Vocabulary and Functional Communication in Preschool-Aged Children With Cochlear Implants

Early cochlear implantation is a critical factor influencing spoken language development in children with congenital hearing loss. Vocabulary acquisition, as a core component of language, is dependent on early auditory access. This study aimed to examine the relationship between functional auditory communication and receptive-expressive vocabulary development in children aged 2-6 years with cochlear implants, and to compare outcomes according to age at implantation.

This retrospective study included 29 children with cochlear implants aged between 2 and 6 years. Participants were divided into two groups based on age at first implantation: 12-18 months (n = 16) and 19-24 months (n = 13). Functional communication was assessed using the Functioning after Pediatric Cochlear Implantation (FAPCI). Vocabulary development was evaluated with the Turkish Expressive and Receptive Vocabulary Test (TIFALDI). Group comparisons were performed and correlations between functional communication and vocabulary measures were examined.

Children implanted between 12 and 18 months demonstrated significantly higher functional communication outcomes, including FAPCI total (p = 0.04), speech perception (p = 0.04), and speech production scores (p = 0.032) compared to those implanted between 19 and 24 months. Similarly, significantly higher receptive (p = 0.001) and expressive (p = 0.003) vocabulary scores were observed in the earlier-implanted group. Strong positive correlations were found between receptive vocabulary and FAPCI total (r = 0.734) and speech perception scores (r = 0.689), while expressive vocabulary showed strong to very strong correlations with FAPCI total (r = 0.701) and speech production scores (r = 0.765) (p < 0.001).

Earlier cochlear implantation within the first 18 months of life is associated with superior functional communication and vocabulary outcomes in early childhood. The strong associations between functional auditory communication and receptive-expressive vocabulary highlight the central role of lexical development in spoken language outcomes following cochlear implantation.