Cognitive and outcome measures seem sub-optimal in children with cochlear implants - A cross-sectional study

Abstract

Objective

This study investigates whether cognition as a single variable significantly influences the hearing and speech outcomes of children with cochlear implants (CIs). More specifically, it identifies various types of cognitive disorders among children with CI, comparing these children's cognitive abilities to the outcomes of CI in terms of hearing and speech performance.

Study design

Cross sectional cognitive testing of children with CIs.

Setting

West Danish CI Centre, Aarhus University Hospital, Denmark.

Materials and methods

58 CI children underwent postoperative cognitive evaluation. Cognitive tests included Bayley Scales of Infant Development (Bayley-III), Snijders-Oomen Nonverbal Intelligence Test Revised (SON-R) and Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV), depending on the age of the child. Outcome measures of hearing and speech capacity after CI consisted of Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR) and Peabody Picture Vocabulary Test-4 (PPVT-4).

Results

Only PPVT-4 correlated significantly with cognition scores. Over time, the value of CAP and SIR seems limited by a pronounced ceiling effect.

Conclusion

The most widely used outcome tests after CI, i.e. CAP and SIR, may not reflect cognitive disabilities sufficiently due to pronounced ceiling effects. International guidelines suggesting a panel of robust age-matched tests are warranted in order to optimize rehabilitation programmes as well as the counselling of parents.

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