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Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Simultaneous Bilateral Cochlear Implantation in Very Young Children Improves Adaptability and Social Skills: A
Ying Chen1,2,3, Yun Li1,2,3, Huan Jia1,2,3
1Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
Younger children receiving simultaneous bilateral cochlear implants show improved social skills and adaptability. The Gesell Development Diagnosis Scale (GDDS) effectively predicts speech production in pediatric cochlear implant users.
Area of Science:
- Audiology
- Developmental Pediatrics
- Neuroscience
Background:
- Simultaneous bilateral cochlear implantation (CI) is a common intervention for profound hearing loss in young children.
- Assessing developmental outcomes in this population is crucial for understanding the efficacy of CI.
- The Gesell Development Diagnosis Scale (GDDS) is a comprehensive tool for evaluating child development.
Purpose of the Study:
- To evaluate the predictive value of the GDDS for developmental outcomes in very young children undergoing simultaneous bilateral CI.
- To compare developmental trajectories between infants and older children receiving bilateral CI.
Main Methods:
- A prospective cohort study involving 62 children undergoing simultaneous bilateral CI, divided into "Infants" (6-12 months) and "Children" (12-36 months) groups.
- Data collected included surgical outcomes, auditory development, speech production, and GDDS scores up to 2 years post-fitting.
- Primary outcome was GDDS; secondary outcomes included complication rates and various auditory/speech performance measures.
Main Results:
- Younger age at implantation correlated with higher developmental quotients in language, social skills, and adaptability at 2 years.
- Significant differences were observed in GDDS social skills (p=0.001) and adaptability (p=0.031) domains.
- Auditory performance and speech production improved similarly in both groups, with low complication rates (0% in infants, 2.1% in children).
Conclusions:
- Simultaneous bilateral CI in younger children enhances adaptability and social skills.
- The GDDS is a sensitive tool for assessing the short-term effects of bilateral CI on neuropsychological development.
- GDDS serves as a reliable predictor of speech production in pediatric CI users.
Objectives:
To investigate the value of using the Gesell Development Diagnosis Scale (GDDS) to predict developmental outcomes in very young children who undergo simultaneous bilateral cochlear implantation.
Design:
In this prospective cohort study, a repeated-measures investigation was conducted in a tertiary referral hospital. A total of 62 children receiving simultaneous bilateral cochlear implantations were enrolled from April 2017 to August 2018. They were divided into 2 groups depending on the operative age: "Infants" group (6 to 12 months, N = 38) or "Children" group (12 to 36 months, N = 24). Data on the surgical outcomes, auditory development, speech production, and developmental indicators were collected until 2 years after the initial fitting. The primary outcome measure was the GDDS, a neuropsychological development examination. Secondary outcomes included the following: complication rate, aided pure-tone average, Infant-Toddler Meaningful Auditory Integration Scale, Categories of Auditory Performance-II, Meaningful Use of Speech Scale, Speech Intelligibility Rating, and the LittlEARS Auditory Questionnaire.
Results:
The mean ages at implantation in infants and children groups were 9.2 ± 1.17 and 16.6 ± 3.60 months, respectively. Significant differences were found in the social skills ( p = 0.001) and adaptability ( p = 0.031) domains of GDDS. The younger the age of bilateral cochlear implants surgery, the higher developmental quotient of language, social skills, and adaptability the child could achieve after 2 years. The complication rates in the infants and children groups were 0% versus 2.1% ( p = 0.57). There was no surgical complication in the infants group. In the children group, 1 case with enlarged vestibular aqueduct and Mondini malformation had a receiver-implant misplacement on the right side (2%, 1/48). In the two groups, auditory performance and speech production had improved similarly. In the infants group, social skills developmental quotient at baseline had a significant positive relationship with Meaningful Use of Speech Scale after 2 years.
Conclusions:
Simultaneous bilateral cochlear implantation in younger children improves adaptability and social skills. GDDS is a sensitive tool of evaluating short-term effect of bilateral cochlear implants in neuropsychological development and constitutes a reliable predictor of speech production for the very younger pediatric cochlear implant users.
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