Introduction: Research suggests deaf children who receive cochlear implants (CIs) at an early age can achieve age-appropriate language. Recent studies suggest age at full-time CI use is a better predictor of language outcomes than age at implant. The aim of this study was to investigate whether there are correlations between age at implantation, establishing consistent device use, and language outcomes in a cohort of young children in Aotearoa New Zealand. Methods: A retrospective analysis was conducted. The study included 46 participants, implanted by the Southern Cochlear Implant Programme by age 18 months. The median age at implant was 8 months. Device use was measured via data logging. Consistent device use was defined as ≥8 h per day. Language outcomes were measured at 2- and 3-year post-implantation using PLS-5. Results: Consistent use was established by 78.3% by 3 years. Language results were at least one SD higher for children who achieved consistent use within 2 years of implant. Language scores for Maori children were more than one SD lower than non-Maori, a finding not entirely explained by less usage. There was no correlation between age of implantation and length of time to consistent device use. The presence of additional disabilities affected consistent device use. Conclusion: Simply offering CIs earlier is not sufficient to improve language outcomes in the congenitally deaf population. Earlier consistent use was associated with better language outcomes for those implanted before 18 months of age, and language scores were higher for children who achieved consistent use within 2 years of implantation. There is a need to understand why children with pre-lingual deafness may not be achieving consistent device use, and by doing so, we would be a step closer to being able to tailor culturally appropriate supports and services that could help more children achieve better outcomes.

1.
Dettman
SJ
,
Dowell
RC
,
Choo
D
,
Arnott
W
,
Abrahams
Y
,
Davis
A
, et al
.
Long-term communication outcomes for children receiving cochlear implants younger than 12 Months: a multicenter study
.
Otol Neurotol
.
2016
;
37
(
2
):
e82
95
.
2.
Dettman
S
,
Choo
D
,
Au
A
,
Luu
A
,
Dowell
R
.
Speech perception and language outcomes for infants receiving cochlear implants before or after 9 Months of age: use of category-based aggregation of data in an unselected pediatric cohort
.
J Speech Lang Hear Res
.
2021
;
64
(
3
):
1023
39
.
3.
Fulcher
A
,
Purcell
AA
,
Baker
E
,
Munro
N
.
Listen up: children with early identified hearing loss achieve age-appropriate speech/language outcomes by 3years-of-age
.
Int J Pediatr Otorhinolaryngol
.
2012
;
76
(
12
):
1785
94
.
4.
Wie
OB
.
Language development in children after receiving bilateral cochlear implants between 5 and 18 months
.
Int J Pediatr Otorhinolaryngol
.
2010
;
74
(
11
):
1258
66
.
5.
Karltorp
E
,
Eklöf
M
,
Östlund
E
,
Asp
F
,
Tideholm
B
,
Löfkvist
U
.
Cochlear implants before 9 months of age led to more natural spoken language development without increased surgical risks
.
Acta Paediatr
.
2020
;
109
(
2
):
332
41
.
6.
Ching
TY
,
Dillon
H
,
Leigh
G
,
Cupples
L
.
Learning from the longitudinal outcomes of children with hearing impairment (LOCHI) study: summary of 5-year findings and implications
.
Int J Audiol
.
2018
;
57
(
Suppl 2
):
S105
11
.
7.
Cristofari
E
,
Cuda
D
,
Martini
A
,
Forli
F
,
Zanetti
D
,
Di Lisi
D
, et al
.
A multicenter clinical evaluation of data logging in cochlear implant recipients using Automated Scene Classification Technologies
.
Audiol Neurootol
.
2017
;
22
(
4–5
):
226
35
.
8.
Mauger
SJ
,
Warren
CD
,
Knight
MR
,
Goorevich
M
,
Nel
E
.
Clinical evaluation of the Nucleus 6 cochlear implant system: performance improvements with SmartSound iQ
.
Int J Audiol
.
2014
;
53
(
8
):
564
76
.
9.
Gartstein
MA
,
Bridgett
DJ
,
Dishion
TJ
,
Kaufman
NK
.
Depressed mood and maternal report of child behavior pro-blems: another look at the depression–distortion hypothesis
.
J Appl Dev Psychol
.
2009
;
30
(
2
):
149
60
.
10.
Rönnlund
H
,
Elovainio
M
,
Virtanen
I
,
Matomäki
J
,
Lapinleimu
H
.
Poor parental sleep and the reportedsleep quality of their children
.
Pediatrics
.
2016
;
137
(
4
):
e20153425
.
11.
Wiseman
KB
,
Warner-Czyz
AD
,
Kwon
S
,
Fiorentino
K
,
Sweeney
M
.
Relationships between daily device use and early communication outcomes in young children with cochlear implants
.
Ear Hear
.
2021
;
42
(
4
):
1042
53
.
12.
Park
LR
,
Gagnon
EB
,
Thompson
E
,
Brown
KD
.
Age at full-time use predicts language outcomes better than age of surgery in children who use cochlear implants
.
Am J Audiol
.
2019
;
28
(
4
):
986
92
.
13.
