The predictive value of measures of preverbal communicative behaviors in young deaf children with cochlear implants

Objective: To determine whether measures of early communicative behavior in young children obtained within the first year after implantation could predict speech and language skills measured 3 yr after implantation, Design: An unselected sample of 17 children receiving multichannel cochlear implants under the age of 5 yr were monitored over a 3 yr period. During the first year after implantation, the development of early communicative behavior was measured at intervals using an established video analysis technique. Three years after implantation, four outcome measures were taken: the IOWA closed-set sentence test, a measure of continuous discourse tracking ability, a rating of ability to use the telephone and a global rating of auditory performance. Results: There was a significant correlation between the video analysis measure taken at the 12 mo interval, specifically the extent of auditory and vocal behaviors, and three of the outcomes obtained at the 3 yr interval: both performance-based measures and the telephone rating, When the four outcomes were aggregated to form a composite measure, the correlation was highly significant. There was no significant correlation between the composite measure and the video analysis measures obtained earlier than the 12 mo interval. Conclusion: Development of a predominantly auditory and vocal style of early communicative behavior is predictive of relatively high levels of skill on speech and language tasks measured 2 yr later.