Neuropsychological testing in the screening for cochlear implant candidacy.
OBJECTIVE
To demonstrate the utility of neuropsychological assessment in the screening process for pediatric cochlear implant candidacy.


METHODS
Prospective and ongoing evaluation of children with profound bilateral hearing loss using age-specific neuropsychological test batteries.


METHODS
Eighteen children who met audiological criteria for cochlear implantation were evaluated by two age-specific neuropsychological tests. The Vineland Adaptive Behavior Scales survey assesses several domains of behavioral functions (communication, daily living skills, socialization, and gross motor skills). The Mullen Scales of Early Learning assess the child's visual perception, speech and language, and motor abilities. The Leiter International Performance Scale-Revised assesses intellectual ability.


RESULTS
All patients underwent the Vineland Adaptive Behavior Scales survey. Overall scores were lower than normative means with a mean composite score in the 7th percentile. In addition, there was a strong inverse correlation between score and age of testing. Ten children were assessed using the Mullen Scales of Early Learning, and, again, there was a strong inverse correlation between score and age of testing. Intellectual ability was assessed in seven children using the Leiter International Performance Scale-Revised and was found to be lower than normative means with a mean score in the 13th percentile.


CONCLUSIONS
Neuropsychological testing of profoundly deaf children provides a detailed and accurate assessment of the child's cognitive, behavioral, and motor functions. The profoundly deaf child does not develop at the same rate as normal children in cognitive and behavioral domains. Neuropsychological testing is a useful tool for screening for cochlear implant candidacy and has the potential to track changes before and after implantation.
Kutz
Walter
W
Bobby R. Alford Department of Otolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, TX, USA. k691865@bcm.tmc.edu
Wright
Crystal
C
Krull
Kevin R
KR
Manolidis
Spiros
S
D001483:Base Sequence; D001707:Biopsy, Needle; D002652:Child Behavior; D002675:Child, Preschool; D003054:Cochlear Implants; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis* / Q000523:psychology / Q000601:surgery*; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D008297:Male; D008403:Mass Screening / Q000379:methods; D008969:Molecular Sequence Data; D009483:Neuropsychological Tests / Q000592:standards*; D018579:Patient Selection; D016133:Polymerase Chain Reaction; D011300:Preoperative Care / Q000379:methods; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index