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.

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.

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).

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).

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