Language skill development in children with cochlear implants and the impact of age at switch-on

ABSTRACT

Deaf and hard-of-hearing (DHH) children with cochlear implants (CwCIs) constitute a heterogeneous population. A multitude of factors influence their spoken language development. There is evidence that CwCIs follow similar trajectories in language development as typically developing (TD) children but there is a lack of research on specific types of skills. This study aimed to (1) map the trajectory of receptive and expressive language skill development of a representative group of CwCIs and (2) evaluate the impact of age at switch-on (ASO) on skill development. This paper presents a detailed analysis of the language outcomes of 44 CwCIs with ASO between 11 and 45 months (M = 26.02 SD = 8.31). These children were tracked for the first two years following implantation. Clustered bar charts were used to compare specific types of skills acquired by CwCIs with ASO ≤2 years versus >2 years. The results suggest that CwCIs generally acquire receptive and expressive language skills along a similar sequence to TD children, but there is individual variability relating to specific skills. However, the language outcomes of CwCIs are ultimately the result of a complex interplay of demographic variables.

KEYWORDS:

• cochlear implant
• age at switch-on
• language
• language development
• language outcome
• language skill

Acknowledgements

We would like to thank Julia Hollier and Phillippa MacKenzie for their input on data collection, coding and analysis; Deborah Vickers for her advice on data analysis; and Vaishali Nakrani for her support with data collection.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 The Early Years Foundation Stage (EYFS) statutory framework provided by the UK Department for Education sets out the standards that school and childcare providers must meet for the learning, development and care of children from birth to 5 years (Department for Education, 2014).

2 Currently affiliated with Moor House School and College.

3 Currently affiliated with Barts Health NHS Trust.

Additional information

Notes on contributors

Lauren Sophie Hand

Lauren Hand is a Speech and Language Therapist working with young people with Developmental Language Disorder. She started her education in Biomedical Science at the University of Sheffield before completing a MSc in Speech and Language Sciences at University College London. During her Master’s degree, she completed a research project focussing on early language development in children with cochlear implants.²

Charlotte Ka Yun Liu

Charlotte Liu is a Speech and Language Therapist working with children with developmental language and communication disorders. She completed a BA in Linguistics and MSc in Speech and Language Sciences at University College London. She has undertaken research in the identification of Developmental Language Disorder in bilingual children and the language development of children with cochlear implants.³

Gemma Hardman

Gemma Hardman is a Specialist Speech and Language Therapist currently working in Dorset. She qualified as a Speech and Language Therapist in 2012 and completed an NIHR funded Masters in Clinical Research in 2019. Her specialist interest is working with deaf children and teenagers. She has previously worked on the Cochlear Implant Programme at Great Ormond Street Hospital and as a Teaching Fellow on the MSc Speech and Language Sciences programme at UCL.

Merle Mahon

Merle Mahon is an Associate Professor in the Division of Psychology and Language Sciences at UCL. Her research focuses on deaf children's spoken language development and on the role of gesture in language development. She is currently collaborating with colleagues in the multi-centre BEARS study funded by NIHR award 201608, examining outcomes for deaf children and deaf teenagers who use cochlear implants. Her research interests also include bi/multilingualism and how children learn spoken English when English is an additional language at home.