Development of language in children after cochlear implantation: A narrative review

Abstract

Background: For newborns and young children with congenital bilateral severe to profound sensorineural hearing loss who benefit little from properly fitting hearing aids, pediatric cochlear implantation (CI) is the recommended course of treatment. Pediatric CI significantly improves speech and language development. The development of speech and language is often faster than pre-CI rates. Materials and Methods: A narrative review of published literature was conducted by using databases like Google Scholar, Scopus, PubMed, and Medline. Key references were identified through searching the database and manual screening of reference lists from seminal papers. There were 45 out of the 70 publications (24 case reports, 20 case series, and 26 original studies) received from different databases included in this PRISMA Flow diagram for study selection. Results: The outcomes of CI in pediatric patients are highly variable. The consistent speech therapy, involvement of family, and early intervention are vital for maximizing language skills. For young children with severe-to-profound sensorineural hearing loss (SNHL), CI is a surgical substitute for conventional amplification (hearing aids) that can promote spoken language development. Post-implant spoken language outcomes are still very diverse, ranging from strong speech recognition and age-appropriate language to little improvement in sound detection with limited speech perception and language delays, despite notable advancements in cochlear implant device technology and surgical safety.  By considering post-implant language development predictions into intrinsic and extrinsic elements and emphasizing clinically useful tactics to maximize therapies, this narrative review incorporates data from the literature. Conclusion: Early CI in children followed by early auditory verbal therapy (AVT) is helpful for optimum speech and language development. Regular follow-up and active participation by parents are required to optimize the outcomes. The duration of AVT after pediatric cochlear implantation has an 
impact on the hearing and language development of a child.