Trajectory of auditory and language development in the early stages of pre-lingual children post cochlear implantation: A longitudinal follow up study

Objectives: The aim of this longitudinal follow-up study was to explore the trajectories of early auditory and language development in Mandarin speaking children younger than 3 years of age following switch-on of their cochlear implants (CIs). Methods: Early auditory and language development was measured longitudinally using the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS), which is a commonly used tool for assessing early prelingual auditory development (EPLAD) in children, and the subtest (Words and Gestures, W&G) of the simplified short form version of the Mandarin Communicative Development Inventory (SSF-MCDI) to assess receptive and expressive vocabulary growths of children in 24 pediatric cochlea implant recipients at baseline, 3, 6, and 12 months following switch-on. Age at switch-on ranged from 1 to 3 years of age. Participants were divided into two groups based on age at switch-on. The IT-MAIS and SSF-MCDI (W&G) scores were analyzed with comparison to normal children, unaided hearing-impaired children, and CI children. Results: Significant improvements in IT-MAIS and SSF-MCDI (W&G) scores from baseline to 12 months were seen after switch-on in both CI groups and were comparable to the normal hearing children in the first year of age. The IT-MAIS scores of CI children in both groups at 12 months after switch-on surpassed the average level of unaided peers with profound hearing loss and were similar to the average level of unaided peers with mild hearing loss. SSF-MCDI (W&G) scores in word comprehension and expression were significantly different between groups at some intervals. Conclusions: Children younger than 3 years of age with cochlear implants have similar trajectories in early auditory and language developments to normally hearing children. Moreover, early implantation is an important factor for the early auditory development when comparing EPLAD results between CI children and unaided peers with different hearing loss. Finally, it is noteworthy that CI children master the skill of word comprehension before the skill of word expression, and that word comprehension may be the basis of word expression.