(1063) The Impact of Daily Cochlear Implant Use on Language Outcomes

Introduction: An improvement in auditory outcomes has been shown in pediatric patients who have increased daily usage of their cochlear implant (CI). The purpose of this study was to evaluate the impact of hearing hour percentage (HHP), as a measure of daily CI usage, on language outcomes over time.

Methods: This was a retrospective review from 2013 to 2023 of pediatric CI recipients with a minimum of 6 months of CI use at two institutions. Patients were excluded if they had no available language outcome scores, were non-verbal, or had medical comorbidities impacting cognition. Demographic characteristics and audiologic history were collected. HHP was calculated using datalogging hours for each patient. Language measures included the Peabody Picture Vocabulary Test-5 (PPVT-5) and Expressive Vocabulary Test-3 (EVT-3). Changes in standardized test scores over time were correlated using Spearman’s Rank correlation.

Results: There were 111 patients reviewed, and 35 patients met inclusion criteria. Average age at CI implantation was 3  2.68 years. Most recent follow up was between 0.5 to >5 years. Neither PPVT-5 nor EVT-3 scores significantly correlated with HHP at most recent time point (n=17, p=0.39; n=28, p=0.60, respectively) or over time (n=9,p=0.86; n=10, p=0.98, respectively).

Conclusions: In this study, there was no significant correlation noted between language standard scores and HHP, at a single time point or over time. Evaluation of raw scores individualized to patients‘ chronological age may better reflect true impact of HHP on vocabulary measures (e.g., PPVT, EVT) because after standard scores approach 100, patients may continue to progress at age-level. In addition, longer duration of follow up may be needed to detect changes in higher order language skills, which require cognitive processing of the auditory signal. Lastly, the impact of socioeconomic status, maternal education and school resources were not fully investigated and could additionally influence the results of this study.