Developmental Trajectories and Influencing Factors of Aural/Oral Performance in Mandarin-Speaking Children with...

The trend of cochlear implantation at a younger age has become increasingly prominent in recent years. However, early intervention also presents significant challenges to postoperative assessment. Parent-reported questionnaires have demonstrated notable advantages in outcome evaluation for infants and young children. In the present study, we investigate the auditory development of Mandarin-speaking children with cochlear implants (CIs) using the Chinese version of the Parents' Evaluation of Aural/Oral Performance of Children (PEACH). A total of 187 children with CIs participated. According to their age at implantation, the children were classified into five groups: <12 months, 13-18 months, 19-24 months, 25-42 months, and >42 months. Evaluations were administered at CIs switch-on (baseline), and at 1, 2, 3, 6, 12, 24, 36, 48, 60 months post switch-on, resulting in 933 records. We employed a linear mixed-effects model to identify key factors influencing PEACH performance. Results show that the PEACH scores enter a stable plateau phase after approximately 20 months of CI use. Notably, children who received CIs at a younger age exhibited faster improvements in auditory functional performances. This advantage is particularly prominent in children implanted before 18 months of age. Analysis indicated that significant influencing factors include age at implantation, duration of CI use, development quotient, and preoperative residual hearing level. This study explores the longitudinal trends of early aural/oral performance in children with CIs. The findings emphasize the critical importance of early cochlear implantation for improving outcomes while revealing the challenges associated with the late-implanted children.