Cochlear Implants

Early vs. Late Intervention on Language

Cochlear Implants: What are they?

  • Surgically implanted device that bypasses the outer and middle ear
  • Wire of electrodes is strung into the cochlea, collects impulses, and send to auditory nerve
  • Does not cure hearing loss

Universal Newborn Hearing Screening

  • 1993- NIH issued a consensus Statement
  • Newborns prior to three months of age, follow-up and intervention
  • Before: diagnosed with severe HL at 2;1 and 4;0-5;7 for borderline HL

Early vs. Late Intervention

Nott et al. (2009)

  • Compared children with normal hearing and children with CI
  • Single words and word combination
  • Results


Tobey et al. (2013)

  • Comprehensive Assessment of Spoken Language (CASL)
  • Four subtests: vocabulary (antonyms), syntax construction, paragraph comprehension, and pragmatic judgments
  • Expressive and receptive language
  • Children with implants before 2;5 and between 2;5-5;0
  • Results

Optimal Time Frame for Implant

Tobey et al. (2013) & Sharma et al. (2009)

  • Visual and auditory integration plays an important role for developmental learning at an early age
  • Multisensory integration may not typically develop when a single sense is dominant
  • 3;5- maximal plasticity in central pathways

Long-term Effects on Cochlear Use

Sparreboom et al. (2015)

  • BiCI vs. UCI, 5-6 years
  • Speech recognition and vocabulary perception
  • Duration and Educational placement (mainstream)


Halpin, K. S., Smith, K. Y., Widen, J. E., & Chertoff, M.E. (2010). Effects of universal newborn hearing screening on an early intervention program for children with hearing loss, birth to 3 yr of age. Journal of the American Academy of Audiology, 21 (3), 169-175. doi: 10.3766/jaaa.21.3.5

NIH Medical Arts. Ear with Cochlear Implant. 2013. National Institute on Deafness and Other Communication Disorders (NIDCD), Maryland. National Institute on Deafness and Other Communication Disorders (NIDCD). Web. 17 Nov. 2015.

Nott, P., Cowan, R., Brown, M., & Wigglesworth, G. (2009). Early language development in children with profound hearing loss fitted with a device at a young age: Part 1- the time period taken to acquire first words and first word combinations. Ear and Hearing, 30 (5), 526-540. doi: 10.1097/AUD.0b013e3181a9ea14

Ramirez-Inscoe, J., & Moore, D. R. (2012). Genetics and environment- more than cochlear implants- to blame for language difficulties in children. The Hearing Journal, 65 (10), 30-32. doi: 10.1097/

Sharma, A., Nash, A. A., & Dorman, M. (2009). Cortical development, plasticity and re-organization in children with cochlear implants. Journal of Communication Disorders, 42 (4 ), 272-279. doi: 10.1016/j.jcomdis.2009.03.003

Sparreboom, M., Langereis, M. C., Snik, A. F. M., & Mylanus E. A. M. (2015). Long-term outcomes on spatial hearing, speech recognition and receptive vocabulary after sequential bilateral cochlear implantation in children. Research in Developmental Disabilities, 36 (1), 328-337. doi: 10.1016/j.ridd.2014.10.030

Tobey, E. A., Thal, D., Niparko, J. K., Eisenberg, L. S. Quittner, A. L., Wang, N., & The CDaCL Investigative Team. (2013). Influence of implantation age on school-age language performance in pediatric cochlear implant users. International Journal of Audiology, 52 (4), 219-229. doi: 10.3109/14992027.2012.759666