A recent study of outcomes in infants and young deaf children with cochlear implants (implanted electronic hearing device), suggests that socioeconomic status (SES) plays a major role in whether spoken language becomes their primary communication mode. The researchers found that communication primarily using spoken language occurred in 85 percent of commercially insured children with cochlear implants compared to 33 percent of Medicaid-eligible children. Results were published in the journal Laryngoscope .
"We know from previous research that early implantation of children born with severe to profound hearing loss for whom hearing aids don't provide access to spoken language is advantageous. Our study shows that socioeconomic status also is a very important influence on spoken language after implantation," said lead author Nancy M. Young, MD , Medical Director of Audiology and Cochlear Implant Programs at Ann & Robert H. Lurie Children's Hospital of Chicago and Professor of Pediatric Otolaryngology at Northwestern University Feinberg School of Medicine. "For many reasons, socioeconomic status affects language and literacy in hearing children, so it's not surprising that it is also a major factor for children with cochlear implants."
The study also examined whether family language (English only, bilingual English/Spanish or Spanish only) impacts acquisition of spoken language in implanted children. Results show that family language was not a significant contributor to the primary use of speech.
"Implant programs should not view family language other than English to be a negative factor in terms of spoken language development. However, in our study these families are more likely to have lower socioeconomic status. For this reason, the child's language therapy needs to emphasize effective ways for parents to engage their child to encourage spoken language," noted Dr. Young. "For most typical hearing and developing children bilingualism is no longer considered a negative influence on language development. Our study supports that this may be true of children receiving a cochlear implant as well."
The study included medical records data on 176 children who received cochlear implants before their third birthday. The average age at follow-up was 5.8 years.
"More research is needed on how to best intervene to improve language outcomes in children from low socioeconomic backgrounds," said Dr. Young. "There is evidence that targeted coaching of parents on interactive multimodal (visual and verbal) communication strategies to encourage spoken language is effective. How to best mentor lower socioeconomic families in these strategies and whether they are effective when provided virtually needs to be studied."
This work was supported by the Lillian S. Wells Foundation and the National Institute on Deafness and Other Communication Disorders (R01DC019387).
Dr. Young holds the Lillian S. Wells Professorship in Pediatric Otolaryngology.
Lurie Children's Cochlear Implant Program is one of the largest and most experienced in the world, with more than 2,000 cochlear implant procedures performed since its inception in 1991.
Ann & Robert H. Lurie Children's Hospital of Chicago is a nonprofit organization committed to providing access to exceptional care for every child. It is the only independent, research-driven children's hospital in Illinois and one of less than 35 nationally. This is where the top doctors go to train, practice pediatric medicine, teach, advocate, research and stay up to date on the latest treatments. Exclusively focused on children, all Lurie Children's resources are devoted to serving their needs. Research at Lurie Children's is conducted through Stanley Manne Children's Research Institute, which is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children's is the pediatric training ground for Northwestern University Feinberg School of Medicine. It is ranked as one of the nation's top children's hospitals by U.S. News & World Report.
