Effects of Age at Cochlear Implantation on Learning and Cognition: A Critical Assessment

Marc Marschark, Louise Duchesne, David Pisoni

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose Age at cochlear implantation frequently is assumed to be a key predictor of pediatric implantation benefits, but outcomes related to learning and cognition appear inconsistent. This critical assessment examines relevant literature in an effort to evaluate the impact of age at implantation in those domains for individuals who received their devices as children. Method We examined 44 peer-reviewed articles from 2003 to 2018 considering age at implantation and conducted statistical analyses regarding its impact on several domains, including literacy, academic achievement, memory, and theory of mind. Results Across 167 assessments in various experiments and conditions, only 21% of the analyses related to age at implantation yielded evidence in favor of earlier implantation, providing greater benefits to academic achievement, learning, or cognition compared to implantation later in childhood. Among studies that considered cognitive processing (e.g., executive function, memory, visual-spatial functioning), over twice as many analyses indicated significant benefits of earlier implantation when it was considered as a discrete rather than a continuous variable. Conclusion Findings raise methodological, practical, and theoretical questions concerning how "early" is defined in studies concerning early cochlear implantation, the impact of confounding factors, and the use of nonstandard outcome measures. The present results and convergent findings from other studies are discussed in terms of the larger range of variables that need to be considered in evaluating the benefits of cochlear implantation and question the utility of considering age at implantation as a "gold standard" with regard to evaluating long-term outcomes of the procedure as a medical treatment/intervention for hearing loss. Supplemental Material https://doi.org/10.23641/asha.8323625.

Original languageEnglish (US)
Pages (from-to)1318-1334
Number of pages17
JournalAmerican journal of speech-language pathology
Volume28
Issue number3
DOIs
StatePublished - Aug 9 2019

Fingerprint

Cochlear Implantation
Cognition
cognition
Learning
learning
Theory of Mind
academic achievement
Executive Function
Hearing Loss
Outcome Assessment (Health Care)
gold standard
Pediatrics
Equipment and Supplies
physician's care
literacy
childhood
experiment
evidence
Therapeutics

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Developmental and Educational Psychology
  • Linguistics and Language
  • Speech and Hearing

Cite this

Effects of Age at Cochlear Implantation on Learning and Cognition : A Critical Assessment. / Marschark, Marc; Duchesne, Louise; Pisoni, David.

In: American journal of speech-language pathology, Vol. 28, No. 3, 09.08.2019, p. 1318-1334.

Research output: Contribution to journalArticle

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