EHDI 1-3-6 guidelines also had an indirect positive effect on language outcomes via increasing the probability that the children's CIs would be activated earlier. Maternal education did not significantly predict age of cochlear implant activation nor whether a child met EHDI 1-3-6. Conclusion: Ensuring families meet the EHDI 1-3-6 guidelines is an early step that can lead to higher language outcomes and also earlier cochlear implantation.

The Input Matters: Assessing Cumulative Language Access in Deaf and Hard of Hearing Individuals and Populations

“…Despite many cases that would be considered successes at the clinical level (i.e., one child at a time), DHH children as a population remain at serious risk of not developing age-appropriate proficiency in any language by the time they enter school. The lack of true population-based datasets in the United States makes it difficult to know for certain, but large, multi-site/multi-state studies such as CDaCI, OCHL, and NECAP typically report language outcomes in DHH children that are 1-2 standard deviations below their hearing peers, or language quotients below the 80% threshold (Koehlinger et al, 2013;Tobey et al, 2013;Ambrose et al, 2014Ambrose et al, , 2015Tomblin et al, 2015;Eisenberg et al, 2016;Geers et al, 2017;Lewis et al, 2017;Hoffman et al, 2018;Yoshinaga-Itano et al, 2018). A separate and more recent study of over 336 DHH children between kindergarten and second grade reported similar outcomes on measures of spoken language, with mean scores again ranging from 1 to more than 2 standard deviations below the normative mean (Lederberg et al, 2019;Antia et al, 2020).…”

Status of early hearing detection and intervention in South Korea: a nationwide population-based study of national infant health checkup

“…Early detection and intervention of hearing impairment in infants and children is associated with better outcomes in language and communication development 1 – 3 . In many countries, newborn hearing screening (NHS) tests are conducted on all newborns, leading to a gradual decrease in the age when deafness or hearing loss can be detected 4 .…”

Trajectory of auditory and language development in the early stages of pre-lingual children post cochlear implantation: A longitudinal follow up study

“…The results showed that age at implantation and high maternal educational level had a positive impact on spoken language development. A recent study by Yoshinaga-Itano et al [20] analyzed the language outcomes of 125 children with CIs and concluded that the early hearing detection and intervention, higher levels of maternal education and early cochlear implant activation had direct, positive impacts on language development outcomes.…”