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Updated: Aug 22, 2026
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
The relationship between executive functions and daily auditory behaviors in preschool cochlear implant users
Rumeysa Nur Akbaş1, Ayşe Özer2
1Department of Audiology, Gülhane Faculty of Health Sciences, University of Health Sciences, Ankara, Turkey.
Insights
Working memory (WM) is crucial for children with cochlear implants (CIs), enhancing auditory skills. Supporting WM development alongside device use maximizes potential in CI users.
Area of Science:
- Neuroscience
- Audiology
- Developmental Psychology
Background:
- Children with cochlear implants (CIs) face unique developmental challenges.
- Executive functions, particularly working memory (WM), are critical for auditory development and learning.
- Understanding the interplay between auditory behaviors and executive functions is essential for optimizing CI outcomes.
Purpose of the Study:
- To investigate the relationship between parent-reported auditory behaviors and teacher-evaluated executive functions in preschool children with bilateral CIs.
- To determine the role of working memory in mediating the association between cochlear implant experience and auditory performance.
- To explore potential sex differences in executive functions among children with CIs.
Main Methods:
- A cohort of 47 preschool children (aged 4-6 years) with bilateral CIs was assessed.
- Parent-reported Auditory Behavior in Everyday Life (ABEL) and teacher-evaluated Childhood Executive Functioning Inventory (CHEXI) scales were utilized.
- Correlational, hierarchical regression, and mediation analyses were employed to examine the data.
Main Results:
- Duration of cochlear implant use positively correlated with auditory behaviors and working memory (WM).
- WM significantly predicted auditory performance, explaining an additional 22% of the variance.
- Auditory behaviors partially mediated the link between device experience and WM development, with girls showing higher WM scores.
Conclusions:
- Working memory is a key neurocognitive factor that synergizes with auditory experience in children with CIs.
- Clinical interventions should integrate strategies to bolster WM capacity to enhance developmental outcomes.
- Early and consistent support for WM development is vital for maximizing the potential of children with cochlear implants.
Abstract:
Objective: This study aims to investigate the relationship between parent-reported daily life auditory behaviors and teacher-evaluated executive functions in preschool children using cochlear implants (CIs). Material and Methods: Forty-seven children (23 girls, 24 boys) aged 4-6 years with bilateral CIs participated. The clinical profile showed successful auditory access (aided thresholds: 24.8 dB HL; word recognition: 82.5%). Auditory Behavior in Everyday Life (ABEL) and the Childhood Executive Functioning Inventory (CHEXI) scales were used. Data were analyzed using correlation, hierarchical regression, and mediation analyses. Results: Duration of CI use correlated significantly with auditory behaviors (r = .50, p < .01) and working memory (WM) (r = .48, p < .01). Regression analysis showed WM explained an additional 22% of variance in auditory performance (β = .45, p < .001). Mediation analysis confirmed auditory behaviors partially mediate the relationship between device experience and WM development (β = .22, p = .014). Girls demonstrated significantly higher WM scores than boys (p = .032). Conclusion: WM is a vital neurocognitive resource operating in synergy with auditory experience. Clinical protocols should include integrated strategies supporting WM capacity to maximize developmental potential.
