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Original Articles

Long-term outcomes of cochlear implantation in the preschool years: From elementary grades to high school

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Pages S21-S30 | Received 30 Sep 2007, Published online: 07 Jul 2009
 

Abstract

The objective of this study was to document the development of speech, language, and reading skills between primary and secondary school ages in children who received cochlear implants during preschool years. Subjects were a sample of 85 North American adolescents recruited from a larger sample of 181 participants from a previous investigation. Students were first tested in early elementary school (ages eight to nine years) and were re-evaluated in high school (ages 15–18 years) for this study. The methods used were: performance on a battery of speech perception, language, and reading tests. These were compared at both test ages and significant predictors of outcome level identified through multiple regression analysis. Speech perception scores improved significantly with long-term cochlear implant use. Average language scores improved at a faster than normal rate, but reading scores did not quite keep pace with normal development. Performance in high school was most highly correlated with scores obtained in elementary grades. In addition, better outcomes were associated with lower PTA cochlear implant threshold, younger age at implantation and higher nonverbal IQ. In conclusion, early cochlear implantation had a long-term positive impact on auditory and verbal development, but did not result in age-appropriate reading levels in high school for the majority of students.

Abbreviations
BKB=

Bamford-Kyle-Bench sentence test

FS=

Factor score

OC=

Oral communication

LNT=

Lexical neighborhood test

PIQ=

Performance intelligence quotient

SES=

Socio-economic status

TC=

Total communication

Abbreviations
BKB=

Bamford-Kyle-Bench sentence test

FS=

Factor score

OC=

Oral communication

LNT=

Lexical neighborhood test

PIQ=

Performance intelligence quotient

SES=

Socio-economic status

TC=

Total communication

Sumario

El objetivo de este estudio fue documentar el desarrollo de habla, lenguaje y habilidades para la lectura entre los años de la primaria y la secundaria en niños que fueron implantados en edad preescolar. Los sujetos fueron una muestra de 85 adolescentes norteamericanos seleccionados de una amplia muestra de 181 participantes de una investigación previa. Los estudiantes fueron primero examinados en la escuela elemental temprana (edad de ocho a nueve años) y fueron revalorados en la preparatoria (edad de 15-18 años) para este estudio. Los métodos usados fueron: rendimiento con una batería de percepción del habla, lenguaje y pruebas de lectura. Estas fueron comparadas en ambas edades de prueba y se identificaron predictores significativos de niveles de respuesta por medio de un análisis de regresión múltiple. Las puntuaciones de la percepción del habla mejoraron significativamente con el uso del implante coclear a largo plazo. Las puntuaciones promedio de lenguaje mejoraron a una tasa más rápida que la normal pero las puntuaciones en lectura no mantuvieron el ritmo del desarrollo normal. El rendimiento en la preparatoria se observó en su mayoría correlacionado con las puntuaciones obtenidas en los grados elementales. Además, los mejores resultados se asociaron con umbrales PTA más bajos con el implante coclear, edades de implantación menores y CI no verbal más alto. En conclusión, la implantación coclear temprana tiene un impacto positivo a largo plazo en el desarrollo auditivo y verbal, pero no determina niveles de lectura apropiados para la edad, en la escolaridad preparatoria, en la mayoría de los estudiantes.

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