Related Experiment Video
Updated: Mar 16, 2026
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Compliance with cochlear implantation in children subsequently diagnosed with autism spectrum disorder
Monica Rodriguez Valero1, Mira Sadadcharam2, Lise Henderson1
1a The Richard Ramsden Centre for Auditory Implants, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre , UK.
Insights
Cochlear implantation (CI) compliance varies in children later diagnosed with autism spectrum disorder (ASD). Severity of ASD impacts device use, highlighting the need for comprehensive preoperative counseling regarding potential challenges.
Area of Science:
- Audiology
- Developmental Pediatrics
- Neurodevelopmental Disorders
Background:
- Cochlear implantation (CI) is a critical intervention for hearing loss in children.
- Autism spectrum disorder (ASD) presents diverse communication and social challenges.
- Understanding CI compliance in children with co-occurring ASD is essential for optimizing outcomes.
Purpose of the Study:
- To evaluate cochlear implantation (CI) compliance in children subsequently diagnosed with autism spectrum disorder (ASD).
- To identify potential pre-implantation risk factors for ASD in CI candidates.
- To assess the benefits of CI in children with ASD.
Main Methods:
- Retrospective case review and survey at a tertiary referral center.
- Included children implanted between 1989-2015 who later received an ASD diagnosis.
- Assessed CI compliance, pre-CI risk factors, and post-CI benefits.
Main Results:
- 22 of 1050 implanted children were diagnosed with ASD post-implantation.
- Average age at CI was 2.6 years; ASD diagnosis at 5 years (2 years post-CI).
- CI compliance was 72.7% (regular users), with 27.3% non-users; 59% used some verbal communication.
Conclusions:
- CI compliance in children with ASD is variable and appears linked to ASD severity.
- Preoperative counseling should address the potential impact of neurodevelopmental conditions like ASD on CI device use and outcomes.
- Further research is needed to tailor CI strategies for children with ASD.
Objective:
To assess the compliance with cochlear implantation (CI) in children subsequently diagnosed with autism spectrum disorder (ASD).
Methods:
This was a retrospective case review and survey performed at a tertiary referral centre. Children meeting the criteria for CI who were implanted between 1989 and 2015 and who subsequently received a diagnosis of ASD were included. The primary outcome measure was to assess compliance with CI in children subsequently diagnosed with ASD. Secondary outcome measures included assessment of pre-CI risk factors that may have identified children at higher risk of a subsequent diagnosis of ASD, as well as the benefit obtained by these children following CI.
Results:
1050 children were implanted between 1989 and 2015. Of these, 22 children were diagnosed with ASD after receiving their CI. The average age at implantation was 2.6 years (median 3, range 1-8 years). The average age for diagnosis of ASD was 5 years, approximately 2 years (median 22 months, range 2-85 months) following CI. Of these, 16/22 (712.7%) regularly use their CI. 6/22 (27.2%) children became non-users of their implant. Some degree of verbal communication was used by 13/22 (59%) of our studied group.
Conclusion:
There is a range of level of disabilities in ASD, with some relatively minor social communication difficulties through to severe language, cognitive, and behavioural difficulties. Compliance with CI is variable and appears to correlate with the severity of the ASD. Preoperative counselling should include information about the possible impact of later diagnosed disabilities such as ASD on performance.
