Language Performance in Disabled Children with Cochlear Implants

What are the effects of cochlear implants (CIs) on language among children with disabilities?

Background: Early implantation of a CI in children with typical development is strongly associated with improved outcomes. There are few studies, however, showing the effects of CI among children with additional disabilities, making decision-making and standards of care difficult for families and providers.

Study design: Small cohort study.

Setting: Twenty children with CIs and developmental disabilities were enrolled at Cincinnati Children’s Hospital.

Synopsis: The median age of CI was 24 months and median duration was 27.7 months. The range of nonverbal cognitive quotients (NVCQ) was 27 to 115, with 15 subjects having NVCQs less than 80. Seventy-five percent had cognitive deficits and 55 percent had motor delays.

The objectives of the study were to evaluate language development post-CI and to determine the role that cognition plays in predicting language outcomes among children with developmental disabilities. The team used a combination of retrospective and prospective designs for evaluations.

Although children had significant increases in language age pre- to post-CI, median language quotients did not significantly change after implantation. NVCQ, age at hearing loss diagnosis, implant duration and number of different therapies attended were significant, with NVCQ contributing the most unique variance. Pre-CI language performance did not predict post-CI performance.

Bottom Line: Early measures of nonverbal cognition were the strongest predictor of language, although cognition is not always sufficient for good language development. Earlier ages at hearing loss diagnosis also contributed to higher language skills, although post-CI language skills were not a predictor of post-CI language outcomes. Information gained from this study sets the foundation of understanding appropriate expectations regarding language gains post-implant.

Citation: Meinzen-Derr J, Wiley S, Grether S, et al. Language performance in children with cochlear implants and additional disabilities. The Laryngoscope. 2009;120(2):405-413.