Spoken Language Skills in Children With Bilateral Hearing Aids or Bilateral Cochlear Implants at the Age of Three Years.
Taina T Välimaa, Sari Kunnari, Antti A Aarnisalo and 15 others
PMID 34260435WHAT IT FOUND
At age three, most children with hearing aids scored below norms in phonology and vocabulary, more so than those with cochlear implants.
Better unaided hearing predicted comprehension in hearing aid users. High maternal education predicted comprehension and expressive vocabulary in implant users.
Key findings
01Children with bilateral hearing aids were significantly more likely to have poorer receptive vocabulary and phonological skills than children with bilateral cochlear implants.
02For children with hearing aids, better unaided hearing (lower dB) was associated with improved spoken language comprehension, but age at fitting and active use hours were not significant predictors.
03For children with cochlear implants, high maternal education was associated with better spoken language comprehension and expressive vocabulary compared to low maternal education.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The groups differed significantly in access to early speech and language therapy (none in the hearing aid group vs. 23 in the implant group), which confounds the comparison of device effectiveness. The study used normative data for comparisons rather than a matched control group, potentially underestimating the impact of socioeconomic status. Exact hours of daily device use and aided speech audibility were not measured, relying instead on parental reports of 'systematic' use. Findings are specific to Finnish, a language with rich inflectional morphology, and may not generalize to languages with different phonological structures. The sample size is small (28 per group), limiting the power to detect subtle associations in some variables.
Declared interests
Funded by the Academy of Finland. Authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the better language scores in the cochlear implant group as proof that implants are superior to hearing aids for language outcomes. The implant group had vastly more access to early speech and language therapy (23 children vs. 0 in the hearing aid group), and the groups had different degrees of hearing loss, making a direct comparison of device efficacy invalid.