Socioeconomic Status Influences Speech Development in Deaf Children with Cochlear Implants

A recent study published in the journal *Laryngoscope* indicates a significant correlation between socioeconomic status (SES) and the speech outcomes of infants and young children with cochlear implants. The research, conducted by Dr. Nancy M. Young, Medical Director of Audiology and Cochlear Implant Programs at Ann & Robert H. Lurie Children's Hospital of Chicago and Professor of Pediatric Otolaryngology at Northwestern University Feinberg School of Medicine, found that children with private insurance had a markedly higher success rate in developing spoken language compared to their counterparts on Medicaid.

The study examined medical records of 176 children who received cochlear implants before the age of three, tracking their language development until an average age of 5.8 years. Results revealed that 85% of commercially insured children primarily used spoken language, in contrast to only 33% of those eligible for Medicaid. This disparity highlights the impact of socioeconomic factors on language acquisition for children with hearing impairments, suggesting that financial resources play a crucial role in access to language therapy and supportive resources.

Dr. Young emphasized the importance of early implantation of cochlear devices for children with severe to profound hearing loss. "We know from previous research that early implantation is advantageous, but our study shows that socioeconomic status is also a significant influence on spoken language development post-implantation," she stated. The implications of this finding underscore the need for targeted interventions that address the barriers faced by families from lower SES backgrounds.

The study also evaluated the role of family language dynamics, considering whether children from bilingual or non-English speaking households faced additional challenges in acquiring spoken language. Interestingly, the findings indicated that family language did not significantly affect the primary mode of communication in implanted children. However, Dr. Young noted that families with lower socioeconomic status were more likely to be non-English speaking, which could complicate their access to language therapy resources.

Dr. Young advocates for the development of innovative strategies that enable parents from diverse linguistic backgrounds to engage effectively with their children. She stated, "For many hearing children, bilingualism is no longer seen as a negative influence on language development, and our study supports the notion that this may also apply to children receiving cochlear implants."

The research was funded by the Lillian S. Wells Foundation and the National Institute on Deafness and Other Communication Disorders (R01DC019387). Dr. Young, a holder of the Lillian S. Wells Professorship in Pediatric Otolaryngology, noted the importance of ongoing research to improve outcomes for children from low socioeconomic backgrounds. She indicated that targeted coaching for parents on interactive multimodal communication strategies could be beneficial, adding that further exploration is needed to understand the efficacy of virtual intervention methods.

Lurie Children's Cochlear Implant Program, one of the largest and most experienced in the world, has performed over 2,000 cochlear implant procedures since its establishment in 1991. This nonprofit organization is dedicated to providing exceptional care to children and is recognized for its commitment to research-driven pediatric healthcare. According to the latest rankings by *U.S. News & World Report*, Lurie Children's Hospital is among the top children's hospitals in the nation, reinforcing its role as a leader in pediatric medicine and research.

In conclusion, this study not only sheds light on the critical intersection of socioeconomic status and language development in deaf children but also emphasizes the urgent need for equitable access to healthcare resources and targeted interventions to improve outcomes for all children, regardless of their economic circumstances.