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Updated: Apr 24, 2026
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Developmental Trajectories and Influencing Factors of Aural/Oral Performance in Mandarin-Speaking Children with
Jie Bai1, Ying Li1, Zhihan Lin1
1Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Insights
Early cochlear implantation (CI) significantly improves auditory development in children. Younger implantation ages, especially before 18 months, lead to faster auditory gains and better long-term outcomes.
Area of Science:
- Pediatric audiology
- Otolaryngology
- Developmental pediatrics
Background:
- Cochlear implantation (CI) is increasingly performed at younger ages.
- Assessing auditory development in young children post-CI presents challenges.
- Parent-reported outcomes are valuable for evaluating infants and young children.
Purpose of the Study:
- To investigate the longitudinal auditory development of Mandarin-speaking children with CIs.
- To identify factors influencing auditory performance using the Parents' Evaluation of Aural/Oral Performance of Children (PEACH) questionnaire.
- To compare outcomes based on age at cochlear implantation.
Main Methods:
- A cohort of 187 Mandarin-speaking children with CIs was studied.
- Children were grouped by age at implantation (<12, 13-18, 19-24, 25-42, >42 months).
- Longitudinal data collected using the Chinese PEACH questionnaire up to 60 months post-CI activation, analyzed with a linear mixed-effects model.
Main Results:
- PEACH scores plateau after approximately 20 months of CI use.
- Children implanted younger showed faster auditory improvements, particularly those implanted before 18 months.
- Key factors influencing performance included age at implantation, CI duration, development quotient, and preoperative hearing levels.
Conclusions:
- Early cochlear implantation is crucial for optimal auditory development and functional outcomes.
- Younger implantation age significantly accelerates auditory progress in children with CIs.
- Late-implanted children face greater challenges in auditory development, highlighting the importance of timely intervention.
Abstract:
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.
