Nonword Repetition as a Predictor of Long-Term Speech and Language Skills in Children With Cochlear Implants

Hypothesis: The rapid phonological processing skills of children with cochlear implants early in life (ages 8-10), as measured by nonword repetition performance, will predict their language development 8 years later (ages 16-18). This core processing ability will also correlate with concurrent measures of language at both ages of testing. Background: Understanding the causes of the wide range of performance in pediatric cochlear implant users currently constitutes a major barrier to clinical and research progress in the field. Research into children's neurocognitive abilities such as working memory capacity and verbal rehearsal speed, in addition to conventional demographic variables, has shown that these foundational skills play a key role in determining outcomes. Here, we investigate the impact of rapid phonological processing, an ability which is critical in spoken language use, for children with cochlear implants. Methods: Fifty-two deaf children with cochlear implants completed a battery of 14 clinical and research measures of language, neurocognitive, and nonword repetition skills in 2 testing sessions 8 years apart. Results: Performance on the nonword repetition task at both testing sessions correlated significantly with concurrent language abilities. Importantly, nonword repetition accuracy at age 8 to 10 also significantly predicted performance on measures of language ability at age 16 to 18 in a wide range of domains, from speech intelligibility to sentence recognition in noise. These relations were significant even when other neurocognitive measures were controlled. Conclusion: Early nonword repetition performance in children with cochlear implants predicts later language development and, therefore, may identify those children at high risk for poor outcomes.