Editorial: Long-Term Outcomes of Cochlear Implantation in Early Childhood

Abstract

The articles in this issue are based on a follow-up study of a nationwide sample of 181 children who received a cochlear implant (CI) between 1990 and 1996 when they were between 2 and 5 yrs old. These children were among the first to receive CIs after the U.S. Food and Drug Administration approval of multichannel devices and were drawn from the most common educational environments available in North America, including those using oral communication modes and those using modes of communication augmented with signed language. A previous study, published as an Ear and Hearing Monograph supplement in 2003, reported speech perception, speech production, language, and reading levels measured when these children were 8 or 9 yrs old. The articles in this supplement are based on 112 of these children who returned for follow-up testing 8 yrs later when they were in high school. The follow-up study was initiated to learn whether the children's language and reading skills, which were close to those of age-mates with normal hearing in elementary grades, kept pace with normal development or fell further behind those of normal-hearing peers by their high school years. Results indicate that substantial development continued into adolescence for all outcomes measured. More than half of the teenagers achieved scores on language, reading, and psychosocial measures that were within 1SD of normal-hearing age-mates. The longitudinal nature of the design provided an opportunity to explore multiple pathways of influence from early predictors, such as communication mode and cognitive processes, to later communication skills while controlling for sample characteristics associated with outcome level. This broad sampling of children from educational environments across North America, who were tested near the beginning and end of the standard academic grades, provides a unique opportunity to examine long-term benefits derived from early generations of CI technology and clinical standards in place at that time. The teenagers who participated in this study received their devices about 20 yrs ago and did not have many of the advantages available to more recently implanted children. Their performance data provide a frame of reference against which to judge improvements achieved with current technologies and practices when those recipients reach an equivalent duration of use. ACKNOWLEDGMENTS The studies contained in this volume were supported by the National Institute of Deafness and Other Communication Disorders (NIDCD) (R01 DC008335). In addition, we gratefully appreciate the support from the Nelle C. Johnston Chair in Early Childhood Communication Disorders, The University of Texas at Dallas and Dr. Peter Roland from the Department of Otolaryngology—Head and Neck Surgery at the University of Texas Southwestern Medical Center. The authors thank the teenagers and their families whose enthusiastic participation made this project possible. Many clinicians across North America initially referred families to the study and also encouraged families to participate in the follow-up study. Their professional commitment to the project contributed to the size and breadth of the sample. Most of the articles in this issue have benefited from statistical advice, analysis, and interpretation from Michael J Strube in the Psychology Department, Washington University in St. Louis, and from data management, storage, and access by Christine Brenner at the Moog Center for Deaf Education. The Moog Center provided the project with excellent testing facilities and technical support from Michael Fioretti. The test battery was administered by a highly skilled team of clinicians and teachers whose dedication to maintaining standardized testing procedures while achieving a high degree of rapport with the students greatly increased the veracity of the test scores reported. Many of these clinicians participated in both the elementary age and high school test sessions: Julia Biedenstein, Amy Birath, Christine H. Gustus, Rachelle Joyce, Karen Kupper, Terri O'Donoghue, and Valerie Sonneveldt from the Moog Center for Deaf Education; Lisa Davidson, Heather Hayes, Victoria Kozak, and Brent Spehar from Washington University/Central Institute for the Deaf; Abbie Frank, Mary Gamache, and Joyce Saffa from the Special School District of St. Louis County; and Allison Sedey from the University of Colorado. The outstanding editorial input that we received from Mario Svirsky, Gail Donaldson, Brenda Ryals, Quentin Summerfield, and several anonymous reviewers is greatly appreciated and contributed substantially to the clarity and accuracy of the articles contained in this issue. Ann E. Geers Emily A. Tobey Dallas Cochlear Implant Program Callier Advanced Hearing Research Center The University of Texas at Dallas, and Department of Otorhinolaryngology-Head and Neck Surgery The University of Texas Southwestern Medical Center Dallas, Texas Jean S. Moog Moog Center for Deaf Education St. Louis, Missouri