Narrative abilities in early implanted children

Objectives/hypothesis: To investigate the effect of age at cochlear implant activation on oral narrative ability in children implanted before 2.5 years of age and to examine the role of other variables (gender, parental education level, stimulation modality) in narrative skills.

Study design: retrospective nonrandomized group study

Methods: Thirty children (21 females; 9 males) with congenital, bilateral severe-to-profound sensorineural hearing loss were included in this study. The mean age at cochlear implant activation was 14.7 months (standard deviation [SD] ± 5.3). The Renfrew Bus Story was used to analyze oral narrative skills at mean chronological age of 63 months (SD ± 0.2).

Results: The total information on the Renfrew Bus Story raw score ranged from 8 to 40, with a mean of 22.7 (SD ± 8.6). Children produced on average 7.5 words in a sentence (SD ± 1.5). The mean score for complexity was 2.2 (SD ± 1.5). Regression analysis revealed a highly significant and negative linear effect of age at cochlear implant activation on all outcomes. The mother's education level had a positive strong effect on sentence length but a weak effect on total information and complexity. The paternal education score had a weak influence on the sentence length. Gender, age at diagnosis, and stimulation modality were not correlated with the narrative outcomes.

Conclusions: Early implanted children can develop narrative skills close to normal hearing children. The sociocultural context, expressed by maternal and paternal educational level, are positively related to the development of oral narrative.