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Margaret B. Pulsifer, PhD; Cynthia F. Salorio, PhD; John K. Niparko, MD

Arch Pediatr Adolesc Med. 2003;157:552-558.

Objectives  To examine changes in audiological, speech perception, and developmental functioning subsequent to cochlear implantation in children with severe to profound hearing impairment, and to identify factors related to those changes.

Design  Prospective, longitudinal analysis to compare functioning of pediatric patients who underwent cochlear implantation before and 1 year after surgery.

Setting  Outpatient pediatric cochlear implantation program in an academic institution (The Listening Center, The Johns Hopkins University School of Medicine, Baltimore, Md).

Patients  Forty consecutive pediatric patients between 1 and 9 years of age who received a cochlear implant between April 1, 1996, and August 31, 1998, and who also underwent psychological, audiological, and speech perception evaluations immediately before and 1 year after implantation.

Main Outcome Measure  Scores on the Bayley Scales of Infant Development–Second Edition, Stanford-Binet Intelligence Scale–Fourth Edition, Developmental Profile II, Child Behavior Checklist, speech perception categories, and audiological pure-tone thresholds.

Results  Mean (SD) duration of hearing impairment was 37.78 (27.94) months, mean (SD) age at surgery was 50.72 (27.66) months. Significant improvements were found 1 year after surgery in audiological, speech perception, and developmental functioning, but not in nonverbal intelligence or behavior. Greater benefits in audiological and developmental functioning were associated with younger age (<48 months) at implantation.

Conclusions  Patients showed significant improvement in audiological status, overall developmental functioning, and speech perception skills in a short time after surgery. Greatest improvement in speech perception was for children with the least initial impairment, and greatest developmental gains were associated with young age at implantation.

From the Departments of Psychiatry and Behavioral Sciences (Drs Pulsifer and Salorio) and Otolaryngology (Dr Niparko), The Johns Hopkins University School of Medicine, Baltimore, Md. Dr Pulsifer is now with Massachusetts General Hospital, Boston.

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