Assessment of early language development in Turkish children with a cochlear implant using the TEDIL test

Abstract

Objectives: To analyse language development of children with a cochlear implant (CI) in relation to length of CI use and age at implantation and to examine the suitability of the TEDIL as an assessment tool for measuring early language development in Turkish children.

Methods: A total of 119 children implanted with a CI before 5 years of age were assessed acutely on sound field thresholds, speech recognition thresholds, open-set and closed-set monosyllabic word tests, the TEDIL, categories of auditory performance (CAP), and speech intelligibility rating (SIR). The outcome scores were analysed in relation to length of CI use (3, 4, and 5 years) and age at implantation (<24 months vs. >24 months). The TEDIL scores were compared to all other outcome measures.

Results: Scores significantly increased with CI experience. CAP and SIR were significantly higher in the younger implanted group. No significant difference was observed between the younger and older implanted group on the closed-set and open-set monosyllabic tests and the TEDIL. The TEDIL scores significantly correlated with CAP, SIR, and the closed-set and open-set word scores. The mean TEDIL standard score was close to average.

Conclusions: Performance of CI users improves with increased CI experience. CI users implanted <24 months tend to have better auditory skills and clearer speech than CI users implanted >24 months. CI users implanted between 24 months and 60 months tend to develop language similarly to CI users implanted <24 months. The TEDIL is a suitable tool for assessing early receptive and expressive language development in Turkish children.

Keywords:

• Cochlear Implantation
• Outcomes
• Age
• Length of use

Acknowledgements

The authors thank Ursula Lehner-Mayrhofer (MED-EL Innsbruck, Austria) for medical writing assistance.

Disclaimer statements

Contributors Julie Koşaner - designer of protocol, writer of article, fitting and testing audiologist; Murat Deniz, Hüseyin Deniz and Deniz Uruk - fitting and testing audiologists, compilers of results; Edda Amann - statistician.

Funding None.

Conflicts of interest Julie Koşaner and Edda Amman are both employees of MED-EL and receive monthly salaries.

Ethics approval No ethical approval was sought for this study. All programming of CI's and tests conducted afterwards to check the child's performance with the CI and his or her state of development in listening and speaking were all done as per usual. Each child was seen in his or her usual clinic, and fitting and testing were carried out by the audiologist who usually sees the child. Just the same procedures and tests as always used at fitting sessions and follow-up visits were implemented. Children were fitted and tested according to their normal fitting schedule. Parents read and signed a consent form allowing their child's test results to be used anonymously to establish means of performance in paediatric Turkish CI users.