EFFECT OF VERY EARLY COCHLEAR IMPLANTATION ON LANGUAGE
Principal Investigator: Johanna Grant Nicholas
Affiliation: Washington University School of Medicine
Abstract: Recent developments in the field of newborn hearing screening and pediatric cochlear implantation have led to extraordinary benefits for many children with born with severe-profound sensori-neural hearing loss. Receiving a cochlear implant by 12-18 months of age coupled with early training in spoken language communication often leads to spoken language skills which are similar to that of typical, hearing children by kindergarten age. While some language deficits may still exist, these children are proficient enough in the language of the surrounding "hearing" community to be able to fully participate in mainstream educational, family and community experiences. The broad objective of this continuation project is to explore the new boundaries of cochlear implantation and to establish long-term outcomes of evolving surgical practices. In Aim 1, we will diagnose the specific spoken language deficits that remain after implantation between the ages of 1-3 years and to examine the role of even earlier cochlear implantation - below the age of 12 months -- in the amelioration of those deficits. In Aim 2, we will assess the role of the specific timing of implantation in infancy on the child's acquisition of a normal speech sound repertoire. While spoken language skills may be adequate, speech articulation may still have room for improvement. Finally, we will determine the long-term benefits of very early cochlear implantation on the speech perception, production, language and literacy skills of 10-year-old children who received a cochlear implant in infancy in Aim 3. Currently, we can measure significant differences in spoken language skills conferred to preschoolers who receive an implant closer to their first birthday than to their second birthday. These advantages are significant even when controlling for length of cochlear implant use. It is important to know whether these advantages remain evident during the elementary school years or whether those who receive the implant somewhat later are able to catch up. Across the U.S., there are children currently receiving implants between the ages of 6-12 months - below the current FDA guideline. It is crucial to gather outcome data to understand whether this evolving practice is warranted. We will test 25 children nationwide who have received an implant below 12 months of age. Detailed speech/language analyses will determine whether this practice produces measurable and meaningful benefits for children. For longterm outcomes, we will test 60 children (from our longitudinal sample) who will undergo a 2-day battery of tests to evaluate differences due to age at implantation and to establish their current level of skill in speech, language and cognitive functioning. The findings of this study will inform parents, surgeons, teachers, clinicians and policy-makers in their efforts to determine the protocol for early cochlear implantation with the highest likelihood of leading to optimal spoken language skills.
Funding Period: 2000-09-27 - 2012-08-31
more information: NIH RePORT
- Cochlear implantation updates: the Dallas Cochlear Implant ProgramEmily A Tobey
Dallas Cochlear Implant Program, Dallas, TX 75235, USA
J Am Acad Audiol 23:438-45. 2012..Multiple statistical techniques are used by the team to analyze outcomes. The team has provided critical information regarding electrode placement, signal processing, and communication outcomes in users of cochlear implants...
- Enduring advantages of early cochlear implantation for spoken language developmentAnn E Geers
University of Texas at Dallas, TX, USA
J Speech Lang Hear Res 56:643-55. 2013..Relative advantages of receiving a bilateral CI after age 4.5 years, better pre-CI-aided hearing, and longer CI experience were also examined...
- Spoken language benefits of extending cochlear implant candidacy below 12 months of ageJohanna G Nicholas
Department of Otolaryngology Head and NeckSurgery, Campus Box 8115, Washington University School of Medicine, 660 S Euclid Avenue, St Louis, MO 63110, USA
Otol Neurotol 34:532-8. 2013..To test the hypothesis that cochlear implantation surgery before 12 months of age yields better spoken language results than surgery between 12 and 18 months of age...
- Interdependence of linguistic and indexical speech perception skills in school-age children with early cochlear implantationAnn E Geers
Callier Center for Advanced Hearing Research, University of Texas at Dallas, Dallas, TX 75235, USA
Ear Hear 34:562-74. 2013....
- Effects of early auditory experience on the spoken language of deaf children at 3 years of ageJohanna Grant Nicholas
Central Institute for the Deaf Research, Department of Otolaryngology, Washington University School of Medicine, St Louis, Missouri 63110, USA
Ear Hear 27:286-98. 2006..The purpose of the analysis was to examine the effects of age, duration, and type of early auditory experience on spoken language competence at age 3.5 yr...
- Will they catch up? The role of age at cochlear implantation in the spoken language development of children with severe to profound hearing lossJohanna Grant Nicholas
Central Institute for the Deaf at Washington University School of Medicine, Department of Otolaryngology, Box 8115, 660 South Euclid Avenue, St Louis, Missouri 63110, USA
J Speech Lang Hear Res 50:1048-62. 2007..The authors examined the benefits of younger cochlear implantation, longer cochlear implant use, and greater pre-implant aided hearing to spoken language at 3.5 and 4.5 years of age...
- Expected test scores for preschoolers with a cochlear implant who use spoken languageJohanna G Nicholas
Department of Otolaryngology Head and Neck Surgery, Box 8115, Washington University School of Medicine, 660 S Euclid Avenue, St Louis, MO 63110, USA
Am J Speech Lang Pathol 17:121-38. 2008....