Outcomes of children with cochlear implants and implications for paediatric referral

摘要

Background The advent of Universal Newborn Hearing Screening (UNHS) has made it possible for early detection of hearing loss and early intervention for all affected infants. Although there is some evidence to suggest that early intervention leads to better language outcomes, many of the studies had methodological flaws (for a review, see Thompson et al, 2001; Nelson et al, 2008). Therefore, the question of whether UNHS is effective in improving long-term outcomes of children with hearing loss remains unanswered. To address this question, the National Acoustic Laboratories (NAL) commenced a population-based study, the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study, to directly compare the outcomes of children who received early intervention to those who received later intervention. The study also examines the effect of multiple factors on children's development (for details, see study website: www.outcomes.nal.gov.au). In this paper, the language outcomes and functioning in everyday activities of children with cochlear implants are reported, and the factors that contribute to these outcomes, including age of implantation, are examined. The hypotheses were that (1) children with cochlear implants would have degraded receptive and expressive language skills, compared with children with normal hearing of the same age; (2) children with cochlear implants would have deficits in everyday functioning, compared with children with normal hearing of the same age; (3) children who received a cochlear implant before 12 months of age would have higher language scores, compared with children who received implantation after 12 months of age; (4) children who received a cochlear implant before 12 months of age would function more effectively in everyday life, compared with children who received implantation after 12 months of age.