Hearing and speech in children under 2 years of age with a cochlear implant

Abstract

Background. To compare the auditory abilities and speech performance of children with a profound prelingual bilateral hearing impairment, treated with a cochlear implant (CI) before or after 2 years of age. To analyze the complications arising during the selection process of the children, or as a result of the implantation, programming and follow-up. Methods. Prospective cohort single-subject repeated-measures study of 130 children who received an implant at our center. The children were divided into two age groups: 0-2 (n=36), and 2-6 years of age (n=94). Preoperative evaluation included: 1. History, physical exploration, and ENT examination. 2. Neuropaediatric examination, family evaluation, and psychological assessment. 3. Auditory brainstem responses. 4. High resolution computed tomogram of temporal bones. 5. Counseling and informed consent. The children were evaluated prior to, and each year following, the intervention (for up to 5 years), using closed and open-set logoaudiometric tests, and speech perception tests. Speech was evaluated according to the Peabody Picture Vocabulary and Reynell general oral expression scale. Results. Auditory and speech perception tests improved significantly in all children after CI, regardless of the follow-up time. The infant’s performance was better in the group of early implantees. Speech tests showed that the development of children treated before 2 years of age was similar to that of normal children. No additional complications were observed when compared to CI in older children. Conclusions. When performed before 2 years of age, CI offers a quicker and better improvement of performance, with no increase in complications when compared with a later intervention.