Title: |
'Early Functional Skill Development in Children with Cochlear Implants and Additional Developmental Disabilities' |
Track: |
3-Early Intervention and Beyond
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Keyword(s): |
functional outcomes, cochlear implant, additional disabilities |
Learning Objectives: |
Participants will be able to describe functinoal outcomes in children who have received a cochlear implant and have an additional developmental disability |
Abstract: |
Functional outcomes are important in children with cochlear implants (CI) and additional disabilities as studies on auditory skill and speech/language development may not identify qualitative benefits from implantation. This study sought to determine development of functional performance skills of young children with developmental disabilities post-CI.
Eight children with cognitive disabilities undergoing cochlear implantation were enrolled in a prospective study of language and functional abilities; 6 with 1 year follow-up included. Functional performance was measured using Pediatric Evaluation of Disability Inventory (PEDI), providing standardized (mean 50) and scaled scores (range 0-100) of functional domains: Self-Care, Mobility and Social Function. The PEDI was administered pre-implant, 6 and 12 months post implantation along with language testing.
All children had cognitive disability; 5 also had motor delay. The ages at CI was 13.8-134 months. Children did not make significant changes in domain-specific standard scores over 1 year, with the exception of self-care which decreased (43.5 to 22.9; p=0.09). Children made progress in scaled scores by 1-year post-implant. The largest increase for all domains occurred in first 6 months (7-11.5 point increase). Children made a median 5.5-month increase in receptive language age (p=0.06) and 5-month increase in expressive language age (p=0.03) in the first year post-CI with no change in language quotients. Receptive language at each visit was highly correlated with social function after controlling for cognitive abilities (Spearman rho=0.53, p=0.03).
This is the first study to measure daily functional abilities in children with implants and disabilities using a standardized tool. Although our small group of complex children did not have an increase in standard scores (gap-closing trajectories), they made progress in skill development on scaled scores. Receptive language appears to play a key role in social functioning in this population. Functional assessments are informative for treatment planning and identifying specific areas to target intervention.
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Presentation: |
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