Published online September 1, 2008
PEDIATRICS Vol. 122 No. 3 September 2008, pp. 535-544 (doi:10.1542/peds.2007-2028)
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ARTICLE

Early Language Outcomes of Early-Identified Infants With Permanent Hearing Loss at 12 to 16 Months of Age

Betty Vohr, MDa, Julie Jodoin-Krauzyk, MEd, MAa, Richard Tucker, BAa, Mary Jane Johnson, MEdb, Deborah Topol, BAb and Marianne Ahlgren, PhDb

a Department of Pediatrics, Warren Alpert Medical School, Brown University, Providence, Rhode Island
b Rhode Island School for the Deaf, Providence, Rhode Island

OBJECTIVES. The objectives of this study were to determine the early language outcomes of children with mild to profound hearing loss, compared with hearing control children, at 12 to 16 months of age and to examine the effects of "very early" enrollment (≤3 months) in early intervention.

METHODS. This was a prospective longitudinal study of the outcomes of a cohort of 30 infants identified in the Rhode Island universal newborn hearing screening program and 96 hearing control subjects. Eligible families with children with all degrees of congenital hearing loss were invited to enroll. Child language skills were assessed by using the MacArthur-Bates Communicative Development Inventory, Words and Gestures, at 12 to 16 months.

RESULTS. Children with moderate/profound hearing loss had significantly lower numbers of phrases understood, words understood, and early, later, and total gestures, compared with children with mild/minimal hearing loss and hearing control subjects. Furthermore, children with hearing loss who were enrolled in early intervention at ≤3 months had significantly higher percentile scores for number of words understood, words produced, and early, later, and total gestures, compared with those enrolled at >3 months. Regression analyses to test the independent effects on language skills of children with hearing loss identified enrollment in early intervention at ≤3 months as an independent predictor of percentile scores for word and early gesture production.

CONCLUSIONS. Very early enrollment (≤3 months) in early intervention has beneficial effects on early language for children with hearing loss. Nevertheless, 12- to 16-month-old children with moderate/profound hearing loss exhibit delayed receptive and expressive language skills in oral and signed English modes, compared with peers with either mild/minimal hearing loss or typical hearing sensitivity.

Key Words: hearing loss • early intervention • language • infants

Abbreviations: ASL—American Sign Language • CDI—Communicative Development Inventory • EHDI—early hearing detection and intervention • HL—hearing loss • RITRACK—Rhode Island tracking database • SES—socioeconomic status • EI—early intervention

Accepted Dec 19, 2007.


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