Peer-reviewed article
Speech Perception Development From Childhood to Adulthood Following Pediatric Cochlear Implantation: A 30-year Longitudinal Study.
Chieh Kao, Kathryn B Wiseman, Sophie E Ambrose, Jacquelyn L Baudhuin, Adam K Bosen et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study followed 294 children who received cochlear implants over 32 years to understand how their ability to understand spoken words developed from childhood into adulthood. Children who received implants before 18 months old and used their devices consistently showed faster improvement in speech perception. Children with auditory neuropathy, genetic syndromes, or low family income showed slower development, suggesting that both the timing of the implant and family resources matter for outcomes.
Key points
- Early implantation before 18 months of age was associated with faster speech perception development
- Bilateral cochlear implant use and longer daily device use were associated with better outcomes
- Auditory neuropathy, syndromic hearing loss, and low socioeconomic status were associated with poorer speech perception development
- Spoken English as primary language and better vestibular function predicted faster development
- The study suggests improving access to specialists and encouraging consistent device use, especially for children implanted later
Limitations
The study is observational and retrospective, so causal relationships cannot be established. The analysis is limited to English speech perception tests conducted in quiet environments, which may not reflect real-world listening situations.
Abstract
OBJECTIVE: Speech perception development in pediatric cochlear implant users varies widely, and its progression into late childhood and early adulthood remains unclear. This study examines long-term developmental trajectories and influencing factors using a longitudinal clinical dataset. STUDY DESIGN: Speech perception data collected across 22 clinical tests conducted in English and in quiet were retrospectively analyzed with a hierarchical scoring system to understand development of 294 pediatric cochlear implant users between 1992 and 2024 at Boys Town National Research Hospital. Medical records provided data on age at cochlear implant activation, year of first cochlear implant implantation, device configuration, daily device use, hearing loss etiology, revision history, primary language use, insurance type, race, and comorbidities. These variables were incorporated into statistical models to predict longitudinal speech perception outcomes. RESULTS: Pediatric cochlear implant users generally show steady improvement in speech perception with chronological age. Faster early development of speech perception was associated with implantation before 18 months of age, bilateral cochlear implant use, longer daily device use, spoken English as a primary language, having private insurance, and better vestibular function. Alternatively, auditory neuropathy, syndromic hearing loss, hearing loss due to prenatal infections and low socioeconomic status were associated with poorer speech perception. CONCLUSIONS: Auditory neuropathy or syndromic hearing loss and low socioeconomic status are key factors associated with slower speech perception development. Improving access to cochlear implant specialists and encouraging consistent device use-especially for later implantees-may enhance outcomes. Additional support for families and educators is recommended to promote increased device use.