Related Experiment Video
Updated: Aug 29, 2025
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Children with cochlear implant and additional disabilities benefit from consistent device use
Cynthia Glaubitz1, Tim Liebscher1, Ulrich Hoppe1
1Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, ENT-clinic, Department of Audiology and Cochlear Implant Centre, Waldstr.1, 91054, Erlangen, Germany.
Insights
Children with cochlear implants (CI) and additional disabilities (AD) show improved auditory and language skills over time. Consistent daily device use and exposure to speech environments correlate with better outcomes, highlighting the importance of monitoring CI use in this population.
Area of Science:
- Audiology
- Speech-language pathology
- Pediatric rehabilitation
Background:
- Children with cochlear implants (CI) often have additional disabilities (AD), yet are frequently excluded from studies.
- Evaluating auditory and language development in CI children with AD requires considering demographic variables and disability type/severity.
- Little is known about device usage patterns in CI children with AD and their impact on outcomes.
Purpose of the Study:
- To determine auditory and language outcomes in CI children with AD.
- To analyze datalogging-based daily device use at 1 and 2 years post-implantation.
- To identify correlations between outcomes and device use in this cohort.
Main Methods:
- Retrospective analysis of 32 CI children with 5 types of AD.
- Auditory and language outcomes assessed using LittlEARS, ELFRA, and CAP tools.
- Device use analyzed via system-integrated data-logging (duration, disconnections, listening scenes).
Main Results:
- Significant progress in auditory and language performance over 2 years.
- Mean daily CI use increased, while coil disconnections decreased significantly.
- Rank correlations found between outcomes and device use (duration, disconnections, speech environments).
Conclusions:
- Auditory and language outcomes in CI children with AD are variable but progress over time.
- Consistent daily device use and high exposure to speech environments benefit children.
- Monitoring device use, especially coil disconnections in motor-impaired children, is crucial for improving CI services.
Objectives:
Although the prevalence of additional disabilities (AD) in children with a cochlear implant (CI) is high, children with such disabilities are often excluded from clinical studies, or their specific characteristics are only partially included. The literature shows that several factors need to be considered in evaluating auditory and language development in CI children with AD, including demographic variables as well as the severity and type of disability. Current findings on device use in children show correlations with auditory and language outcome, but little is known about device use specifically in children with AD. The purpose of this study was to determine the auditory and language outcome of CI children with AD and to analyse their datalogging-based daily device use, both 1 year and 2 years after implantation. In addition, any potential correlations between outcome and device use were to be identified.
Methods:
A cohort of 32 CI children with 5 different types of AD were included in this retrospective analysis. The children's auditory and language outcome was assessed by the parental questionnaires LittlEARS and ELFRA and by the professional observation tool CAP (Categories of Auditory Performance) 1 and 2 years after implantation. Longitudinal device use was analysed by using the CI system-integrated data-logging; daily duration of CI use, number of coil disconnections and exposure to different listening scenes were recorded.
Results:
Overall, the cohort's auditory and language performance showed significant progress over time, while reduced abilities became more obvious after 2 years of CI experience. The mean daily duration of CI use increased significantly from 7.8 ± 2.8 to 8.2 ± 2.7 h after 2 years. High numbers of daily coil disconnections were detected, with a significant mean decrease from 83.4 ± 73.1 to 66.3 ± 54.6 whereas the percentage exposure to different listening environments was widely stable over time. Significant rank correlations were identified between outcomes measured by ELFRA and CAP with daily duration of CI use, numbers of coil disconnections and percentage of exposure to speech-characterised listening scenes.
Conclusion:
The auditory and language outcome in CI children with AD is variable, but it progresses over time. Children benefit from a consistent daily device use as well as from a high exposure to speech-characterised environments. Device use should be monitored constantly, with particular focus on daily duration of CI use and, in particular, on the number of coil disconnections if children have a severe motor impairment. Objective data-logging is an important addition to outcome assessment by testing, observations and parental questionnaires. Although assessment in children with AD is a major challenge for professionals, comprehensive assessment is needed to improve cochlear implant services with special adaption to children with AD, and this should include audiological, development-related and psychosocial information. A unified system to classify types of disabilities could help to improve procedures for analysing different outcomes.
