Title: 'Early Functional Skill Development in Children with Cochlear Implants and Additional Developmental Disabilities'
Track: 3-Early Intervention and Beyond
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


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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Daniel Choo - Cincinnati Children's Hospital Medical Center
     Credentials: MD
     Other Affiliations: FAAP
      BIO: Dr. Choo is a professor of pediatric otolaryngology at Cincinnati Children's Hospital Medical Center. He is a neuro-otologist and has an extensive clinical practice and active research career in the field of childhood hearing loss.
Jareen Meinzen-Derr - Cincinnati Children's Hospital Medical Center
     Credentials: PhD, MPH
      BIO: Dr. Meinzen-Derr is quantitative epidemiologist at the Cincinnati Children's Hospital Medical Center. She has focused her research on outcomes of children who are deaf or hard of hearing, and specifically those who have additional developmental disabilities.