Receptive and Expressive Language Following Early Cochlear Implantation

Objective: Examine the effects of age-at-implant and cognition on receptive language trajectories (RLTs) and expressive language trajectories (ELTs). Study Design: Retrospective cohort study. Analysis of language in children who received their first cochlear implants (CIs) before 2 years of age. Each child completed at least 2 receptive and/or 2 expressive language assessments at least 6 months apart; individual RLTs (n = 403) and ELTs (n = 364) were derived. Pearson correlation and ANOVA were used to analyze RLT/ELT across 4 age-at-implant groups: Group 1 first CI before 9 months; Group 2 CI from 9 to 12 months; Group 3 CI from 12 to 18 months; and Group 4 CI from 18 to 24 months. Cognition, sex, implant configuration, relative socioeconomic advantage, and language background were evaluated. Results: Mean RLT for Groups 1−4 were 1.02 (SD, 0.42; n = 52), 0.86 (SD, 0.36; n = 100), 0.74 (SD, 0.42; n = 140), and 0.75 (SD, 0.38; n = 111), respectively, where 1.0 represents typical language growth over 1 calendar year. Mean ELT for groups 1−4 were 0.87 (SD, 0.41; n = 51), 0.75 (SD, 0.39; n = 99), 0.68 (SD, 0.45; n = 128), and 0.67 (SD, 0.40; n = 86), respectively. There was a significant negative association between age-at-implant and RLT (r = −0.21; P < 0.001) and ELT (r = −0.14; P = 0.007). Cognition was associated with language outcomes, but other child/family variables were not. Conclusions: Cochlear implantation before 9 months of age was associated with age-appropriate language development in children with no cognitive delay. Findings strengthen current arguments for implantation before 9 months.