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Updated: Jun 4, 2026
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Published on: June 21, 2024
Balance in children with bilateral cochlear implants
Marcia E Eustaquio1, Wayne Berryhill, Jace A Wolfe
1University of Colorado Denver Health Sciences Center, Aurora, Colorado 80045, USA. Marcia.Eustaquio@ucdenver.edu
Insights
Cochlear implants do not significantly alter children's functional balance compared to peers with hearing loss. However, all groups, including those with cochlear implants, scored below average on balance tests.
Area of Science:
- Pediatric audiology
- Neuroscience
- Rehabilitation medicine
Background:
- Children with severe-to-profound bilateral hearing loss often face challenges in functional balance.
- Cochlear implantation is a common intervention for hearing loss, but its impact on balance requires further investigation.
Purpose of the Study:
- To compare the functional balance of children with unilateral or bilateral cochlear implants to that of non-implanted children with severe-to-profound bilateral hearing loss.
- To assess if cochlear implantation influences the balance capabilities of pediatric patients.
Main Methods:
- Observational case-control study involving three groups of children (aged 4-17): unilateral cochlear implant (n=12), bilateral cochlear implant (n=26), and non-implanted hearing loss (n=26).
- Balance was assessed using the Bruininks-Oseretsky Test, Second Edition (BOT2).
- Scores were analyzed and compared between groups and against standardized norms.
Main Results:
- No significant differences in mean BOT2 scale scores were found between the unilateral cochlear implant (10.16), bilateral cochlear implant (11.31), and non-implanted hearing loss (11.15) groups.
- All three groups demonstrated significantly lower scores on the BOT2 compared to standardized norms for healthy children.
Conclusions:
- Cochlear implantation does not appear to significantly affect functional balance in children when compared to a hearing-impaired population.
- Children with cochlear implants, as well as those with severe-to-profound hearing loss, exhibit poorer balance than their typically hearing peers.
Objective:
To determine whether unilateral or bilateral cochlear implantation affects the functional balance of children when compared with children with severe-to-profound bilateral hearing loss without a cochlear implant.
Designs:
An observational case control study.
Methods:
Three cohorts of children aged 4 to 17 years were studied: those with unilateral cochlear implants, those with bilateral cochlear implants, and nonimplanted children with severe-to-profound bilateral hearing loss. Each participant's balance was assessed with the Bruininks-Oseretsky Test, Second Edition (BOT2). Raw test scores and age- and sex-matched scale scores were obtained and used to compare each of the 3 groups with one another as well as with standardized norms.
Results:
Sixty-four children were tested. Twelve had a unilateral cochlear implant, 26 had bilateral cochlear implants, and 26 were nonimplanted. The mean scale scores for the unilateral cochlear implant group, the bilateral cochlear implant group, and the children with severe-to-profound hearing loss were 10.16, 11.31, and 11.15, respectively. The mean scale scores for the 3 groups did not differ significantly from each other. When compared with the standardized norms, all 3 groups had significantly lower scores on the BOT2 than the accepted mean score.
Conclusion:
Balance, as measured by the BOT2, is not significantly different in children with cochlear implants versus a hearing-impaired population. However, all 3 tested groups scored lower than the validated mean score for a healthy population of children.
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