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Updated: Jun 14, 2025

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
[The LittlEARS® Auditory Questionnaire : An analysis of multicentre data of children after early bilateral cochlear
Yvonne Seebens1,2, Dennis Metzeld3, Barbara Streicher4
1Cochlear Implant Center (CIC) Rhein-Main Friedberg der HSF gGmbH, Friedberg, Deutschland. yseebens@cic-rheinmain.de.
Insights
Early detection of developmental delays in children with cochlear implants (CI) is crucial. The LittlEARS® Auditory Questionnaire (LEAQ) shows limited value as a general reference for early bilateral CI, with chronological age being a better diagnostic measure.
Area of Science:
- Pediatric audiology
- Developmental pediatrics
- Speech-language pathology
Background:
- Optimizing support for children with cochlear implants (CI) requires early detection of developmental delays.
- The LittlEARS® Auditory Questionnaire (LEAQ) is used to assess auditory development in children with CI.
- This study evaluates LEAQ data in relation to age and compares it with later language development.
Purpose of the Study:
- To evaluate the effectiveness of the LEAQ in identifying developmental progress in children with early bilateral CI.
- To compare LEAQ scores with chronological age (CA) and hearing age (HA).
- To assess the correlation between LEAQ results and later speech development.
Main Methods:
- Retrospective multicentre study of 554 children with CI.
- Inclusion of children without additional disabilities who received bilateral CI.
- Analysis of LEAQ data in relation to CA and HA, and correlation with speech development tests.
Main Results:
- High correlations observed between hearing age (HA) and LEAQ total scores.
- Developmental trajectories analyzed by chronological age (CA) parallel those of normal-hearing children, but at a lower level.
- Children implanted by 12 months achieved higher LEAQ scores; later LEAQ results correlated with specific areas of speech development.
Conclusions:
- Early detection of developmental processes in children with CI is critical.
- Chronological age (CA) should be the primary reference in diagnostics for very early CI fitting.
- LEAQ values have limited applicability as general reference values for children with early bilateral CI; further research on early development and later speech is needed.
Background:
In order to optimise the support of children with cochlear implants (CI), it is very important to detect slow developmental processes as early as possible. Data from the LittlEARS® Auditory Questionnaire (LEAQ) from children with early bilateral CI are evaluated and presented in relation to age and hearing age and compared with language development data recorded later.
Materials And Methods:
This retrospective multicentre study included data from a total of 554 children for whom at least one LEAQ was completed during the course of CI rehabilitation. Children without additional disabilities who received bilateral simultaneous or sequential CI treatment were included.
Results:
As expected, there are high correlations between hearing age (HA) and the overall LEAQ total score. When analysed according to chronological age (CA), development runs roughly parallel to the development of children with normal hearing, albeit at a lower level. Children implanted early up to an age of ≤ 12 months consistently achieve approximately 7-8 raw points more. Only the LEAQ results of the later test times (from the age of 18 months) correlate with some areas of the speech development test for children (SETK; areas 3-5).
Conclusion:
The earliest possible detection of critical developmental processes in children with CI is extremely important. In the case of very early CI fitting, the CA should be used as a reference measure in diagnostics. The LEAQ values determined for the group of children with CI are suitable to a limited extent as generally valid reference values for children with early bilateral CI. Further studies should continue to work out the correlations between early preverbal development and later speech development.
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