Systematic review of cochlear implantation in children with developmental disability.

OBJECTIVE

To perform a systematic review comparing the xoutcome of cochlear implantation in children with developmental disability with children without developmental disability.

DATA SOURCES

MEDLINE, EMBASE, and Cochrane databases were searched from 1950 or the start date of each database. The search was performed on 1st November 2012, and included articles published ahead of print with no language restrictions.

STUDY SELECTION

The initial search presented 441 articles of which 13 met the inclusion criteria. The articles studied children with cochlear implants and developmental disability where expressive and/or receptive language outcomes were compared with children with cochlear implants and normal development.

DATA EXTRACTION

Study quality assessment included whether ethical approval was gained, prospective design, eligibility criteria specified, appropriate controls used, adequate follow-up achieved, and defined outcome measures. Cochlear implant outcome analysis included expressive/receptive speech and language development in addition to quality of life and behavior.

DATA SYNTHESIS

Because of heterogeneity in postoperative follow-up periods and outcome measures reported, it was not possible to pool the data and perform meta-analysis. Comparisons were made by structured review.

CONCLUSION

Seven studies demonstrated a worse outcome for children with developmental disability. Six articles showed no difference in the outcome between the 2 groups. Children with developmental disability may not benefit from cochlear implantation based on traditional assessment tools but appear to improve their environmental awareness and quality of life. More work is needed to define the term benefit when used in this context for this vulnerable group. Autistic children consistently had a negative outcome.