Cochlear implants beneficial in children with developmental delays and hearing loss: AAP

USA: Children with developmental difficulties and deafness benefit from cochlear implantation, says an article published in Pediatrics, the journal of the American Academy of Pediatrics.

Cochlear implantation is often recommended for infants with significant hearing loss. Many insurance companies refuse implantation to children with developmental disabilities since they have a limited ability to learn spoken communication. As a result, John S. Oghalai and colleagues used different insurance coverage constraints to evaluate results after cochlear implantation vs ongoing hearing aid usage.

Young children with deafness were identified prospectively from two distinct states, Texas and California, and followed longitudinally for an average of two years for this study. Cohort 1 (n = 138) children had normal cognitive and adaptive behavior and received cochlear implantation. Cohorts 2 (n = 37) and 3 (n = 29) children exhibited low cognitive and adaptive behavior. Cochlear implantation was performed on individuals in cohort 2, whereas hearing aids were used on those in cohort 3.

The key findings of this study were as follows:

1. Demographic characteristics did not differ significantly between cohorts.

2. Using cohort 2 as a control, children in cohort 1 showed faster growth in language, cognitive, adaptive function, and auditory skills (estimated coefficients, 0.166 to 0.403), whereas children in cohort 3 demonstrated slower gains (0.119 to 0.243).

3. Children in cohort 3 had a significant increase in stress within the parent-child system (1.328), but children in cohorts 1 and 2 did not.

4. Because insurance coverage for cochlear implants is sometimes denied because of EDI, physicians are often hesitant to send patients for cochlear implant examinations in the first place.

In conclusion, this discovery has ramifications for health policy not only for commercial insurers, but also for major, statewide, publicly operated programmes. Cognitive and adaptive abilities should not be utilized as a criterion for juvenile cochlear implantation.

Reference:

Oghalai, J. S., Bortfeld, H., Feldman, H. M., Chimalakonda, N., Emery, C., Choi, J. S., & Zhou, S. (2022). Cochlear implants for deaf children with early developmental impairment. Pediatrics, e2021055459. https://doi.org/10.1542/peds.2021-055459