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Updated: Aug 12, 2026
Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
Performance of 2- and 3-year-old children and prediction of 4-year from 1-year performance
R S Tyler1, B J Gantz, G G Woodworth
1University of Iowa, Department of Otolaryngology-Head and Neck Surgery, Iowa City 52242-1078, USA.
Insights
Children who receive cochlear implants between 2 and 4 years of age show better outcomes than older children. Early performance after cochlear implantation can predict long-term results.
Area of Science:
- Pediatric audiology
- Otolaryngology
- Neuroscience
Background:
- Cochlear implantation is a vital intervention for children with severe to profound hearing loss.
- Optimal age for cochlear implantation remains a key area of research.
Purpose of the Study:
- To compare the performance of children receiving cochlear implants at different ages (2-4 years vs. 4-9 years).
- To assess the predictability of long-term outcomes based on early post-implantation results.
Main Methods:
- Children were divided into two age groups for cochlear implantation: 2-4 years and 4-9 years.
- Performance was evaluated at 1 year and 4 years post-implantation for both groups.
Main Results:
- Children implanted between 2 and 4 years of age demonstrated significantly higher performance scores at 36 months compared to those implanted later.
- One-year post-implantation performance was a reliable indicator of four-year outcomes.
Conclusions:
- Early cochlear implantation, ideally before 2 years of age, may be beneficial for children.
- Further research is needed to establish precise selection criteria for optimal early implantation.
Objective:
To examine whether children perform better when they receive cochlear implants when they are 2 to 4 years of age than when they are older, and to determine whether 4-year performance can be predicted from 1-year results.
Method:
Children in two age groups (2 to 4, 4 to 9 years) were tested for performance, and the age groups were compared. Children were also tested 1 and 4 years after implantation.
Results:
The results suggest that the "implanted young" group scored higher than the "implanted old" group after 36 months, and that 1-year performance is helpful in predicting 4-year performance.
Conclusion:
It may be desirable for children to undergo implantation when they are under 2 years of age, provided that appropriate selection criteria can be determined.
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