Receptive Vocabulary of Children With Bilateral Cochlear Implants From 3 to 16 Years of Age.
Tobias Busch, Ellen Irén Brinchmann, Johan Braeken and 1 others
PMID 35426854WHAT IT FOUND
Children with cochlear implants showed a U-shaped vocabulary gap compared to hearing peers.
Scores were near normal at ages 3 and 16 but dropped significantly between 5 and 12 years. The deficit peaked at 8.7 years. Good early progress does not guarantee age-appropriate skills later.
Key findings
01Receptive vocabulary scores for children with cochlear implants were significantly lower than matched hearing peers, with the gap widening to a maximum of 23.9 points at 8.7 years of age before narrowing again.
02When compared to hearing children with similar amounts of auditory experience (hearing age), the vocabulary performance of children with cochlear implants was not significantly different.
03Sequential bilateral implantation and exclusive spoken language use at school were associated with higher vocabulary scores, while frequent avoidance of social situations was associated with lower scores.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study is cross-sectional, so it cannot confirm that the same children experienced the U-shaped decline over time; it compares different children at different ages. The BPVS-II showed a ceiling effect for hearing children around age 13, which may have artificially narrowed the vocabulary gap for the oldest participants. The sample was highly homogeneous (all Norwegian, all early bilateral implants, high socioeconomic status), limiting generalizability to other contexts. Speech perception was measured using a quiet monosyllable test and parent reports, which may not reflect real-world listening difficulties. Associations with implantation type (sequential vs. simultaneous) are confounded by age, as sequentially implanted children were older on average.
Declared interests
The authors have no conflicts of interest to disclose.
The easy way to misread this
Do not interpret the narrowing gap at age 16 as evidence of full catch-up. The authors note this may be due to a ceiling effect in the hearing group's test scores, masking continued deficits in the cochlear implant group.