Behavioral assessment of prelingually deaf children before cochlear implantation.

OBJECTIVES/HYPOTHESIS: To determine whether scores from a behavioral assessment of prelingually deafened children who present for cochlear implant surgery are predictive of audiological outcomes.

STUDY DESIGN

Retrospective review of longitudinal data collected from 42 children with prelingual hearing loss who presented for a cochlear implant before age 5 years.

METHODS

The Vineland Adaptive Behavioral Scales (VABS) was administered during the preimplant workup. Standardized scores reflect daily living skills, socialization, and motor development compared with a normative sample. Regression analyses were conducted to determine whether any subject variables were related to VABS scores. Mixed-model analyses were computed to determine whether preimplant VABS scores were predictive of longitudinal spoken-language data obtained after cochlear implant surgery.

RESULTS

Motor scores tended to be higher than nonmotor scores. Nonmotor scores were significantly lower than the normative mean and decreased with testing age. Children with acquired deafness demonstrated lower motor scores than children with congenital causes. Children with higher motor scores demonstrated significantly higher performance on language, vocabulary, and word recognition tests than children with lower motor scores. Nonmotor domains were not as robustly related to spoken-language measures, although similar trends were observed.

CONCLUSION

Profound deafness and language delay may confound the assessment of daily living skills and socialization in the population studied. Motor development appears to proceed normally in prelingually deafened children and is a preimplant predictor of spoken-language outcome in young infants and children with cochlear implants, a finding consistent with the large body of work establishing links between perceptual-motor and language development.