Early identification and cochlear implantation: critical factors for spoken language development.

Documentation is lacking regarding the ability of congenitally deaf children to attain age-appropriate spoken language skills using a cochlear implant, and how early implantation must occur if such development is to be possible. Spoken language data are presented for infants who underwent implantation at 18 months of age or younger. Additional data are used to compare outcomes among children who differed in age at implantation. Data collected at Carle Clinic and Foundation Hospital were reviewed for 47 consecutively implanted children ranging in age from 9 to 48 months at implantation. These data were analyzed and compared by age-at-implantation groupings for speech perception skills, communication mode, and spoken language abilities. The groups differed dramatically in abilities. The best outcomes occurred in children who underwent implantation at or before 18 months of age. Several of these infants demonstrated age-appropriate spoken language skills. We conclude that early implantation is desirable. Children who undergo implantation as infants may develop language skills commensurate with those of their hearing peers.