Sara Lopez Vera

Third reaction paper: Effect of age at implantation on auditory skill development in

infants and toddlers by Robbin et al. (2003)

In this paper, the authors present two different studies. Firstly, the results of early

cochlear implants (CI) on infants from 6 to 36 months-old. Secondly, a comparison with

normal-hearing (NH) subjects in the same range of age. The test applied for this study is the

IT-MAIS. It is based on a structured interview (10 questions) about the reaction of the subjects

to different stimuli and directed to the parents. The test was done in four times: before

receiving the cochlear implant plus at 3, 6 and 12 months of implantation. The aim of this

interview was to sample three different areas of auditory skill development: changes in

vocalization, alerting to sounds in everyday environment and deriving meaning from sound. It

is noteworthy to mention that all clinicians had received prior training in the administration of

the test, thus further reducing inter-examiner variability.

According to the first study, the results were clear, they showed a great improvement

regardless to the age at which they started using the CI but always within the first three years

of life. In relation to the second research, the results were also positive since subjects from 12-

18 months old equaled their NH peers after three months of the CI implantation. Subjects from

19- 24 months old equaled them after six months. In the case of the oldest studied infants, 24-

36 months old, they showed a lower development in comparison to their NH peers after six

months.

The main conclusion that Robbins et al claim is the fact that children implanted under

age 3 showed amazing auditory skill development during the first year of device use.

Implanting at earlier ages is very convenient due to its connection to the development and
acquisition of communication skills that put them closer to their NH peers. It seems that a

critical period is not relevant on auditory development, since it is not even mentioned in this

article. However, if the rate of the development after CI is regular, we can infer that older

infants could have a slower rate since they need more time to equalize the level of development

of their NH peers. For that reason, we can conclude saying that the more delayed the age of

acquisition of a skill, the farther behind children are in the amount of cumulative practice they

have had to perfect that skill.

The article is very clear and well-organized. The topic and the main purpose that this

paper presents are very relevant and interesting because not only does the paper provide with

relevant information, but also the different studies addressed by the authors complement each

other and they are contrasted professionally, thanks to the great researches. If I would have to

highlight the weakest point that I find in this study would be the non-involvement of the

subjects in the test when it comes to taking the answers or results of the test. There are not

doubts about the honest will that the parents contributed with, but it is obvious that the parents’

answers could still be subjectivized, uncertain and ambiguous due to the close relationship with

the subjects. As we have seen in previous researches about infant speech perception, for

instance, the tests were applied to the subjects and the answers were taken from them directly.

We can think of Eimas et al (1971) or Lasky et al (1975), among others. There were not doubts

about the results that they showed.

All in all, nonetheless, I really think that this paper provides the community with a great

and practical study that evidences that early intervention is preferred to intensive post-implant

aids. The results exposed here can help to promote faster and more effective treatment for

children with auditory (or another type of sensory or developmental) problems. This study,

also, collaborates in the advancement of the first language acquisition theories.

I have worked with Alexandra Lopez Vera