Educational factors contributing to cochlear implant benefit in children

Background: Factors contributing to auditory, speech, language and reading outcomes in children with prelingual deafness after 4 to 6 years of multichannel cochlear implant use were examined. The effects of child, family and implant characteristics were controlled to identify the educational factors most conducive to maximum implant benefit. Methods: One hundred eighty-one 8- and 9-year-old children from across North America who were implanted by age 5 were administered a comprehensive battery of outcome measures of speech perception, speech production, language and reading tests. A series of multiple regression analyses determined the amount of variance in each outcome accounted for first by child and family characteristics, then by implant characteristics and finally by educational variables, such as communication mode, amount of therapy and classroom placement. Results: Characteristics of the child (primarily nonverbal IQ) and the family accounted for approximately 20% of the variance in post-implant outcome. An additional 24% was accounted for by implant characteristics and 12% by educational variables, particularly oral communication mode. Conclusions: Providing the child with the most up-to-date processing strategy with a well-fitted map, and an emphasis on speech and auditory skill development in their educational program can make a significant difference in the overall benefit children obtain from cochlear implantation.