Cochlear Implants
by Cochlear Guest Author

New TECH Talk: Age of implantation and critical development window

May 11, 2020
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Dr. Jace Wolfe, clinical audiologist and Director of Audiology and Research at the Hearts for Hearing Foundation in Oklahoma City, uses his 22 years of cochlear implant experience to examine results from the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) Study based out of Australia to understand the long-term impact of age at implantation. The March 2020 FDA approval to expand pediatric indications to nine months further reinforces the urgency to give pediatric patients early access to sound, especially as they reach hearing and language milestones.

Moreover, the LOCHI study observed children from the age of hearing loss identification until early adulthood to explore speech, language, literacy, auditory, educational, vocational, social and pragmatic outcomes. Wolfe further recaps the factors that may influence hearing outcomes such as age of implantation.

Key finding of the LOCHI Study:

  • For every 6-month delay in implantation there’s a ½ standard deviation (about seven points from the mean score for a standardized measure of language ability) reduction in their language outcomes.1,2

This suggests the presence of a critical window for language development and auditory stimulation. Through partnership, together we can reach further to give pediatric patients early access to sound.

“Every moment within that critical period counts,” Wolfe concludes.

To learn more about early implantation visit our TECH Talks page or website.

References:

  1. Ching, T.Y., Dillon, H., Leigh, G., & Cupples, L. (2018). Learning from the longitudinal outcomes of children with hearing impairment (LOCHI) study: summary of 5-year findings and implications. International Journal of Audiology, 57(2), S105-S111.
  2. Ching, T.Y., Dillon, H., Button, L., Seeto, M., Buynder, P.V., Marnane, V., Cupples, L., & Leigh, G. (2017). Age at Intervention for Permanent Hearing Loss and 5-Year Language Outcomes. Pediatrics, 140 3.

In the US, the cochlear implant system is intended for use in children 9 to 24 months of age who have bilateral profound sensorineural deafness and demonstrate limited benefit from appropriate binaural hearing aids. Children two years of age or older may demonstrate severe to profound hearing loss bilaterally. In the Canada, the cochlear implant system is intended for use in children 12 to 24 months of age who have bilateral profound sensorineural deafness and demonstrate limited benefit from appropriate binaural hearing aids. Children two years of age or older may demonstrate severe to profound hearing loss bilaterally.

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Cochlear Guest Author

In an effort to keep our content fresh and reflective of a diverse industry, Cochlear Americas features a mix of employees and professional partners to contribute to Cochlear ProNews as Guest Authors.

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Counseling new indications and the importance of early access to sound

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By Ryan Lopez, Director, Nucleus® Product Management & Marketing at Cochlear Americas

For 20 years, cochlear implants have been indicated in children no younger than 12 months of age. Earlier this year, Cochlear received FDA approval to lower the age of cochlear implantation from 12 months to 9 months for children with bilateral profound sensorineural hearing loss.* This important approval ensures that children who are born deaf have earlier access to a cochlear implant which can provide them with the hearing capabilities to develop speech and language at a trajectory similar to their hearing peers.1-3­

As clinicians, counseling parents and caregivers though the decision-making process to implant their child can be an emotional journey. Confidence in understanding why early implantation in children is so important can help to reinforce the vitality of the counseling process.

Age at intervention has been shown to be highly correlated with longitudinal outcomes. Receiving a cochlear implant early in a child’s life provides a greater chance of realizing personal best speech, social and language skills.1 Early access to sound can allow a child’s speech and language development to be on par with normal-hearing peers, enabling a life of possibilities.2-3

In addition to other imperative information surrounding cochlear implantation in children, the Pediatric Evidence Summary for Cochlear Implants take a retrospective approach to clinical data focused on the importance of early access to sound.

Read the Pediatric Evidence Summary now!

References:

  1. Ching TYC and Dillon H. Major Findings of the LOCHI study on children at 3 years of age and implications for audiological management. Int J Audiol. (2013 Dec); 52 Suppl 2:S65-8. doi: 10.3109/14992027.2013.866339
  2. Dettman SJ, Dowell RC, Choo D, Arnott W, Abrahams Y, Davis A, Dornan D, Leigh J, Constantinescu G, Cowan R, Briggs RJ. Long-term communication outcomes for children receiving cochlear implants younger than 12 months: A multicenter study. Otol Neurotol. (2016 Feb); 37(2):e82–e95. doi: 10.1097/MAO.0000000000000915. Copyright 2016 Wolters Kluwer Health, Inc.
  3. Geers AE and Nicholas JG. Enduring advantages of earlier cochlear implantation for spoken language development. J Speech Lang Hear Res. (2013 Apr); 56(2):643-55. doi:10.1044/1092-4388(2012/11-0347).

*In Canada (for CI500 and CI600 series implants) and the United States, the cochlear implant system is intended for use in children 9 to 24 months of age who have bilateral profound sensorineural deafness and demonstrate limited benefit from appropriate binaural hearing aids. Children two years of age or older may demonstrate severe to profound hearing loss bilaterally.

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This material is intended for health professionals. If you are a consumer, please seek advice from your health professional about treatments for hearing loss. Outcomes may vary, and your health professional will advise you about the factors which could affect your outcome. Always read the instructions for use. Not all products are available in all countries. Please contact your local Cochlear representative for product information.

 

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