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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Hoffman, Michael; Tiddens, Elena; Quittner, Alexandra L et al. (2018) Comparisons of visual attention in school-age children with cochlear implants versus hearing peers and normative data. Hear Res 359:91-100
Cejas, Ivette; Mitchell, Christine M; Hoffman, Michael et al. (2018) Comparisons of IQ in Children With and Without Cochlear Implants: Longitudinal Findings and Associations With Language. Ear Hear 39:1187-1198
Geers, Ann E; Mitchell, Christine M; Warner-Czyz, Andrea et al. (2017) Early Sign Language Exposure and Cochlear Implantation Benefits. Pediatrics 140:
Quittner, Alexandra L; Cejas, Ivette; Wang, Nae-Yuh et al. (2016) Symbolic Play and Novel Noun Learning in Deaf and Hearing Children: Longitudinal Effects of Access to Sound on Early Precursors of Language. PLoS One 11:e0155964
Eisenberg, Laurie S; Fisher, Laurel M; Johnson, Karen C et al. (2016) Sentence Recognition in Quiet and Noise by Pediatric Cochlear Implant Users: Relationships to Spoken Language. Otol Neurotol 37:e75-81
Cheng, Yew Song; Kozin, Elliott D; Remenschneider, Aaron K et al. (2016) Characteristics of Wax Occlusion in the Surgical Repair of Superior Canal Dehiscence in Human Temporal Bone Specimens. Otol Neurotol 37:83-8
Hoffman, Michael F; Cejas, Ivette; Quittner, Alexandra L et al. (2016) Comparisons of Longitudinal Trajectories of Social Competence: Parent Ratings of Children With Cochlear Implants Versus Hearing Peers. Otol Neurotol 37:152-9
Barnard, Jennifer M; Fisher, Laurel M; Johnson, Karen C et al. (2015) A Prospective Longitudinal Study of U.S. Children Unable to Achieve Open-Set Speech Recognition 5 Years After Cochlear Implantation. Otol Neurotol 36:985-92
Hoffman, Michael F; Quittner, Alexandra L; Cejas, Ivette (2015) Comparisons of social competence in young children with and without hearing loss: a dynamic systems framework. J Deaf Stud Deaf Educ 20:115-24
Ratjen, Felix; Bell, Scott C; Rowe, Steven M et al. (2015) Cystic fibrosis. Nat Rev Dis Primers 1:15010

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