Prognostic Factors for Communication Improvement in Young Children After Cochlear Implant Surgery

Objective: Our objective was to examine the prognostic factors for post-cochlear implant (CI) communication improvement and determine whether the otologist's and speech-language pathologist's (SLP's) recommendations exhibited the same predictive performance regarding children's post-CI verbal expression acquisition. Study Design: Retrospective, diagnostic study. Setting: Hospital. Patients: The study reviewed 339 medical charts of preschool children who underwent CI surgery before the age of 6 years during 1999 to 2016. After these medical charts were assessed, the cohort comprised of 79 preschool children with pre- and post-CI surgery speech-language assessment reports and medical records. Intervention: A senior SLP and an otologist conducted blind testing of CI candidacy according to the 79 children's pre-CI reports. Main Outcome Measures: Spoken mean length of utterance (MLU). Results: Children with superior skills in comprehending facial and gesture expressions or using gestures or sounds for expression were significantly more likely to receive the SLP's recommendation for CI surgery. The SLP's CI candidacy recommendation, based on background information, communication skill assessments, and magnetic resonance imaging (provided by an otologist), had significant predictive effects. Children recommended by the SLP exhibited a 20 times higher probability of benefiting from CI surgery; such a benefit would be a longer MLU after 2 years. Conclusion: CI candidacy testing for young children with prelingual hearing impairment based on a SLP's recommendations provided significant predictive effects. Level of Evidence: 4 (Evidence from well-designed case-control or cohort studies).