Related Experiment Video
Updated: Aug 7, 2026
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Developmental delay and outcomes in paediatric cochlear implantation: implications for candidacy
Lindsey C Edwards1, Ruth Frost, Fiona Witham
1Cochlear Implant Programme, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, United Kingdom. Edwarl@gosh.nhs.uk <Edwarl@gosh.nhs.uk>
Insights
Developmental delay in young pediatric cochlear implant candidates predicts speech outcomes. Mild delays allow progress, but significant delays indicate poorer results, emphasizing the need for developmental assessments in candidacy decisions.
Area of Science:
- Pediatric audiology
- Developmental pediatrics
- Speech-language pathology
Background:
- Cochlear implant candidacy criteria for children are expanding.
- Children with additional developmental challenges are increasingly considered.
- Understanding the impact of developmental delay on cochlear implant outcomes is crucial.
Purpose of the Study:
- To investigate the association between developmental delay and cochlear implant outcomes in young children.
- To identify predictors of speech perception and intelligibility in pediatric cochlear implant recipients.
Main Methods:
- Retrospective case series of 32 children (1.2-2.8 years old) undergoing cochlear implantation.
- Pre-implant assessment using Schedule of Growing Skills II and IT-MAIS.
- Post-implant monitoring of speech perception (E2L toy test) and intelligibility (SIR) at 1 and 2 years.
Main Results:
- General development and cognitive functioning were the strongest predictors of speech outcomes.
- These developmental measures accounted for approximately 40% of the variance in speech perception and intelligibility.
- Age at switch-on and pre-implant aided hearing loss were not significant predictors.
Conclusions:
- Routine developmental assessment is valuable for pediatric cochlear implant candidacy.
- Significant developmental delay predicts poorer outcomes, while mild delays show potential for progress.
- Developmental assessment aids in candidacy decisions and parental counseling regarding cochlear implant benefits.
Objective:
Criteria for paediatric cochlear implant candidacy continue to evolve, as research indicates an increasingly broad range of children for whom the procedure can produce benefit. Children with difficulties in addition to their deafness, or global developmental delay, are not routinely excluded. The aim of this study is to explore the association between developmental delay in young paediatric cochlear implant candidates and progress with the device.
Materials And Methods:
The study is a retrospective case series analysis of 32 children, aged between 1.2 and 2.8 years at pre-implant assessment. Children were assessed using the Schedule of Growing Skills II and IT-MAIS before implantation. Progress in speech perception and Speech Intelligibility was monitored using the E2L toy test and Speech Intelligibility Rating (SIR), respectively, 1 and 2 years after switch-on.
Results:
Data were subjected to regression analyses, with either the E2L or SIR as the outcome variables, and variables derived from the Schedule of Growing Skills II (general development and cognitive functioning), IT-MAIS, age at switch-on and average aided hearing loss pre-implant as the predictor variables. In each analysis the strongest (and statistically significant) predictors of speech perception and Speech Intelligibility were the measures of general development and cognitive functioning, accounting for around 40% of the variance in outcomes.
Conclusion:
This study indicates the value of routinely assessing the general development of young paediatric cochlear implant candidates, as part of the pre-implant decision-making process. Significant developmental delay is predictive of poor outcomes, but children with a mild delay do make appreciable progress. Developmental assessment of young deaf children is therefore important in terms of candidacy decisions and counselling parents regarding potential benefit from a cochlear implant.