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Early Educational Placement and Later Language Outcomes for Children With Cochlear Implants

Moog, Jean Sachar*; Geers, Ann E.†‡

doi: 10.1097/MAO.0b013e3181eb3226
Cochlear Implants

Hypothesis: This investigation examined the hypothesis that the type of preschool intervention provided to children who receive a cochlear implant affects their language scores at school entry.

Background: Recent research has documented faster language acquisition when children attend specialized preschool programs beginning at age 3 years. We hypothesized that if similar intervention were initiated before age 3 years, the rate of language acquisition might increase even more.

Methods: Thirty-nine listening and spoken language (LSL) programs located in 20 different states across the United States contributed language test scores for 141 five- and six-year-olds who had used a cochlear implant for at least 1 year. A retrospective analysis compared outcomes at 5 to 6 years based on interventions received each year before age 5 years: 1) individual parent-infant intervention; 2) LSL class with only deaf children, or 3) LSL class with 1 or more hearing children.

Results: The specific type of intervention at ages 1 and 2 years provided a lasting positive impact on language, at least until kindergarten. The probability that a child would reach normal language levels by kindergarten increased significantly if, at age 1 year, intervention included a combination of cochlear implant use and parent-infant intervention and, at age 2 years, a LSL class with other deaf children was added.

Conclusion: These results favor providing a cochlear implant by age 1 year and supplementing early parent-infant intervention with an intensive toddler class designed specifically for developing spoken language in children with hearing loss by age 2 years.

*Moog Center for Deaf Education, St. Louis, Missouri; †Dallas Cochlear Implant Program, Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center; and ‡Callier Advanced Hearing Research Center, University of Texas at Dallas, Dallas, Texas, U.S.A.

Address correspondence and reprint requests to Jean S. Moog, M.S., Moog Center for Deaf Education, 12300 South Forty Drive, St. Louis, MO 63141; E-mail:

© 2010 Otology & Neurotology, Inc.