Factors Affecting the Development of Speech, Language, and Literacy in Children With Early Cochlear Implantation

PURPOSE: This study investigated factors contributing to auditory, speech, language, and reading outcomes in children with prelingual deafness after 4-6 years of multichannel cochlear implant use. The analysis controlled for the effects of child, family, and implant characteristics so that educational factors most conducive to maximum implant benefit could be identified. METHOD: The sample included 136 8- and 9-year-old children from across the United States and Canada who were implanted by age 5 with the Nucleus 22-channel implant. Type and amount of educational intervention since implantation constituted the independent variables. The dependent variable was performance on a battery of tests of speech perception, speech production, language, and reading administered 4-6 years postimplant. Characteristics of the child, the family, and the implant itself constituted intervening variables. A series of multiple regression analyses determined the amount of variance in each outcome accounted for by the intervening variables and the amount of additional variance attributable to independent variables. RESULTS: Characteristics of the child and the family (primarily nonverbal IQ) accounted for approximately 20% of the variance in postimplant outcome. An additional 24% was accounted for by implant characteristics and 12% by educational variables, particularly oral communication mode. CLINICAL IMPLICATIONS: Auditory, speech, language, and reading skills achieved 4-6 years after cochlear implantation were most strongly associated with nonverbal IQ, implant functioning, and use of an oral communication mode.