The Correlation between Age at Implant, Consistent Device Use, and Language Outcomes for Children Implanted under 18 Months

Matthew McCall; Janitha Jayawardana; Jill Mustard; Joanne Lake; John Pearson; Philip Bird

doi:10.1159/000542361

The Correlation between Age at Implant, Consistent Device Use, and Language Outcomes for Children Implanted under 18 Months

Audiol Neurootol. 2024 Dec 10:1-10. doi: 10.1159/000542361. Online ahead of print.

Authors

Matthew McCall¹, Janitha Jayawardana², Jill Mustard³, Joanne Lake³, John Pearson⁴, Philip Bird⁵

Affiliations

¹ Te Whatu Ora Christchurch Hospital, Christchurch, New Zealand.
² Royal Victorian Eye and Ear Hospital Melbourne, East Melbourne, Victoria, Australia.
³ Southern Cochlear Implant Programme, Christchurch, New Zealand.
⁴ Biostatistics and Computational Biology University of Otago, Christchurch, New Zealand.
⁵ Southern Cochlear Implant Programme Department of Surgery, University of Otago, Christchurch Department of Otolaryngology, Head and Neck Surgery, Christchurch Hospital, Christchurch, New Zealand.

PMID: 39657623
DOI: 10.1159/000542361

Abstract

Introduction: Research suggests deaf children who receive cochlear implants (CIs) at an early age can achieve age-appropriate language. Recent studies suggest age at full-time CI use is a better predictor of language outcomes than age at implant. The aim of this study was to investigate whether there are correlations between age at implantation, establishing consistent device use, and language outcomes in a cohort of young children in Aotearoa New Zealand.

Methods: A retrospective analysis was conducted. The study included 46 participants, implanted by the Southern Cochlear Implant Programme by age 18 months. The median age at implant was 8 months. Device use was measured via data logging. Consistent device use was defined as ≥8 h per day. Language outcomes were measured at 2- and 3-year post-implantation using PLS-5.

Results: Consistent use was established by 78.3% by 3 years. Language results were at least one SD higher for children who achieved consistent use within 2 years of implant. Language scores for Maori children were more than one SD lower than non-Maori, a finding not entirely explained by less usage. There was no correlation between age of implantation and length of time to consistent device use. The presence of additional disabilities affected consistent device use.

Conclusion: Simply offering CIs earlier is not sufficient to improve language outcomes in the congenitally deaf population. Earlier consistent use was associated with better language outcomes for those implanted before 18 months of age, and language scores were higher for children who achieved consistent use within 2 years of implantation. There is a need to understand why children with pre-lingual deafness may not be achieving consistent device use, and by doing so, we would be a step closer to being able to tailor culturally appropriate supports and services that could help more children achieve better outcomes.

Keywords: Cochlear implant; Data logging; Full-time use; Language outcomes; Pre-lingual deafness.