Early educational placement and later language outcomes for children with cochlear implants.

HYPOTHESIS: This investigation examined the hypothesis that the type of preschool intervention provided to children who receive a cochlear implant affects their language scores at school entry.
BACKGROUND: Recent research has documented faster language acquisition when children attend specialized preschool programs beginning at age 3 years. We hypothesized that if similar intervention were initiated before age 3 years, the rate of language acquisition might increase even more.
METHODS: Thirty-nine listening and spoken language (LSL) programs located in 20 different states across the United States contributed language test scores for 141 five- and six-year-olds who had used a cochlear implant for at least 1 year. A retrospective analysis compared outcomes at 5 to 6 years based on interventions received each year before age 5 years: 1) individual parent-infant intervention; 2) LSL class with only deaf children, or 3) LSL class with 1 or more hearing children.
RESULTS: The specific type of intervention at ages 1 and 2 years provided a lasting positive impact on language, at least until kindergarten. The probability that a child would reach normal language levels by kindergarten increased significantly if, at age 1 year, intervention included a combination of cochlear implant use and parent-infant intervention and, at age 2 years, a LSL class with other deaf children was added.
CONCLUSION: These results favor providing a cochlear implant by age 1 year and supplementing early parent-infant intervention with an intensive toddler class designed specifically for developing spoken language in children with hearing loss by age 2 years.