Background and educational characteristics of prelingually deaf children implanted by five years of age.

Purpose: This study documents child, family and educational characteristics of a large representative sample of 8- to 9-yr-old prelingually deaf children who received a cochlear implant by 5 yr of age. Because pre-existing factors such as the child's gender, family characteristics, additional handicaps, age at onset of deafness and at implant, may affect postimplant outcomes, these variables must be accounted for before the impact of educational factors on performance with an implant can be adequately determined. Classroom variables that may affect postimplant outcomes include placement in public or private, mainstream or special education, oral or total communication environments. Other intervention variables include type and amount of individual therapy, experience of the therapist and parent participation in therapy. Documenting these characteristics for a large representative sample of implanted children can provide clinicians and researchers with insight regarding the types of families who sought early cochlear implantation for their children and the types of educational programs in which they placed their children after implantation. It is important to undertake studies that control for as many of these factors as possible so that the relative benefits of specific educational approaches for helping children to get the most benefit from their cochlear implant can be identified.

Method: Over a 4-yr period, 181 children from across the US and Canada, accompanied by a parent, attended a cochlear implant research camp. Parents completed questionnaires in which they reported the child's medical and educational history, characteristics of the family, and their participation in the child's therapy. The parent listed names and addresses of clinicians who had provided individual speech/language therapy to the child and signed permission for these clinicians to complete questionnaires describing this therapy.

Results: To the extent that this sample is representative of those families seeking a cochlear implant for their child, especially during the initial period of device availability, this population can be characterized as follows. Most parents had normal hearing, were of majority (white) ethnicity and had more education and higher incomes than the general population. The families tended to be intact with both a mother and a father who involved their hearing-impaired child in family activities on a regular basis. The children were enrolled in the full range of educational placements available across the United States and Canada. Fairly even distributions of children from public and private schools, special education and mainstream classes and oral and total communication methodologies were represented. Educational placement changed as children gained increased experience with a cochlear implant. They received an increased emphasis on speech and auditory skills in their classroom settings and tended to move from private school and special education settings to public school and mainstream programs. These data support the position that early cochlear implantation is a cost effective procedure that allows deaf children to participate in a normal school environment with hearing age mates.