Improving the language environment for children with cochlear implants, using the LENA language and environment analysis system - A CONSORT analysis.

Objectives: To assess the contribution of family counseling based on Language and Environment Analysis (LENA) recording data to improving the language environment of children with cochlear implants.

Material and methods: Cochlear implanted children with prelingual deafness were included from 2 French cochlear implant centers and randomized between 2 age-matched groups: intervention and control. LENA recording and lexical assessment (PPVT-R or GAEL-P) were performed at T1 and, 5 months later, T2. Between the two, intervention group families received feedback from the LENA recording and parental counseling.

Endpoints: The main endpoint was improvement in language environment after LENA-based family counseling: adult word count (AWC), child vocalizations (CV), conversational turns (CT), and TV/media exposure (TV). Secondary endpoints comprised feasibility of LENA and the impact of the language environment on language reception (PPVT-R and GAEL-P scores).

Results: Eighty-three of the 90 included children were analyzed. Mean age was 39±14.2 months, with 43 boys. Between T1 and T2, CT increased by 15 percentiles in the intervention group, in contrast to a median 0 change in controls (P=0.03). For the other 3 LENA parameters (CV, AWC, TV), median change was zero, in both groups. Mean implant acceptability rating was 83%. Lexical reception scores correlated positively with CV (r=0.37, P<0.01), AWC (r=0.31, P<0.01) and CT (r=0.41, P<0.01) but not with TV (r=0.11, P=0.33).

Conclusion: The LENA system can help parents optimize the child's language environment, and thus oral language development, particularly in young children.