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Updated: Sep 9, 2025

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Consonant Proficiency in Children With and Without Hearing Impairment Assessed With Profiles of Early Expressive
Anna Persson1,2,3, Dyveke Christensen Karlström4, Traci Flynn5
1Department of Hearing Habilitation for Children and Youth, Karolinska University Hospital, Stockholm, Sweden.
Background:
Children with hearing impairment (HI) are at risk for language difficulties, which can persist during childhood. There is a lack of clinical language tests adapted for young preschool children, enabling early identification of language delays. The expressive phonological test PEEPS-SE could enable such testing in these ages.
Aims:
The present study sought to compare the phonological abilities of children with and without HI at ages 24 and 30 months and to contribute to the development of the test.
Methods And Procedures:
Outcomes of children with HI (n = 9) were compared to children with normal hearing (n = 21) with regard to the number of different established true consonants, fricatives, and percentage of consonants correct (PCC).
Outcomes And Results:
The HI group had significantly fewer consonants at 24 months and lower PCC at both ages, displaying no differences regarding fricatives.
Conclusions And Implications:
The results from this study indicate that language delays occur in children with HI during early preschool years and that PEEPS-SE can identify these children.
What This Paper Adds:
What is already known on this subject It is well known that children born with hearing impairment are at risk for speech and language delays, but studies on the early auditory and speech development of children with hearing impairment that have been followed with the current recommendations in paediatric healthcare are lacking. Until recently, speech-language pathologists have lacked age-appropriate tests to measure phonological development in children under 3 years of age. This is particularly true for languages with few speakers (e.g., Swedish). What this paper adds to the existing knowledge In this paper, we report on results on early phonological skills in a group of Swedish children with hearing loss in comparison to a group of children with normal hearing at 24 and 30 months of age. We see this study as an important update on the early auditory and speech development of children with hearing impairment who have been followed with the current recommendations in paediatric healthcare. It adds information on how to adapt and develop instruments created for this young age group into another language. What are the potential or actual clinical implications for this work? The results from this study have led to the creation of a detailed manual of the PEEPS-SE, which is free to download on the web. The methods used in this study are all feasible, which makes it possible for future studies to replicate this study, including larger groups of children.
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