Cognitive skills affect outcome of CI in children: A systematic review

To systematically review previous literature to determine to what extent hearing- impaired children with cognitive disabilities benefit from cochlear implantation (CI). Ultimately, to recommend guidelines for preoperative cognitive testing of hearing- impaired children and for the postoperative rehabilitation programs.

Pubmed, Cinahl, Embase, and The Cochrane Library was searched systematically for studies reporting cognitive disabilities in CI children.

Seven hundred and sixty-three studies were discovered by the search of which 15 fulfilled the inclusion- and exclusion criteria. An overall correlation was evident regarding cognitive abilities and benefit of CI in hearing, speech and language development, and speech perception.

Many of the eligible studies were case series with evidence level four. Furthermore, heterogeneity of studies impeded comparison between the preoperative cognitive tests and the postoperative outcome tests. However, studies agree that cognitive abilities in hearing- impaired children can predict outcome after CI. International guidelines for preoperative cognitive tests in different age groups, along with international guidelines for postoperative outcome tests are necessary for better inter-study comparison.

The degree of preoperatively cognitive disabilities is associated with the outcome after CI, thereby emphasizing why accurate cognitive tests are an important part of the preoperative evaluation of CI and pre-requisite for shared decision making. Furthermore, individual postoperative rehabilitation programs must be created depending on the child's cognitive ability.