Longitudinal functional performance among children with cochlear implants and disabilities: A prospective study using the Pediatric Evaluation of Disability Inventory

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• 作者：Susan Wiley^a ; ^b ; ^d ; Jareen Meinzen-Derr^b ; ^c ; ^d ; ^{jareen.meinzen-derr@cchmc.org} ; Sandra Grether^a ; Daniel I. Choo^b ; ^d ; Michelle L. Hughes^e
• 关键词：Pediatric cochlear implantation ; Disabilities ; Functional assessments ; Prospective study design
• 刊名：International Journal of Pediatric Otorhinolaryngology
• 出版年：2012
• 期刊代码：135_01655876
• 类别：med
• 出版时间：May, 2012
• 卷：76
• 期：5
• 页码：693-697
• 文件大小：675 K

摘要

Objective

Functional outcomes are important in children with cochlear implants (CI) and additional disabilities as studies on auditory skill and speech/language development may not identify functional benefits from implantation. This study sought to measure functional performance skills of young children with developmental disabilities post-CI.

Methods

Eight children with cognitive disabilities undergoing cochlear implantation were enrolled in a prospective study of language and functional abilities; 6 with 1 year follow-up were included in the analysis. Functional performance was measured using Pediatric Evaluation of Disability Inventory (PEDI), providing standardized (mean: 50) and scaled scores (range: 0-100) of functional domains: Self-Care, Mobility and Social Function. The PEDI was administered pre-implant, 6 and 12 months post-implantation along with language testing at the same intervals.

Results

All children had cognitive disability; 5 also had motor delay. The ages at CI ranged from 13.8 to 134 months. For functional abilities, children did not make significant changes in domain-specific standard scores over 1 year. Children made progress in scaled scores by 1-year post-implant. The largest increase for all domains occurred in the first 6 months (7-11.5 point increase). For language abilities, children made a median 5.5-month increase in receptive language age (p = 0.06) and 5-month increase in expressive language age (p = 0.03) in the first year post-CI with no change in language quotients. Receptive language level was significantly (p < 0.05) associated with increasing scores in the domains of Self-Care and Social Function.

Conclusions

This is the first study to measure daily functional abilities in children with implants and disabilities using a standardized tool. Although our small group of complex children did not have an increase in standard scores (gap-closing trajectories), they made progress in skill development on scaled scores. Receptive language appears to play a key role in social functioning in this population. Functional assessments are informative for treatment planning and identifying specific areas to target intervention.