Hear and Say are paediatric hearing loss and speech development experts.



Dettman, S., Dowell, R., Choo, D., Arnott, W., Abrahams, Y., Davis, A., Dornan, D., Leigh, J., Constantinescu, G., Cowan, R., & Briggs, R.

Long term communication outcomes for children receiving cochlear implants younger than 12 months: A multi-centre study. Otology & Neurotology, 37(2), e82-e95.


Objective: Examine the influence of age at implant on speech perception, language, and speech production outcomes in a large unselected paediatric cohort.

Study Design: This study pools available assessment data(collected prospectively and entered into respective databases from 1990 to 2014) from three Australian centers.

Patients: Children (n¼403) with congenital bilateral severe to profound hearing loss who received cochlear implants under 6 years of age (excluding those with acquired onset of profound hearing loss after 12 mo, those with progressive hearing loss and those with mild/moderate/severe additional cognitive delay/disability).

Main Outcome Measure(s): Speech perception; open-set words (scored for words and phonemes correct) and sentence understanding at school entry and late primary school time points. Language; PLS and PPVT standard score equivalents at school entry, CELF standard scores. Speech Production; DEAP percentage accuracy of vowels, consonants, phonemes-total and clusters, and percentage word-intelligibility at school entry.

Results: Regression analysis indicated a significant effect for age-at-implant for all outcome measures. Cognitive skills also accounted for significant variance in all outcome measures except open-set phoneme scores. ANOVA with Tukey pairwise comparisons examined group differences for children implanted younger than 12 months (Group 1), between 13 and 18 months (Group 2), between 19 and 24 months (Group 3), between 25 and 42 months (Group 4), and between 43 and 72 months (Group 5). Open-set speech perception scores for Groups 1, 2, and 3 were significantly higher than Groups 4 and 5. Language standard scores for Group 1 were significantly higher than Groups 2, 3, 4, and 5. Speech production

outcomes for Group 1 were significantly higher than scores obtained for Groups 2, 3, and 4 combined. Cross tabulation and Chi-square tests supported the hypothesis that a greater percentage of Group 1 children (than Groups 2, 3, 4, or 5)  demonstrated language performance within the normative range by school entry.

Conclusions: Results support provision of cochlear implants younger than 12 months of age for children with severe to profound hearing loss to optimize speech perception and subsequent language acquisition and speech production accuracy.

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Maia’s Story

At 9.10pm on 24 October 2013 our beautiful daughter Maia was born. 

The moment of elation was short-lived as we immediately noticed her left ear was missing. I frantically looked to the medical team around me for answers but received none.

Panic set in as we waited 4 days in hospital for an ENT to explain her condition, by which point we already had all the answers from Simone, who runs the Microtia and Atresia Program at Hear and Say.

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