Socioeconomic Status Influences Communication Outcomes in Children with Cochlear Implants: Study

A recent study on infants and young deaf children with cochlear implants found that socioeconomic status (SES) significantly impacts whether spoken language becomes their primary communication mode. While 85% of commercially insured children primarily used spoken language, only 33% of Medicaid-eligible children did, highlighting disparities linked to SES.The researchers found that communication primarily using spoken language occurred in 85 percent of commercially insured children with cochlear implants compared to 33 percent of Medicaid-eligible children. Results were published in the journal Laryngoscope.

“We know from previous research that early implantation of children born with severe to profound hearing loss for whom hearing aids don’t provide access to spoken language is advantageous. Our study shows that socioeconomic status also is a very important influence on spoken language after implantation,” said lead author Nancy M. Young, MD, Medical Director of Audiology and Cochlear Implant Programs at Ann & Robert H. Lurie Children’s Hospital of Chicago and Professor of Pediatric Otolaryngology at Northwestern University Feinberg School of Medicine. “For many reasons, socioeconomic status affects language and literacy in hearing children, so it's not surprising that it is also a major factor for children with cochlear implants.”

The study also examined whether family language (English only, bilingual English/Spanish or Spanish only) impacts acquisition of spoken language in implanted children. Results show that family language was not a significant contributor to the primary use of speech.

“Implant programs should not view family language other than English to be a negative factor in terms of spoken language development. However, in our study these families are more likely to have lower socioeconomic status. For this reason, the child’s language therapy needs to emphasize effective ways for parents to engage their child to encourage spoken language,” noted Dr. Young. “For most typical hearing and developing children bilingualism is no longer considered a negative influence on language development. Our study supports that this may be true of children receiving a cochlear implant as well.”

The study included medical records data on 176 children who received cochlear implants before their third birthday. The average age at follow-up was 5.8 years.

“More research is needed on how to best intervene to improve language outcomes in children from low socioeconomic backgrounds,” said Dr. Young. “There is evidence that targeted coaching of parents on interactive multimodal (visual and verbal) communication strategies to encourage spoken language is effective. How to best mentor lower socioeconomic families in these strategies and whether they are effective when provided virtually needs to be studied.”

Reference:

Nancy M. Young, Denise Thomas, Elizabeth Tournis, Stephen R. Hoff, Emily Shimeng Xu, Impact of Socioeconomic Status and Family Language on Implanted Children's Communication Mode, Laryngoscope, https://doi.org/10.1002/lary.32315