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Screening for Developmental Delays in Pediatric Cochlea Implant Candidates and Recipients
Mallory Warrick1, Sophie Sherman1, Kaylene King2
1Division of Occupational Therapy, College of Health Professions, Medical University of South Carolina, Charleston, South Carolina.
Insights
Routine screening effectively identifies developmental delays in children with hearing loss and cochlear implants (CIs). Early detection and intervention beyond communication ensure better developmental outcomes for these children.
Area of Science:
- Pediatric audiology
- Developmental pediatrics
- Clinical improvement science
Background:
- Children with hearing loss and cochlear implants (CIs) face heightened risks for developmental delays.
- Current CI center practices often lack routine screening for non-communication developmental delays.
- Early identification is crucial for maximizing CI benefits and language acquisition.
Purpose of the Study:
- To implement and evaluate a pilot clinical improvement project for screening hearing-impaired children with CIs for developmental delays.
- To assess the feasibility and effectiveness of using standardized questionnaires for early detection.
Main Methods:
- A pilot study involving 31 children (≤5 years old) with bilateral hearing loss using CIs or CI candidacy.
- Caregivers completed the Ages and Stages Questionnaire (ASQ) and Sensory Profile-2 (SP2).
- Prospective evaluation conducted at a tertiary medical center's CI center.
Main Results:
- Approximately 40-50% of children screened positive for risks of developmental delay in non-communication areas.
- Referrals were made for occupational therapy (51.6%), physical therapy (41.9%), and developmental pediatrics (41.9%).
- Six children were diagnosed with developmental delays beyond communication domains after evaluation.
Conclusions:
- Routine screening effectively detects developmental delays in children with significant hearing loss that might otherwise be missed.
- This proactive screening approach facilitates timely and comprehensive interventions for a broader range of developmental issues.
- Implementing such screenings can significantly improve overall developmental trajectories and outcomes for children with hearing loss.
Objective:
Conduct a pilot clinical improvement project to effectively screen children with hearing loss for developmental delays. Children with hearing loss and cochlear implants (CIs) are at risk for additional developmental delays; however, screening to aid in early identification and referral for developmental delays is not routinely performed at CI centers. It is important to consider all aspects of child development to maximize CI outcomes and access to language.
Study Design:
Caregivers of 31 children completed the Ages and Stages Questionnaire (ASQ) and the Sensory Profile-2 (SP2), which are standardized questionnaires that assess developmental milestones in areas of communication, gross motor, fine motor, problem solving, personal-social, and sensory integration.
Setting:
Participants were prospectively evaluated at a CI center in a tertiary medical center.
Patients:
Participants included children, aged ≤5 years old with bilateral hearing loss who use CIs or who were CI candidates, and their families.
Main Outcome Measures:
Scores on ASQ and SP2 questionnaires.
Results:
Thirty-one children were screened, and approximately 40 to 50% screened positive for risk of developmental delay in areas excluding communication and received referrals for evaluations in occupational therapy (n = 16; 51.6%), physical therapy (n = 13; 41.9%), and developmental pediatrics (n = 13; 41.9%). Of children referred and seen for evaluations, six were diagnosed with developmental delays in at least one developmental area beyond the communication domains.
Conclusions:
Routine screening in children with significant hearing loss can successfully detect developmental delays, which may go unnoticed. This proactive approach enables timely and comprehensive treatment for developmental delays beyond those solely related to communication.
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