Impact of lockdowns on language exposure for kids with cochlear implants


The lockdowns caused by the pandemic have led to many potential negative effects on children. An investigation looks into how they’ve impacted the exposure to spoken language for children with cochlear implants.

The move to spending every day in the home, with little exposure to others, during the coronavirus disease 2019 (COVID-19) pandemic has led to many concerns about what it means for socialization, education, nutrition, and how children who need additional resources in school will fare. A report in JAMA Otolaryngology – Head & Neck Surgery examines how the lockdowns as a result of COVID-19 impacted the amount of exposure to spoken communication that children with cochlear implants had.1

The researchers recruited children with cochlear implants from a tertiary pediatric hospital in Ontario, Canada. The cochlear implants monitor and create datalogs of the levels and types of sound during hourly use each day. The datalogs of pre-COVID-19, which was February 1, 2020 to March 16, 2020, were collected and then during the initial easing of lockdown restrictions, peri-COVID-19, were collected. The hours of sound were categorized into 6 input levels: <40, 40-49, 50-59, 60-69, 70-79, ≥80 A-weighted dB sound pressure level. The sound was also put into 6 auditory scene categories: quiet, speech, speech-in-noise, music, noise, and other.

A total of 45 children were included in the study. The investigators found that there was similar daily use of cochlear during both time periods (9.80 mean hours pre–COVID-19 and 9.34 mean hours peri–COVID-19). However, despite a similar amount of daily use, there was significant quieting of input sound levels peri–COVID-19 by 0.49 hour (95% CI, 0.21-0.80 hour) at 60 to 69 dBA and 1.70 hours (95% CI, 1.42-1.99 hours) at 70 to 79 dBA with clear reductions in speech exposure by 0.98 hour (95% CI, 0.49-1.47 hours), which translated into a reduction of speech:quiet from 1.6:1.0 pre–COVID-19 to 0.9:1.0 during lockdowns. The greatest percentage reduction in daily speech were found in school-aged children (elementary, 12.32% [95% CI, 7.15%-17.49%]; middle school, 11.76% [95% CI, 5.00%-18.52%]; and high school, 9.60% [95% CI, 3.27%-15.93%]). An increase in daily percentage of quiet was found to be most prevalent in children who had fewer numbers of people in their household.

The researchers concluded that the lockdowns for COVID-19 were linked to a reduction in exposure to spoken communication. As children with hearing loss are already at risk of less than optimal outcomes for language, this additional reduced exposure could have increased risk of poorer outcomes. Making parents aware of the reduction and encouraging increased spoken language during the pandemic could help mitigate the results.


1. Gordon K, Daien M, Negandhi J, et al. Exposure to spoken communication in children with cochlear implants during the COVID-19 lockdown. JAMA Otolaryngology–Head & Neck Surgery. February 18, 2021. Epub ahead of print. doi:10.1001/jamaoto.2020.5496

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