Paruthi
S
,
Brooks
LJ
,
D’Ambrosio
C
,
Hall
WA
,
Kotagal
S
,
Lloyd
RM
, et al
.
Consensus statement of the American academy of sleep medicine on the recommended amount of sleep for healthy children: methodology and discussion
.
J Clin Sleep Med
.
2016
;
12
(
11
):
1549
61
.
14.
Contrera
KJ
,
Choi
JS
,
Blake
CR
,
Betz
JF
,
Niparko
JK
,
Lin
FR
.
Rates of long-term cochlear implant use in children
.
Otol Neurotol
.
2014
;
35
(
3
):
426
30
.
15.
Easwar
V
,
Sanfilippo
J
,
Papsin
B
,
Gordon
K
.
Factors affecting daily cochlear implant use in children: data logging evidence
.
J Am Acad Audiol
.
2016
;
27
(
10
):
824
38
.
16.
Spencer
LJ
,
Gantz
BJ
,
Knutson
JF
.
Outcomes and achievement of students who grew up with access to cochlear implants
.
Laryngoscope
.
2004
;
114
(
9
):
1576
81
.
17.
Wiseman
KB
,
Warner-Czyz
AD
.
Inconsistent device use in pediatric cochlear implant users: prevalence and risk factors
.
Cochlear Implants Int
.
2018
;
19
(
3
):
131
41
.
18.
Busch
T
,
vanpoucke
F
,
van Wieringen
A
.
Auditory environment across the life span of cochlear implant users: insights from data logging
.
J Speech Lang Hear Res
.
2017
;
60
(
5
):
p1362
1377
.
19.
Gagnon
EB
,
Eskridge
H
,
Brown
KD
.
Pediatric cochlear implant wear time and early language development
.
Cochlear Implants Int
.
2020
;
21
(
2
):
92
7
.
20.
de Jong
T
,
van der Schroeff
M
,
Vroegop
J
.
Child- and environment-related factors influencing daily cochlear implant use: a Datalog study
.
Ear Hear
.
2021
;
42
(
1
):
122
9
.
21.
Geers
AE
.
Factors affecting the development of speech, language, and literacy in children with early cochlear implantation
.
Lang Speech Hear Serv Sch
.
2002
;
33
(
3
):
172
83
.
22.
Holzinger
D
,
Dall
M
,
Sanduvete-Chaves
S
,
Saldaña
D
,
Chacón-Moscoso
S
,
Fellinger
J
.
The impact of family environment on language development of children with cochlear implants: a systematic review and meta-analysis. Ear and Hearing
.
Ear Hear
.
2020
;
41
(
5
):
1077
91
.
23.
Zimmerman
IL
,
Steiner
VG
,
Pond
RE
.
Preschool language scale
. 5th ed
PsycTESTS Dataset
;
2011
.
24.
Dunn
DM
.
Peabody picture vocabulary test
. 5th ed.
San Antonio, TX
:
NCS Pearson, Inc
;
2018
.
25.
Crampton
P
,
Salmond
C
,
Atkinson
J
.
A comparison of the NZDEP and New Zealand IMD indexes of socioeconomic deprivation
.
Kotuitui
.
2019
;
15
(
1
):
154
69
.
26.
Cejas
I
,
Hoffman
M
,
Quittner
A
.
Outcomes and benefits of pediatric cochlear implantation in children with additional disabilities: a review and report of family influences on outcomes
.
Pediatr Health Med Ther
.
2015
;
6
:
45
63
.
27.
Gagnon
EB
,
Eskridge
H
,
Brown
KD
,
Park
LR
.
The impact of cumulative cochlear implant wear time on spoken language outcomes at age 3 years
.
J Speech Lang Hear Res
.
2021
;
64
(
4
):
1369
75
.
28.
Pitama
S
.
Meihana model: a clinical assessment framework
.
New Zealand J Psychol
.
2007
;
36
(
3
).
29.
Wepa
D
,
Wilson
D
.
Struggling to be involved: an interprofessional approach to examine Māori whanau engagement with healthcare services
.
J Nurs Res Pract
.
2019
;
03
(
03
):
1
5
.
30.
Chapman
RS
,
Schwartz
SE
,
Bird
EK-R
.
Language skills of children and adolescents with Down syndrome: I. Comprehension
.
J Speech Hear Res
.
1991
;
34
(
5
):
1106
20
.
31.
Ching
TY
,
Dillon
H
,
Leigh
G
,
Cupples
L
.
Learning from the longitudinal outcomes of children with hearing impairment (LOCHI) study: summary of 5-year findings and implications
.
Int J Audiol
.
2018
;
57
(
Suppl 2
):
S105
11
.
32.
Wie
OB
,
Torkildsen
JK
,
Schauber
S
,
Busch
T
,
Litovsky
R
.
Long-term language development in children with early simultaneous bilateral cochlear implants
.
Ear Hear
.
2020
;
41
(
5
):
1294
305
.
33.
Wakil
N
,
Fitzpatrick
EM
,
Olds
J
,
Schramm
D
,
Whittingham
J
.
Long-term outcome after cochlear implantation in children with additional developmental disabilities
.
Int J Audiol
.
2014
;
53
(
9
):
587
94
.
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