Related Experiment Video
Updated: Dec 19, 2025
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Cochlear implantation in children under 12 months: Prevalence and implications of 'hidden' disabilities
David R Friedmann1, Kaitlyn M Tona1, J Thomas Roland1
1Department of Otolaryngology-Head & Neck Surgery, NYU Cochlear Implant Center, New York, NY, USA.
Insights
Early cochlear implantation (CI) benefits children even with later-diagnosed disabilities. While most infants with CIs show no issues, some develop new conditions, yet still gain significant auditory and linguistic advantages.
Area of Science:
- Pediatric audiology
- Developmental pediatrics
- Neurosurgery
Background:
- Cochlear implantation (CI) before 12 months is increasingly common.
- The impact of co-occurring or newly identified disabilities on CI outcomes is not well understood.
Purpose of the Study:
- To determine the prevalence and impact of additional disabilities in children who received cochlear implants before 12 months of age.
- To evaluate auditory and linguistic benefits in relation to pre-existing or newly diagnosed disabilities.
Main Methods:
- Retrospective chart review of children implanted under 12 months with at least 3 years of follow-up.
- Categorization into three groups: no additional disabilities, newly diagnosed disabilities post-implantation, and pre-existing disabilities.
- Analysis of auditory and linguistic outcomes based on disability status.
Main Results:
- Of 93 eligible children, 79.6% had no additional issues.
- 8.6% were diagnosed with new disabilities post-implantation, while 11.8% had known pre-existing conditions.
- Auditory and linguistic benefits varied with disability severity; pre-existing conditions correlated with lower performance.
Conclusions:
- Children implanted before age one with later-diagnosed disabilities achieve significant, albeit variable, benefits.
- The emergence of new disabilities did not alter the recommendation for early CI in these cases.
- Counseling families on potential co-occurring issues is crucial for managing expectations regarding CI outcomes.
Abstract:
Introduction: While cochlear implants (CI) prior to 12 months of age have become common, the prevalence and impact of issues that either arise or were not evident prior to implantation is unknown. Methods: Retrospective chart review of children implanted under 12 months of age with minimum 3 years follow up. The children were divided into three groups: those with no identified additional disabilities, those with no known disabilities at time of implantation but diagnosed with additional disabilities following implantation, and those that had known anticipated additional disabilities at time of implantation. Results: 108 children under the age of 12 months were implanted at our Center between 2000 and 2013 with an average age of 9 months at time of implantation and n = 93 met inclusion criteria. In 79.6% (74/93) of children, there were no additional issues detected. In 11.8% (11/93), additional issues were known at the time of implantation while in 8.6% (8/93) of the children were diagnosed with additional issues that were not evident prior to implantation. The auditory and linguistic benefits vary commensurate with the severity of their disabilities. Those with anticipated issues preoperatively did not perform as well. Conclusions: Children implanted below one year of age but diagnosed with additional disabilities following implantation obtained substantial though varying degrees of benefit. In none of these cases would knowledge of the disability have altered the decision to offer early CI. It is important to address these potential issues when counseling families about outcomes.
