Title: 'Factors Associated with “Language Gaps” Among Children with Cochlear Implants'
Track: 3 - Language Acquisition and Development
Keyword(s): landuguage development, cochlear implants
Learning Objectives:
  1. Identify the impact of a language gap on functioning.
  2. Describe characteristics of children with a language gap.


The objective of this study was to determine factors associated with an under-performance of language (relative to cognitive ability) among children with CI. Methods 41 children, (3-6 years) with CIs were enrolled in a broader prospective study on language and cognition in children who were DHH. Children received a battery of standardized assessments including the Preschool Language Scales-5, the Leiter International Performance Scale-R, and the Behavioral Rating Inventory of Executive Function. Language relative to cognitive abilities was determined using the ratio of receptive language score to NVIQ. A ratio<0.80 indicated low language relative to cognitive abilities or language gap (underperformance). Multivariable regression was conducted to determine independent factors associated with the language ratio and risk factors for having a language gap. Results The mean study age of the study sample was 58.5 (SD 13.2) months and mean NVIQ was 92 (SD 19.2). Median ages of HL identification and duration with CI were 5.5 and 29.6 months respectively. Mean receptive and expressive standard scores were 73.4 (17.7) and 72.8 (17.5) respectively, with 66% of participants scoring <80 on receptive language testing. Receptive language scores were significantly (p<.0001) lower than NVIQ. Over half of children were underperforming in language (ratio<0.80). Although only 27% of children with NVIQ>100 had language standard scores <80 (threshold for mild language delay in general population), 73% of this subgroup displayed a significant gap in language relative to their cognitive abilities. In multiple linear regression, factors significantly (p<0.05) associated with lower language ratios (larger language gaps) included higher NVIQ, better working memory, lower SES, and having unilateral vs. bilateral CI. Conclusion Many children continue to show substantial underperformance of language abilities based on their cognitive capacity. It is critical to understand a child’s capabilities in order to attempt to reach a child’s language capacity.
Presentation: Tuesday_French_1010_SusanWiley_1605.pdf

Handouts: Handout_1605SusanWiley.pptx
CART: CART Transcription is not Available
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.
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.
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.