Early Surgery Best for Children With Hearing Loss
Cochlear implants yielded best results when put in those younger than 18 months
-- Robert Preidt
Cochlear implants yielded best results when put in those younger than 18 months, researchers find.
FRIDAY, April 23 (HealthDay News) -- Inserting cochlear implants early significantly improves spoken language comprehension and expression in young children who have severe hearing loss, a new study shows.
Researchers assessed spoken language development over three years in 188 children who underwent cochlear implantation before they were 5. The improvements in spoken language performance were much greater than would have been predicted by the children's pre-implant scores on tests of spoken language and comprehension.
The younger the children were when they underwent cochlear implantation, the greater the improvement.
A cochlear implant -- sometimes called a "bionic ear" -- is a small electronic device surgically implanted in the inner ear that stimulates the auditory nerve and allows people who are profoundly deaf to hear many types of sounds.
"Significantly higher rates of comprehension and expression were noted in children undergoing implantation at younger than 18 months compared with children undergoing implantation at ages between 18 and 36 months and at older than 36 months," research leader Dr. John K. Niparko, of the Johns Hopkins University School of Medicine, said in a news release.
In fact, most children who received implants prior to 18 months of age showed trends in improvement that paralleled those of the "control" group of children without hearing loss, Niparko added. Cochlear implantation after 18 months of age, however, was associated with less favorable trends of improvement in performance "and greater variability in measures of both comprehension and expression," he said.
He and his colleagues also found that greater rates of improvement were associated with higher levels of residual hearing prior to cochlear implantation, better parent-child interaction and higher socioeconomic status.
These findings underscore the need to develop objective tools that can evaluate the benefits of hearing amplification in the development of spoken language "and guide timely intervention" with hearing implants, the researchers concluded.
The study appears in the April 21 issue of the Journal of the American Medical Association.
The Nemours Foundation has more about cochlear implants.
SOURCE: Journal of the American Medical Association, news release, April 20, 2010
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Spoken Language Development in Children Following Cochlear Implantation
John K. Niparko, MD; Emily A. Tobey, PhD; Donna J. Thal, PhD; Laurie S. Eisenberg, PhD; Nae-Yuh Wang, PhD; Alexandra L. Quittner, PhD; Nancy E. Fink, MPH; for the CDaCI Investigative Team
Context Cochlear implantation is a surgical alternative to traditional amplification (hearing aids) that can facilitate spoken language development in young children with severe to profound sensorineural hearing loss (SNHL).
Objective To prospectively assess spoken language acquisition following cochlear implantation in young children.
Design, Setting, and Participants Prospective, longitudinal, and multidimensional assessment of spoken language development over a 3-year period in children who underwent cochlear implantation before 5 years of age (n = 188) from 6 US centers and hearing children of similar ages (n = 97) from 2 preschools recruited between November 2002 and December 2004. Follow-up completed between November 2005 and May 2008.
Main Outcome Measures Performance on measures of spoken language comprehension and expression (Reynell Developmental Language Scales).
Results Children undergoing cochlear implantation showed greater improvement in spoken language performance (10.4; 95% confidence interval [CI], 9.6-11.2 points per year in comprehension; 8.4; 95% CI, 7.8-9.0 in expression) than would be predicted by their preimplantation baseline scores (5.4; 95% CI, 4.1-6.7, comprehension; 5.8; 95% CI, 4.6-7.0, expression), although mean scores were not restored to age-appropriate levels after 3 years. Younger age at cochlear implantation was associated with significantly steeper rate increases in comprehension (1.1; 95% CI, 0.5-1.7 points per year younger) and expression (1.0; 95% CI, 0.6-1.5 points per year younger). Similarly, each 1-year shorter history of hearing deficit was associated with steeper rate increases in comprehension (0.8; 95% CI, 0.2-1.2 points per year shorter) and expression (0.6; 95% CI, 0.2-1.0 points per year shorter). In multivariable analyses, greater residual hearing prior to cochlear implantation, higher ratings of parent-child interactions, and higher socioeconomic status were associated with greater rates of improvement in comprehension and expression.
Conclusion The use of cochlear implants in young children was associated with better spoken language learning than would be predicted from their preimplantation scores.
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