Title: 'The Impact of Language on Social and Communication Functioning in Children with Cochlear Implants'
Track: 3 - Language Acquisition and Development
Keyword(s): language development, cochlear implants
Learning Objectives:
  1. Describe impact of language gap on functional communication
  2. Identify risk for poor functional skill development


Despite remarkable impact of advances in early identification interventions for language development for children who are Deaf/Hard of Hearing, social and pragmatic communication delays persist and impact day-to-day communication. Methods 41 children (3-6 years) with cochlear implants enrolled in a prospective study of language and functional outcomes. All received: Preschool Language Scales-5; Leiter International Performance Scale-R, Behavioral Rating Inventory of Executive Function (BRIEF). Daily social and communication functioning was measured using the Pediatric Evaluation of Disability Inventory (PEDI) [mean 50+10] and Vineland Adaptive Behavior Scales (VABS) [mean 100+15]. Language relative to cognitive abilities was evaluated to assess language as a ratio of language score to cognitive score (language “gap” defined as ratio<0.80; low language relative to cognitive abilities). Results The mean (SD) duration with CI was 29.5 (16) months. Mean receptive language was significantly lower than nonverbal IQ (NVIQ) (73 [17.] vs. 92 [19], p<.0001). Children with CI scored significantly lower than the population regarding mean PEDI social function scores (37.5, p<.0001) and VABS communication domain score (84, p<0.001). 44% of children had either social or communication function scores >2SD below the mean. In multiple linear regression, NVIQ and language relative to NVIQ (ratio) accounted for 40% of the variance in social functioning and ~60% in communication scores. Controlling for BRIEF working memory and SES status, compared to children with commensurate language, children with a language gap had significantly lower mean PEDI social function scores (44.5 vs. 33, p=0.009). This difference was the largest among children with higher NIVQ (>85) (41.5 vs. 34.5). Children with normal/above normal IQ and low language levels had similar functional standard scores as children with lower NVIQ(<85) with appropriate language (language commensurate with cognitive abilities). Conclusion Cognitively appropriate language is vital to achieve appropriate social functioning in children.
Presentation: Tuesday_French_940_SusanWiley_1604.pdf

Handouts: Handout_1604SusanWiley.pptx
CART: Topical Session 4- 1604.docx
Susan Wiley - Primary Presenter,POC
Cincinnati Children's Hospital Medical Center
     Credentials: M.D., Developmental Pediatrician, Professor
      Dr. Susan Wiley is a developmental pediatrician with expertise in children who are deaf/hard of hearing. She has many years of experience serving children with multiple disabilities.

Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.
Jareen Meinzen-Derr - Author
Cincinnati Children's Hospital Medical Center
     Credentials: PhD, MPH
      Dr. Meinzen-Derr is quantitative epidemiologist at the Cincinnati Children's Hospital Medical Center. She has focused her research on outcomes of children who are deaf or hard of hearing, and specifically those who have additional developmental disabilities.
Sandra Grether - Author
Cincinnati Children's Hospital Medical Center
     Credentials: PhD - Speech and Language Pathologist
      Dr. Grether is a Speech and Language Pathologist who works with children with developmental disabilities. Her expertise is in the field of augmentative and alternative communication.
Daniel Choo - Author
Cincinnati Children's Hospital Medical Center
     Credentials: MD
     Other Affiliations: FAAP
      Dr. Choo is a professor of pediatric otolaryngology at Cincinnati Children's Hospital Medical Center. He is a neuro-otologist and has an extensive clinical practice and active research career in the field of childhood hearing loss.
Laura Smith - Author
Cincinnati Children's Hospital Medical Center
     Credentials: MPH, Clinical Research Personnel
      Laura is a clinical research coordinator at the Cincinnati Children's Hospital Medical Center. She has been working with an MCHB funded research study evaluting the impact of cognition and language on functional outcomes in young children who are deaf/hard of hearing.