Speech and language results in children with a cochlear implant.

At the House Ear Institute, speech and language assessments are a regular part of the evaluation protocol for the cochlear implant clinical trials in children. The assessments are conducted preimplant and at specific postimplant intervals. Paired comparisons of the children's performance at pre- and post-implant intervals reveal significant improvements in both imitative and spontaneous speech production abilities. However, some differences between groups are noted. Children implanted at an early age demonstrate a greater number of significant improvements in speech production, while children using oral communication have better skills at all test intervals. In addition, significant improvements on three of the four receptive language measures and one of the four expressive language measures are demonstrated at the 6-mo postimplant test interval. A significant decrease in performance is noted for one receptive language measure. In a second study, the speech scores of control groups and postimplant groups of the same age (3, 4, or 5 yr) are compared. Implanted children score higher in all but one of 24 contrasts, and these differences are statistically significant in five of the comparisons.