Clin Exp Otorhinolaryngol.  2012 Apr;5(Suppl 1):S59-S64.

What Factors Are Associated with Good Performance in Children with Cochlear Implants? From the Outcome of Various Language Development Tests, Research on Sensory and Communicative Disorders Project in Japan: Nagasaki Experience

  • 1Kanda ENT Clinic, Nagasaki Bell Hearing Center, Nagasaki, Japan.
  • 2Department of Otolaryngology Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
  • 3Department of Otolaryngology Head and Neck Surgery, Nagasaki University Hospital, Nagasaki, Japan.
  • 4Department of Otolaryngology Head and Neck Surgery, Okayama University Postgraduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan.
  • 5The Association for Technical Aids, Tokyo, Japan.


We conducted multi-directional language development tests as a part of the Research on Sensory and Communicative Disorders (RSVD) in Japan. This report discusses findings as well as factors that led to better results in children with severe-profound hearing loss.
We evaluated multiple language development tests in 33 Japanese children with cochlear implants (32 patients) and hearing aid (1 patient), including 1) Test for question and answer interaction development, 2) Word fluency test, 3) Japanese version of the Peabody picture vocabulary test-revised, 4) The standardized comprehension test of abstract words, 5) The screening test of reading and writing for Japanese primary school children, 6) The syntactic processing test of aphasia, 7) Criterion-referenced testing (CRT) for Japanese language and mathematics, 8) Pervasive development disorders ASJ rating scales, and 9) Raven's colored progressive matrices. Furthermore, we investigated the factors believed to account for the better performances in these tests. The first group, group A, consisted of 14 children with higher scores in all tests than the national average for children with hearing difficulty. The second group, group B, included 19 children that scored below the national average in any of the tests.
Overall, the results show that 76.2% of the scores obtained by the children in these tests exceeded the national average scores of children with hearing difficulty. The children who finished above average on all tests had undergone a longer period of regular habilitation in our rehabilitation center, had their implants earlier in life, were exposed to more auditory verbal/oral communication in their education at affiliated institutions, and were more likely to have been integrated in a regular kindergarten before moving on to elementary school.
In this study, we suggest that taking the above four factors into consideration will have an affect on the language development of children with severe-profound hearing loss.


Cochlear implant; Children; Research on sensory and communicative disorders; Language development; Japan

MeSH Terms

Asian Continental Ancestry Group
Child Development Disorders, Pervasive
Cochlear Implants
Communication Disorders
Hearing Aids
Hearing Loss
Language Development
Mass Screening
Rehabilitation Centers
Weights and Measures


  • Fig. 1 The results of the various language development tests. The results show that children suffering from hearing loss exceeded the national average of all children with hearing difficulties by at least 60.6% and up to 100%. TQAID, test for question and answer interaction development; WFT, word fluency test; PVTR, Peabody picture vocabulary test-revised; SCTAW, standardized comprehension test of abstract words; STA, syntactic processing test of aphasia; PARS, pervasive development disorders ASJ rating scales; RCPM, Raven's colored progressive matrices.

  • Fig. 2 On the criterion-referenced testing for Japanese language and mathematics, 70.0% of all scores exceeded the national average of scores obtained by normal-hearing children.

  • Fig. 3 Whether or not the child went through newborn hearing screening.

  • Fig. 4 Causes of deafness. AN, auditory neuropathy; GJB2, Gap junction protein, beta-2, 26kDa (GJB2) gene mutation; CMV, congenital cytomegalovirus infection; LVAS, large vestibular aqueduct syndrome.

  • Fig. 5 The mean age for children to start wearing a hearing aid (HA) and cochlear implant (CI).

  • Fig. 6 The mean period of the visit at our hearing center and the mean wearing period of cochlear implant (CI).

  • Fig. 7 The mean of the current average hearing level and the present average wearing threshold.

  • Fig. 8 Whether the child has any siblings.

  • Fig. 9 The amount of time spent studying at home on a daily basis.

  • Fig. 10 Educational method (school). A, group A; B, group B.

  • Fig. 11 The period of integration and the period of auditory verbal/oral education.

  • Fig. 12 Educational institution child attended before entrance to primary school.


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