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Language Outcomes Improved Through Early Hearing Detection and Earlier Cochlear Implantation

Yoshinaga-Itano, Christine*,†; Sedey, Allison L.*,‡; Wiggin, Mallene*; Mason, Craig A.§

doi: 10.1097/MAO.0000000000001976
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Hypothesis: Early identification and intervention, earlier cochlear implantation, and mother's level of education will directly and/or indirectly impact the language outcomes of children with cochlear implants (CIs).

Background: Identifying factors that contribute to the wide range of language outcomes in children who use CIs will assist healthcare and rehabilitation professionals in optimizing service delivery for this population. Universal newborn hearing screening provides an opportunity to examine the relationship between meeting the early hearing detection and intervention (EHDI) 1-3-6 guidelines and child language outcomes. These guidelines recommend screening by 1 month, confirmation of hearing loss by 3 months, and intervention by 6 months of age.

Methods: Participants were 125 children with CIs ranging from 13 to 39 months of age. Language ability was measured using the Child Development Inventory and MacArthur-Bates Communicative Development Inventories.

Results: Meeting EHDI 1-3-6, higher levels of maternal education and earlier cochlear implant activation had a direct, positive impact on language outcomes. Meeting the EHDI 1-3-6 guidelines also had an indirect positive effect on language outcomes via increasing the probability that the children's CIs would be activated earlier. Maternal education did not significantly predict age of cochlear implant activation nor whether a child met EHDI 1-3-6.

Conclusion: Ensuring families meet the EHDI 1-3-6 guidelines is an early step that can lead to higher language outcomes and also earlier cochlear implantation.

*University of Colorado-Boulder, Boulder

University of Witwatersrand, Johannesburg, South Africa

Colorado School for the Deaf and the Blind, Colorado Springs, Colorado

§University of Maine, Orono, Maine

Address correspondence and reprint requests to Christine Yoshinaga-Itano, Ph.D., Institute of Cognitive Science, 594 UCB, Boulder, CO 80309-0594; E-mail:

Funding Source: This research was supported by the Disability Research and Dissemination Center (DRDC) through its Cooperative Agreement Number 5U01DD001007, the Association of University Centers on Disabilities (AUCD), and the Centers for Disease Control (CDC) and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the DRDC, AUCD or the CDC.

The authors disclose no conflicts of interest.

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