Younger Age at Cochlear Implant Activation Results in Improved Auditory Skill Development for Children with Congenital Deafness

Younger Age at Cochlear Implant Activation Results in Improved Auditory Skill Development for Children with Congenital Deafness

Purpose: The U.S. Food and Drug Administration indications for cochlear implantation in children is currently 9 months of age and older for children with bilateral profound sensorineural hearing loss (SNHL). Studies have shown that earlier activation of a cochlear implant (CI) can lead to better spo...

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Bibliographic Details
Published in:Journal of speech, language, and hearing research Vol. 65; no. 9; pp. 3539 - 3547
Main Authors: Culbertson, Shannon R, Dillon, Margaret T, Richter, Margaret E, Brown, Kevin D, Anderson, Melissa R, Hancock, Sandra L, Park, Lisa R
Format: Journal Article
Language:English
Published: United States American Speech-Language-Hearing Association 01-09-2022
Subjects:
Age Differences
Assistive Technology
Auditory Perception
Child
Child, Preschool
Cochlear Implantation - methods
Cochlear Implants
Deafness
Deafness - rehabilitation
Deafness - surgery
Hearing Loss, Bilateral - rehabilitation
Hearing Loss, Sensorineural - rehabilitation
Hearing Loss, Sensorineural - surgery
Humans
Infant
Infants
Language Development
Listening Skills
Oral Language
Toddlers
Young Children
North Carolina
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Summary:Purpose: The U.S. Food and Drug Administration indications for cochlear implantation in children is currently 9 months of age and older for children with bilateral profound sensorineural hearing loss (SNHL). Studies have shown that earlier activation of a cochlear implant (CI) can lead to better spoken language outcomes. As auditory skills are a precursor to the development of spoken language, this study was developed to investigate the influence of age at CI activation on auditory skill acquisition in young children. A secondary aim was to describe the auditory skills of children implanted prior to 9 months of age as compared to children with older ages of activation. Method: Functional Listening Index (FLI) scores obtained during routine clinical visits were reviewed for 78 pediatric CI recipients with congenital bilateral profound hearing loss who were activated before 2 years of age. A linear mixed-effects model assessed the effect of age at CI activation on cumulative FLI scores over time. Results: There was a significant interaction between age at activation and chronological age at the time of evaluation, indicating that children with earlier access to sound achieved a greater number of auditory skills than those with later CI activations when measured at the same chronological age. Children activated before the age of 9 months approximated scores expected of children with typical hearing, whereas children activated between 9 and 24 months of age did not. Conclusions: Younger age at CI activation is associated with increased auditory skills over time. Children who undergo cochlear implantation and CI activation before 9 months achieve more auditory skills by 4 years of age than children who are activated at later ages. These data suggest that reducing the approved age at cochlear implantation for children with congenital bilateral profound SNHL may support optimal auditory skill acquisition.
ISSN:1092-4388
1558-9102
DOI:10.1044/2022_JSLHR-22-00039