Language impairment in children with CI: An investigation of Swedish

In spite of earlier implantation, bilateral implants and advances in the care of deaf children with cochlear implants (CI) within-group variation in language skills is large. We use three tasks with predictive value of language impairment in Swedish to identify children with CI most at risk for persistent difficulties in language development, in need of language intervention. The clinical markers investigated are nonword repetition and past tense inflection. We also assessed language comprehension, a predictor of severe language impairment associated with poorer prognosis. Fifteen Swedish-speaking deaf children with CI and 15 controls aged 5-8 years participated. Most children with CI had bilateral implants and had been fitted with CIs before 12 months. At least 70% in the group with CI performed >1.25 and 47% >2 SD below controls on more than one measure, showing risk for persistent language impairment. Speech perception was more crucial in the nonword repetition and language comprehension tasks. No time factor was significantly related to outcome. We conclude that it is important to allocate resources for continuous follow-up and language intervention. Research and care of children with CI will profit from better integration of knowledge from the fields of audiology, speech-language pathology and linguistics.