Categories of Auditory Performance (CAP) describes a scale used to rate outcomes from paediatric cochlear implantation in everyday life. It differs from more technical measures by being readily applied and easily understood by non-specialist professionals and by parents. Being based on subjective assessments, there is a need to establish whether ratings by different persons are comparable. Therefore, an analysis of inter-user reliability was undertaken using ratings from 23 children followed up at various intervals after implantation. Analysis relating scores by local teachers of the deaf and the teachers of the deaf at the implant centre revealed very high inter-user reliability (correlation coefficient 0.97). This result establishes the reliability of CAP as an outcome measure for use in cochlear implant programmes.

The results of the present study provide strong evidence that prelingually deaf children should receive implants as early as possible to facilitate the later development of speech perception skills and speech intelligibility and thus maximize the health gain from the intervention. However, because of the wide variation in individual outcomes, age alone should not be used as a criterion to decide implant candidacy.

All but 1 of the 30 implanted children continue using their devices 10 to 14 years after implantation, showing significant progress in speech perception and production. Device failure was frequent, but successful reimplantation occurred in all cases. One-third to one-half of the implanted children in this study continued to demonstrate improvements at 5 to 10 years of implant use. All children are studying or working and are actively involved in their local communities. The results suggest that cochlear implantation provides long-term communication benefit to profoundly deaf children that does not plateau for some subjects even after reimplantation. This study further indicates that cochlear implant centers need the structure and funding to provide long-term support, counseling, audiologic follow-up, rehabilitation, and device monitoring to implanted children.

No abstract

Cochlear implantation is a relatively new procedure, which has already had significant impact on the lives of many profoundly deaf children and adults, in providing useful hearing to those unable to benefit significantly from hearing aids. After 16 years of cochlear implantation in the United Kingdom, there is now a body of evidence covering a range of outcomes, much of which covers perceptual and linguistic outcomes. This study looks at the impact of cochlear implantation on a group of 29 young people aged 13-16 years, using a semistructured questionnaire. It examines issues from the perspective of the young people themselves, including their understanding of and degree of satisfaction with the way their implant works for them, their social and communication abilities and choices, their educational challenges, and their identity. It concludes that the young people in this group feel positive toward their cochlear implants and the decisions made on their behalf by parents. Many have a flexible attitude to communication modes and an identity which is not fixed in terms of conventional descriptors.