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Auditory comprehension outcomes in children who receive a cochlear implant before 12 months of age
Ryan M Mitchell1,2, Erin Christianson3, Rebecca Ramirez3
1Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, U.S.A.
Insights
Early cochlear implantation (CI) in infants with congenital deafness, under 12 months, significantly improves auditory comprehension (AC) outcomes compared to later implantation. This finding supports earlier CI for better language development in deaf children.
Area of Science:
- Pediatric Otolaryngology
- Audiology
- Developmental Pediatrics
Background:
- Current U.S. Food and Drug Administration guidelines recommend cochlear implantation (CI) for children over 12 months of age.
- Emerging evidence suggests earlier CI may enhance spoken language outcomes in infants with congenital deafness.
Purpose of the Study:
- To compare auditory comprehension (AC) outcomes in children with congenital deafness who received CI before 12 months versus those implanted between 12 to 24 months of age.
- To evaluate the impact of early CI on language development.
Main Methods:
- Retrospective analysis of prospectively collected data from patients under 2 years old who received CI.
- Auditory comprehension was assessed using the Preschool Language Scale (PLS)-AC subtest.
- A linear mixed-effects model analyzed the association between implantation age and post-CI AC scores up to 2 years, controlling for relevant factors.
Main Results:
- The study included 29 patients implanted before 12 months and 82 patients implanted between 12 to 24 months.
- Younger age at implantation was significantly associated with better post-CI AC scores.
- Higher pre-CI PLS-AC scores also correlated with improved post-CI outcomes.
Conclusions:
- Cochlear implantation before 12 months of age in children with congenital deafness is linked to superior auditory comprehension outcomes up to two years post-implantation.
- These findings suggest that earlier CI intervention may be beneficial for language development in this population.
Objective:
The U.S. Food and Drug Administration guidelines for cochlear implantation (CI) include age greater than 12 months. Studies have suggested that implantation in children younger than 12 months with congenital deafness may be associated with better spoken language outcomes. Compare auditory comprehension (AC) outcomes for children with congenital deafness who received CI less than 12 months of age to those implanted at 12 to 24 months of age.
Methods:
Retrospective review of prospectively collected data in consecutively implanted patients under 2 years of age who received CI and had post-CI Preschool Language Scale (PLS)-AC scores. Receptive language was assessed with the AC subtest of the PLS. Patients without pre-CI PLS-AC scores were excluded. The association between age at implantation and post-CI PLS-AC scores up to 2 years after CI surgery was modeled using a linear mixed-effects model. Time from CI surgery, number of implants, risk factors for language delay, pre-CI PLS-AC score, and sex were included in the model. Patients implanted less than 12 months of age were compared to those implanted between 12 and 24 months.
Results:
Twenty-nine patients who had CI surgery by 12 months and 82 who had CI surgery between 12 and 24 months were included in the analysis. Younger age at implantation and better pre-CI PLS-AC scores were significantly associated with better post-CI PLS-AC scores.
Conclusion:
Cochlear implantation in children with congenital deafness less than 12 months of age was associated with better PLS-AC than in children implanted over 12 months of age up to 2 years after implantation.
Level Of Evidence:
4 Laryngoscope, 130:776-781, 2020.
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