Long-term speech and language outcomes in prelingually deaf children, adolescents and young adults who received cochlear implants in childhood.

This study investigated long-term speech and language outcomes in 51 prelingually deaf children, adolescents and young adults who received cochlear implants (CIs) prior to 7 years of age and had used their implants for at least 7 years. Average speech perception scores were similar to those found in prior research with other samples of experienced CI users. Mean language test scores were lower than norm-referenced scores from nationally representative normal-hearing, typically developing samples, although a majority of the CI users scored within 1 standard deviation of the normative mean or higher on the Peabody Picture Vocabulary Test, Fourth Edition (63%), and the Clinical Evaluation of Language Fundamentals, Fourth Edition (69%). Speech perception scores were negatively associated with a meningitic etiology of hearing loss, older age at implantation, poorer preimplant unaided pure-tone average thresholds, lower family income and the use of 'total communication'. Subjects who had used CIs for 15 years or more were more likely to have these characteristics and were more likely to score lower on measures of speech perception compared to those who had used CIs for 14 years or less. The aggregation of these risk factors in the >15 years of CI use subgroup accounts for their lower speech perception scores and may stem from more conservative CI candidacy criteria in use at the beginning of pediatric cochlear implantation.

Long-term performance of Clarion 1.0 cochlear implant users.

OBJECTIVE/HYPOTHESIS: To evaluate the long-term performance of adult Clarion 1.0 cochlear implant users. STUDY DESIGN: This was a retrospective, longitudinal study evaluating word discrimination in quiet for 31 adult cochlear implant patients with preimplantation sentence scores of less than 10%. METHODS: The length of the study was 135 months with a mean follow-up length of 93 (median, 96) months. For the duration of the study, all subjects used the Clarion 1.0 cochlear implant with speech processors programmed for the use of the continuous interleaved sampling strategy. RESULTS: There was no significant growth or decline in speech perception after 24 months postimplantation unless adverse medical events were experienced. Age at implantation was significantly and substantially negatively correlated (-11% word score per decade, r = 0.68) with most recent score, maximum score, time to maximum score, range of performance, 24- to 130-month mean score, and for any longitudinal data point tested: 3 to 6 months, 6 months, 1 year, 2 years, 5 years, and 10 years. There were no age-related declines in performance. There were no observed correlations between duration of deafness and any of the variables listed above. CONCLUSIONS: The lack of correlation between duration of deafness and performance in a cohort without residual hearing suggests the presence of a strong correlation between age and speech performance with a cochlear implant. That the cochlear implant is a safe therapy for the treatment of profound deafness is supported by the stability of scores through the 10-year study period as well as a zero rate of device failures or explantation.