Children with cochlear implants and developmental disabilities: a language skills study with developmentally matched hearing peers.
Cochlear implants alone do not erase language delays when developmental disability is also in play.
01Research in Context
What this study did
Meinzen-Derr et al. (2011) compared language scores in preschoolers who had cochlear implants plus developmental disabilities with hearing peers who had the same cognitive level.
The team used standard language tests to see if the implant group kept pace after the surgery.
What they found
The children with implants scored about 24 points lower on language quotients than their matched hearing peers.
The gap stayed even when both groups had similar non-verbal IQ scores.
How this fits with other research
Chen et al. (2017) saw fast vocabulary growth in toddlers implanted before age three who had no extra disabilities.
The new study shows that adding a developmental disability wipes out that early advantage.
Nittrouer et al. (2016) later found that short preschool sentences predicted later grammar struggles in the same CI-plus-DD group.
Together the papers draw a clear line: early implant timing helps only when no other delays are present.
Why it matters
If you serve a child who is deaf plus has DD, do not assume the implant will close the language gap on its own.
Plan for extra speech sessions, visual supports, and parent coaching right after activation.
Track mean length of utterance early; it flags who will need the most help later.
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02At a glance
03Original abstract
The number of children receiving cochlear implants (CIs) with significant disabilities in addition to their deafness has increased substantially. Unfortunately, children with additional disabilities receiving CIs have largely been excluded from studies on cochlear implant outcomes. Thus limited data exists on outcomes in this population to guide pre-implant counseling for anticipated benefits. The study objectives were: (1) evaluate differences in post-cochlear implant language skills between children with cochlear implants and developmental disabilities and age/cognitively matched controls; (2) quantify possible discrepancies between language level and cognitive level. Fifteen children with a developmental disability who received a CI were matched 1:1 on nonverbal cognitive ability and age to hearing controls. Language was evaluated using Preschool Language Scale-IV and reported as language quotients. Multivariable mixed models for matched pairs analyzed differences in language levels between groups. No significant differences were seen between CI and control groups regarding insurance, maternal education, or family income level. Results of the multivariable models indicated that compared to matched controls, the CI group had significantly lower mean receptive (24.6 points, p=0.002) and mean expressive (21.9 points, p=0.001) language quotients after controlling for confounders such as number of therapies and weekly hours in therapy. Significant discrepancies between language level and cognitive level were seen among CI participants only. Compared to age- and cognitively matched controls, children with CIs had significantly lower language levels with delays disproportionate to their cognitive potential. Mechanisms behind this performance-functional gap need to be understood to deliver appropriate intervention strategies for this special population.
Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2010.11.004