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Published on: March 24, 2023
Cochlear Implantation Can Improve Auditory Skills, Language and Social Engagement of Children With Autism Spectrum
Carolyn M Jenks1,2, Stephen R Hoff1,2, Jennifer Haney3
1Department Otolaryngology - Head and Neck Surgery, Johns Hopkins Medicine, Northwestern University Feinberg School of Medicine.
Insights
Cochlear implantation (CI) can improve speech perception, communication, and social engagement in children with autism spectrum disorder (ASD). These findings suggest CI is a beneficial intervention for some deaf children with ASD.
Area of Science:
- Audiology
- Developmental Pediatrics
- Speech-Language Pathology
Background:
- Autism Spectrum Disorder (ASD) is a neurodevelopmental condition affecting communication and social interaction.
- Deaf children with ASD present unique challenges in auditory rehabilitation.
- Cochlear implantation (CI) offers auditory input but its outcomes in ASD population are less understood.
Purpose of the Study:
- To review the outcomes of cochlear implantation (CI) in children diagnosed with autism spectrum disorder (ASD).
- To assess the impact of CI on speech perception, communication, and social engagement in this population.
Main Methods:
- Retrospective case review of 30 children with ASD who underwent CI between 1991 and 2018.
- Parental surveys were used to gather additional data on behavioral changes and device use.
Main Results:
- 33% of children achieved measurable open-set speech perception after CI.
- 86% of parents reported improvement in social engagement post-CI.
- Communication and attention were most affected behaviors, with positive changes noted.
Conclusions:
- Cochlear implantation shows potential for improving auditory skills, language, and social engagement in select deaf children with ASD.
- CI may be a valuable intervention for enhancing overall development in this population.
Objective:
To review outcomes of cochlear implantation (CI) in children diagnosed with autism spectrum disorder (ASD).
Study Design:
Retrospective case review and parent survey.
Setting:
Tertiary care children's hospital.
Patients:
Thirty children with ASD who underwent CI between 1991 and 2018. Mean age at CI = 3.5 years (0.8-11.8), mean age at diagnosis of ASD = 5.1 years (2.0-15.0) (22/30 diagnosed after CI), mean follow-up = 10.5 years (1.4-21.6). Parents of 7 children returned a survey.
Intervention:
Unilateral or bilateral cochlear implantation.
Main Outcome Measures:
Speech perception; expressive communication mode; educational placement; social engagement; consistency of CI use; parent survey of child behavior change.
Results:
Thirty-three percent of all and 45% of the 22 consistent device users developed measurable open-set speech perception by an average of 4.5 years of device use. Educational placement at last follow-up included 13% mainstreamed without interpreter, 50% Special Education programs, 10% therapeutic residential or day programs, 23% total communication programs, and one home schooled. Spoken language alone was used by 31% and spoken plus sign by 14%, with the remainder using sign alone, augmentative communication devices or no mode of communication. By parent report, 86% showed improvement in social engagement compared to pre-CI. Survey results showed the behaviors most frequently ranked as most affected by CI were communication and attention, while awareness of environment had the lowest (most affected) mean ranking.
Conclusions:
Findings support a growing body of literature that cochlear implantation has the potential to improve auditory skills, language, and enhance social engagement in some deaf children with autism spectrum disorder.
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