Spoken Language Benefits of Extending Cochlear Implant Candidacy Below 12 Months of Age

Objective: To test the hypothesis that cochlear implantation surgery before 12 months of age yields better spoken language results than surgery between 12 and 18 months of age. Study Design: Language testing administered to children at 4.5 years of age (+/- 2 mo). Setting: Schools, speech-language therapy offices, and cochlear implant (CI) centers in the United States and Canada. Participants: Sixty-nine children who received a cochlear implant between ages 6 and 18 months of age. All children were learning to communicate via listening and spoken language in English-speaking families. Main Outcome Measure: Standard scores on receptive vocabulary, expressive, and receptive language (includes grammar). Results: Children with CI surgery at 6 to 11 months (n = 27) achieved higher scores on all measures as compared with those with surgery at 12 to 18 months (n = 42). Regression analysis revealed a linear relationship between age of implantation and language outcomes throughout the 6- to 18-month surgery-age range. Conclusion: For children in intervention programs emphasizing listening and spoken language, cochlear implantation before 12 months of age seems to provide a significant advantage for spoken language achievement observed at 4.5 years of age.