Social conversational skills development in early implanted children

Objectives/hypothesis: Social conversational skills are a salient aspect of early pragmatic development in young children. These skills include two different abilities, assertiveness and responsiveness. This study investigated the development of these abilities in early implanted children and their relationships with lexical development and some language-sensitive variables.

Study design: Prospective, observational, nonrandomized study.

Methods: Participants included 28 children with congenital profound sensorineural hearing loss. The mean age at device activation was 13.3 months (standard deviation [SD] ±4.2). The Social-Conversational Skills Rating Scale was used to evaluate assertiveness and responsiveness. The MacArthur-Bates Communicative Development Inventory (Words and Sentences form) was used to analyze the lexical development. The device experience was 12 months for each child, and the mean age at testing was 25.9 months (SD ±4.6).

Results: Assertiveness and responsiveness scores were within the normal range of normal-hearing age-matched peers. Age at cochlear implant activation exerted a significant impact, with the highest scores associated to the youngest patients. The residual correlations between assertiveness and responsiveness with the lexical development were positive and strongly significant (r = 0.69 and 0.73, respectively). Preoperative hearing threshold demonstrated an associated significant coefficient on the assertiveness score. Age at diagnosis and maternal education level were not correlated with the social conversational skills.

Conclusions: Early-implanted children developed social conversational skills that are similar to normal-hearing peers matched for age 1 year after device activation. Social conversational skills and lexical development were strongly correlated, but the present study design cannot specify the direction of this relationship. Children with better preoperative residual hearing exhibited better assertive ability.

Level of evidence: 4 Laryngoscope, 126:2098-2105, 2016.