The implementation of newborn hearing screening practices is leading to more children with hearing loss being identified in infancy. Parents and hearing professionals are being faced with making decisions about intervention strategies for these young children. This study addresses an issue of critical importance to those who must decide whether and when to provide a young deaf child with a cochlear implant. Research in child language acquisition suggests that improved auditory stimulation should be introduced as early as possible to take advantage of the infant's propensity to learn language. On the other hand, the trauma to a family upon learning that their child is deaf and the difficulties professionals encounter in obtaining reliable behavioral thresholds at very young ages are among reasons cited for waiting until the child is older to perform implant surgery. The consequences of delaying the decision to provide an implant could be substantial. Previous work by the principal investigator on the acquisition of early communicative behaviors by normal hearing and deaf children under 54 months of age documents the dramatic delay exhibited by oral deaf children in many important precursors of normal language. Development of these behaviors is predictive of their spoken language competence several years later. If the documented speech perception benefits available from a cochlear implant can ameliorate these deficits, then early implantation is critical for families who value development of spoken language in their deaf child.
The aim of this study is to examine the effects of implantation during the crucial language-learning period before 3 years of age on communication and language skills exhibited at 3 and 4 years of age. Over 5 years, 50 children receiving an implant before 3 years of age who are enrolled in oral education programs across the country will be videotaped in conversational interaction when they are 3 1/2 years and again at 4 1/2 years of age. The communicative functions, lexical, and syntactic characteristics of their language will be quantified and analyzed in relation to the age at which they received an implant: 18-23 months or 30-35 months. Results will be compared with our existing data on normally hearing 3 1/2 and 4 1/2 year olds. The design will allow for age of implantation effects to be measured while holding duration of implant use constant. It is hypothesized that the importance of early auditory experience will be reflected in communicative function and language use that is closer to that of normally hearing age mates the earlier the child received the implant.

Agency
National Institute of Health (NIH)
Institute
National Institute on Deafness and Other Communication Disorders (NIDCD)
Type
Research Project (R01)
Project #
7R01DC004168-04
Application #
6649718
Study Section
Special Emphasis Panel (ZDC1-SRB-S (02))
Program Officer
Donahue, Amy
Project Start
2000-09-27
Project End
2005-08-31
Budget Start
2003-09-01
Budget End
2004-08-31
Support Year
4
Fiscal Year
2003
Total Cost
$287,640
Indirect Cost
Name
Washington University
Department
Otolaryngology
Type
Schools of Medicine
DUNS #
068552207
City
Saint Louis
State
MO
Country
United States
Zip Code
63130
Nicholas, Johanna G; Geers, Ann E (2018) Sensitivity of expressive linguistic domains to surgery age and audibility of speech in preschoolers with cochlear implants. Cochlear Implants Int 19:26-37
Geers, Ann E; Nicholas, Johanna; Tobey, Emily et al. (2016) Persistent Language Delay Versus Late Language Emergence in Children With Early Cochlear Implantation. J Speech Lang Hear Res 59:155-70
Davidson, Lisa S; Geers, Ann E; Nicholas, Johanna G (2014) The effects of audibility and novel word learning ability on vocabulary level in children with cochlear implants. Cochlear Implants Int 15:211-21
Salas-Provance, Marlene B; Spencer, Linda; Nicholas, Johanna G et al. (2014) Emergence of speech sounds between 7 and 24 months of cochlear implant use. Cochlear Implants Int 15:222-9
Nicholas, Johanna G; Geers, Ann E (2013) Spoken language benefits of extending cochlear implant candidacy below 12 months of age. Otol Neurotol 34:532-8
Geers, Ann E; Nicholas, Johanna G (2013) Enduring advantages of early cochlear implantation for spoken language development. J Speech Lang Hear Res 56:643-55
Geers, Ann E; Davidson, Lisa S; Uchanski, Rosalie M et al. (2013) Interdependence of linguistic and indexical speech perception skills in school-age children with early cochlear implantation. Ear Hear 34:562-74
Tobey, Emily A; Britt, Lana; Geers, Ann et al. (2012) Cochlear implantation updates: the Dallas Cochlear Implant Program. J Am Acad Audiol 23:438-45
Nicholas, Johanna G; Geers, Ann E (2008) Expected test scores for preschoolers with a cochlear implant who use spoken language. Am J Speech Lang Pathol 17:121-38
Nicholas, Johanna Grant; Geers, Ann E (2007) Will they catch up? The role of age at cochlear implantation in the spoken language development of children with severe to profound hearing loss. J Speech Lang Hear Res 50:1048-62

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