Abstract
BACKGROUND: Fitting of a cochlear implant (CI) influences the development of auditory memory and thus the development of speech. Speech development is a prerequisite for the acquisition of written language and reading and, thus, the later educational biography. MATERIALS AND METHODS: Language development tests for 3-5-year-old children (SETK 3-5) represent a standardized procedure to assess receptive and expressive speech development as well as auditory memory. In a retrospective cross-sectional study, data of children who were fitted with bilateral CIs from six CI centers of the ACIR (Arbeitsgemeinschaft CI Rehabilitation) were evaluated. The study group was divided into groups that were analyzed on the basis of age (chronological age; LA) and hearing experience with CI (hearing age; HA). In addition, a distinction was made between CI surgery before the age of 1 year (CI ≤ 12 months) and CI surgery from the second to the fourth year of life (CI > 12 ≤ 48 months). The study group was then subdivided according to the SETK 3;0-3;11 years test into G1LA (CI ≤ 12 months), G2LA (CI > 12 ≤ 48 months), G1HA (CI ≤ 12 months), and G2HA (CI > 12 ≤ 48 months). The study group for the SETK 4;0-5;11 years test was subdivided into G3LA (CI ≤ 12 months), G4LA (CI > 12 ≤ 48 months), G3HA (CI ≤ 12 months), and G4HA (CI > 12 ≤ 48 months). RESULTS: The groups G1LA, G1HA, G3LA, and G3HA (CI ≤ 12 months) achieved age-appropriate values in all subtests of the SETK (3-5). Children who receive CI within the second year of life catch up in terms of language acquisition and some also develop language skills, but the T scores are below the age-adapted norm values. Children with a multilingual background show results below the norm of their hearing peers in both test settings (chronological age and hearing age). CONCLUSION: Early provision of CI in the first year of life is an important prerequisite for children to develop age-appropriate language skills. Nevertheless, there is wide variation within the groups, so that speech diagnostics and therapy are required as part of follow-up treatment during primary language acquisition to detect and avoid major language delay.