Communication Mode and Speech and Language Outcomes of Young Cochlear Implant Recipients: A Comparison of Auditory-Verbal, Oral Communication, and Total Communication.

Objective: To evaluate the effect of communication mode on the spoken language outcomes of children who received a cochlear implant. Study

Design: Retrospective analysis of postoperative speech and language and reading scores for children who received a cochlear implant and used three different modes of communication: auditory-verbal (AV) (n = 39), oral communication (OC) (n = 107), and total communication (TC) (n = 57). Setting: A single tertiary cochlear implant clinic. Patients: All children received their cochlear implant before the age of 5 years, had no known cochlear anomaly or cognitive delay that would affect their outcome with the CI, and had established consistent use of their respective communication methodology. Intervention: Rehabilitation varied depending on the selected communication methodology. Data were collected during routine postoperative speech and language evaluations. Main outcome measures: Receptive and expressive language, reading comprehension, and speech intelligibility scores obtained up to 7 years post-activation of a cochlear implant.

Results: All groups showed improvements over time. Linear mixed model analyses indicated scores obtained by children in the AV group were significantly higher than mean scores obtained by children in the other groups on most test measures at most post-implant intervals. Significantly greater numbers of children in the AV group obtained standard scores within normal limits than children in the OC and TC groups.

Conclusions: These findings support the use of the auditory-verbal communication approach to facilitate development of age-appropriate speech and language and literacy skills in profoundly deaf children.