The Childhood Development after Cochlear Implantation (CDaCI) Study is a multisite, prospective investigation of a large and diverse cohort of US children with cochlear implants. Our primary objective is to evaluate the effect of variables that influence language learning after implantation. Success in spoken language is a matter of success flowing between multiple spheres of development. Thus our aims are driven by hypotheses that relate variability in post-implant language outcome to environmental, social, interventional, and biological influences. A major challenge in such early childhood research relates to the reliable elicitation of communication and linguistic data. We address this task with hierarchical measures and video analytic techniques that allow us to track communicative skills as they emerge. We continue to build on this research experience to examine how language skills unfold in children participating in the study, evaluating their: 1. expressive &receptive language, 2. speech production, 3. speech recognition, 4. cognitive skills, 5. social interaction &behavior, 6. relationships with family members, and 7. health-related quality of life. CDaCI Study participants consist of children who received a cochlear implant (CI) before the age of 5 years (n=188) and a control group (n=97) of normal hearing (NH) age-mates. Average ages at enrollment were 2.2 years (CI) and 2.3 years (NH). So, as CDaCI participants began the study as preschoolers, they will now embark on their middle school experience, entering high school over the next five years. Retention rates for ongoing data accrual are 85% for CI children and 84% for NH children, although all data collected over the past 8+ years have been included in published analyses. Despite wide recognition of the benefits of early cochlear implantation, there remains equipoise with respect to clinical, rehabilitative, and educational strategies that enable cochlear implant technology to be used to its fullest potential for language acquisition. Modifiers of linguistic outcome become even more compelling as CI children face the performance and social demands of their early teens. This prospective, multidimensional study with concurrent controls offers prospects for novel, generalizeable insights into the sources of variation in language learning and the psychosocial outcomes observed after early cochlear implantation. Economic impact, crucial to decision-making in an era of healthcare reform, will be assessed with longitudinal cost data that are merged with outcomes reported by participants and their parents.

Public Health Relevance

Young children with severe hearing loss may be unable to link the sounds of speech with their meaning despite powerful hearing aids. Such children are candidates for a cochlear implant, and it is critical that we determine how cochlear implants can produce consistent, optimized results with objective studies of implant outcome. The ongoing, longitudinal multisite study of Childhood Development after Cochlear Implantation measures the ability of US participants to learn to listen and speak after cochlear implantation, and assesses their ability to interact with their environment and with others, and to attain the experiences that contribute to quality of life.

National Institute of Health (NIH)
National Institute on Deafness and Other Communication Disorders (NIDCD)
Research Project (R01)
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Donahue, Amy
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University of Southern California
Schools of Medicine
Los Angeles
United States
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Cejas, Ivette; Barker, David H; Quittner, Alexandra L et al. (2014) Development of joint engagement in young deaf and hearing children: effects of chronological age and language skills. J Speech Lang Hear Res 57:1831-41
Semenov, Yevgeniy R; Yeh, Susan T; Seshamani, Meena et al. (2013) Age-dependent cost-utility of pediatric cochlear implantation. Ear Hear 34:402-12
Tobey, Emily A; Thal, Donna; Niparko, John K et al. (2013) Influence of implantation age on school-age language performance in pediatric cochlear implant users. Int J Audiol 52:219-29
Quittner, Alexandra L; Cruz, Ivette; Barker, David H et al. (2013) Effects of maternal sensitivity and cognitive and linguistic stimulation on cochlear implant users' language development over four years. J Pediatr 162:343-8.e3
Cruz, Ivette; Quittner, Alexandra L; Marker, Craig et al. (2013) Identification of effective strategies to promote language in deaf children with cochlear implants. Child Dev 84:543-59
Niparko, John K; Tobey, Emily A; Thal, Donna J et al. (2010) Spoken language development in children following cochlear implantation. JAMA 303:1498-506
Barker, David H; Quittner, Alexandra L; Fink, Nancy E et al. (2009) Predicting behavior problems in deaf and hearing children: the influences of language, attention, and parent-child communication. Dev Psychopathol 21:373-92
Wang, Nae-Yuh; Eisenberg, Laurie S; Johnson, Karen C et al. (2008) Tracking development of speech recognition: longitudinal data from hierarchical assessments in the Childhood Development after Cochlear Implantation Study. Otol Neurotol 29:240-5
Lin, Frank R; Wang, Nae-Yuh; Fink, Nancy E et al. (2008) Assessing the use of speech and language measures in relation to parental perceptions of development after early cochlear implantation. Otol Neurotol 29:208-13
Francis, Howard W; Buchman, Craig A; Visaya, Jiovani M et al. (2008) Surgical factors in pediatric cochlear implantation and their early effects on electrode activation and functional outcomes. Otol Neurotol 29:502-8

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