Cochlear Implantation in Children With Autism Spectrum Disorder

Abstract

Objective To assess the outcome of cochlear implantation in children with Autism Spectrum Disorder Study Design Retrospective case review and survey Setting Tertiary referral center Patients Children who meet criteria for cochlear implantation and diagnosis of Autism Spectrum Disorder Main Outcome Measures Receptive and expressive language scores and parental survey data. Results 15 patients with history of ASD and cochlear implantation were analyzed and compared to 15 patients who received cochlear implant and have no other disability. Post-operatively, more than 67% of children with ASD significantly improved their speech perception skills and 60% significantly improved their speech expression skills while all patients in the control group showed significant improvement in both aspects. The top three reported improvements after cochlear implantation were name recognition, response to verbal requests, and enjoyment of music. Of all behavioral aspects, the use of eye contact was the least improved. Survey results in regards to improvements in patient interaction were more subtle when compared to those related to sound and speech perception. The most improved aspects in the ASD patients’ lives after cochlear implantation appeared to be attending to other people’s requests and conforming to family routines. Of note, awareness of the child’s environment is the most highly ranked improvement attributed to the cochlear implant. Conclusions Cochlear implants are effective and beneficial for hearing impaired members of the ASD population even though development of language may lag behind that of implanted children with no additional disabilities. Significant speech perception and overall behavior improvement are noted.

Central Auditory Processing Disorders in Individuals with Autism Spectrum Disorders

“…Another important issue is the outcomes of patients with ASDs after cochlear implantation. Limited number of studies about cochlear implantation in patients with an ASD reported satisfactory hearing outcomes, but implanted patients with ASDs still do not usually develop the expected language skills compared to those with normal neurodevelopment ( 39 , 54 ). Scientific data from ERP studies reveal that despite normal basic sensory perception, patients with ASD may have abnormal cognitive processing of auditory information, and this can explain the insufficient outcomes of language skills in this unique group of patients ( 55 , 56 , 57 , 58 ).…”

“…After the implantation, the speech outcome can be affected because of the dual diagnoses in these patients. In a study regarding cochlear implantation in autistic individuals, Eshraghi et al ( 39 ) proposed new assessment systems for speech perception and expression scales as existing evaluation parameters would not be appropriate to assess this unique group of patients. These new scales allow to assess easily, by caregivers, the function of speech and the perception of expression.…”

Current trends in outcome studies for children with hearing loss and the need to establish a comprehensive framework of measuring outcomes in children with hearing loss in China

“…(2011) demonstrated cognitive status was the most important prognostic indicator regarding outcomes. Some researchers reported positive outcomes in either speech perception skills and/or language development skills for populations with a specific disability, such as cerebral palsy ( Steven et al., 2011 , Lamônica et al., 2014, June ), Usher syndrome type 1 ( Henricson et al., 2012 ), congenital cytomegalovirus infection accompanied by psycho-neurological disorders ( Yamazaki et al., 2012 ), CHARGE syndrome ( Birman et al., 2015 ), and autism spectrum disorders ( Meinzen-Derr et al., 2014 , Eshraghi et al., 2015 ). Further research is required to help guide expected outcomes of implantation of this diverse population.…”

Pediatric Minimum Speech Test Battery

“…First, some children with secondary issues can complete speech perception tasks. For example, Eshraghi et al (2015) found that two-thirds of children with autism spectrum disorder using CIs can at least identify or recognize simple phrases, an early-developing auditory skill, per parent report. Second, eliminating children with secondary disabilities from research studies hinders our ability as clinicians to identify suitable expectations and appropriate recommendations for supplemental technology (such as home FM use) and outcomes assessment in these children.…”