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Updated: May 18, 2026
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Pediatric cochlear implants: additional disabilities prevalence, risk factors, and effect on language outcomes
Catherine S Birman1, Elizabeth J Elliott, William P R Gibson
1The Sydney Children's Network, Westmead, The University of Sydney, Sydney, Australia. Catherine.birman@gmail.com
Insights
Approximately one-third of pediatric cochlear implant patients have additional disabilities, impacting their speech and language outcomes. These comorbidities significantly affect post-implantation auditory performance, highlighting the need for comprehensive care.
Area of Science:
- Audiology
- Pediatric Otolaryngology
- Developmental Pediatrics
Background:
- Pediatric cochlear implantation aims to improve hearing and communication in children with severe to profound hearing loss.
- The presence of additional disabilities can complicate cochlear implant outcomes and rehabilitation.
- Understanding these comorbidities is crucial for setting realistic expectations and optimizing patient management.
Purpose of the Study:
- To determine the prevalence of additional disabilities in pediatric cochlear implant recipients.
- To identify medical and radiologic conditions associated with these disabilities.
- To assess the impact of additional disabilities on speech perception and language development 12 months post-implantation.
Main Methods:
- Retrospective case review of pediatric patients (0-16 years) undergoing cochlear implant operations.
- Analysis of medical and radiologic records to identify associated conditions.
- Evaluation of Categories of Auditory Performance (CAP) scores at 12 months postoperatively.
Main Results:
- 33% of pediatric cochlear implant patients had additional disabilities, including developmental delay, cerebral palsy, and autism.
- Syndromes, chromosomal abnormalities, jaundice, prematurity, and inner ear malformations were frequently associated with additional disabilities.
- Children with additional disabilities showed significantly lower CAP scores (52%) compared to those without (96%) at 12 months.
Conclusions:
- Additional disabilities are common in pediatric cochlear implant candidates, affecting approximately one-third of this population.
- These comorbidities significantly influence the effectiveness of cochlear implantation, particularly in speech perception and language development.
- Comprehensive pre-operative assessment and tailored post-operative rehabilitation are essential for pediatric cochlear implant recipients with additional disabilities.
Objective:
To determine the prevalence of additional disabilities in a pediatric cochlear population, to identify medical and radiologic conditions associated with additional disabilities, and to identify the effect of additional disabilities on speech perception and language at 12 months postoperatively.
Study Design:
Retrospective case review.
Setting:
Tertiary referral center and cochlear implant program.
Patients:
Records were reviewed for children 0 to 16 years old inclusive, who had cochlear implant-related operations over a 12-month period.
Interventions:
Diagnostic and rehabilitative.
Main Outcome Measures:
Additional disabilities prevalence; medical history and radiologic abnormalities; and the effect on Categories of Auditory Performance (CAP) score at 12 months postoperatively.
Results:
Eighty-eight children having 96 operations were identified. The overall prevalence of additional disabilities (including developmental delay, cerebral palsy, visual impairment, autism and attention deficit disorder) was 33%. The main conditions associated with additional disabilities were syndromes and chromosomal abnormalities (87%), jaundice (86%), prematurity (62%), cytomegalovirus (60%), and inner ear abnormalities including cochlea nerve hypoplasia or aplasia (75%) and semicircular canal anomalies (56%). At 12 months postoperatively, almost all (96%) of the children without additional disabilities had a CAP score of 5 or greater (speech), compared with 52% of children with additional disabilities. Children with developmental delay had a median CAP score of 4, at 12 months compared with 6 for those without developmental delay.
Conclusion:
Additional disabilities are prevalent in approximately a third of pediatric cochlear implant patients. Additional disabilities significantly affect the outcomes of cochlear implants.
