An analysis of the five year outcomes of a cohort of 46 deaf children with severe (SLD) or profound and multiple learning difficulties (PMLD) and associated complex needs, including autism (ASD), tracked using the Nottingham Early Cognitive and Listening Links (Early CaLL): This framework monitors the relationship between sound processor use and listening, spoken language, cognition and communicative development, following cochlear implantation

Abstract

Objectives: In 2018, routine data of the five year outcomes from a cohort of 46 children, (18 PMLD and 28 SLD, including nine SLD children with an additional diagnosis of ASD), was analysed to investigate the type and amount of benefit provided by cochlear implantation and to examine any differences in outcome patterns across the populations.

Methods: The level of functional sound processor use achieved over time was reviewed in relation to listening and spoken language outcomes, alongside social engagement, communicative and cognitive development. The extent to which children were able to close the gap between their overall development and their listening abilities was quantified. The outcomes of the children with an additional diagnosis of ASD, was compared to those of the SLD population as a whole.

Results: Although equipment management presented long term challenges, after five years, 80% of children were able to attach some meaning to sound. Children with SLD acquired more auditory skills and spoken language than those with PMLD. Most of the children used a mix of augmentative and alternative communication approaches (AAC), with 7%, all SLD children, acquiring some simple spoken language. An additional diagnosis of ASD had a negative effect on outcomes.

Discussion: For 80% of the patients, the provision of cochlear implants provided benefits, although changes were slow to develop and required high levels of adult persistence.

Conclusion: Outcomes measures which are population specific and acknowledge challenges, alongside providing ways to recognise individual achievements, by matching them against individual capacity, are of great value to families and practitioners.

Keywords:

• Cochlear implantation
• Paediatric population
• Severe learning difficulties
• Profound and multiple learning difficulties
• Intellectual disability
• Deafness
• Autism
• Expectation counselling

Acknowledgements

With gratitude to Chris Bones for her contribution to the development of the materials and Susan Johnson for sharing her assessment expertise so generously. The authors also wish to thank the families, all members of the team at NAIP, past and present, and local professionals for their contributions. Particular thanks to Dr Pádraig Kitterick, Associate Professor in Hearing Sciences, University of Nottingham for his invaluable input and advice.

Notes

1 Preterm birth – World Health Organization. Preterm is defined as babies born alive before 37 weeks of pregnancy are completed. The sub-categories of preterm birth are based on gestational age: extremely preterm (less than 28 weeks) very preterm (28–32 weeks).