title: Speech perception outcome in multiply disabled children following cochlear implantation: investigating a predictive score.
abstract: BACKGROUND
  Children with multiple disabilities account for a small percentage of implantees in a cochlear implant program, but they remain the most challenging group for which to predict benefit from the implant and for cooperation with habilitation postoperatively.
  
  
  OBJECTIVE
  To assess the relationship of pre-implant functional disabilities with postoperative speech perception scores and determine the feasibility of predicting outcome with a cochlear implant in a multiply disabled pediatric population.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Sixty-six children with a cochlear implant and at least one additional disability.
  
  
  METHODS
  We retrospectively examined the relationship between pre-implant Graded Profile Analysis (GPA) scores and postimplant speech perception scores. A pre-implant functional disability score (based on the Battelle developmental screen) was applied to the same cohort of patients and its association with postimplant speech perception scores was examined.
  
  
  RESULTS
  The functional disability score significantly predicted high (k > 24) and low (k < 7) speech perception scores (p < 0.001 and p < .0001) and had excellent discrimination ability (c statistic = 0.88 and 0.93 respectively). The GPA score was not significantly associated with speech perception scores (p = 0.519 and p = 0.146) and demonstrated no ability to discriminate postimplant speech perception scores in this implant population (c statistic = 0.49 and c = 0.57).
  
  
  CONCLUSIONS
  Prediction of outcomes following cochlear implantation in multiply disabled children can be facilitated using this newly developed functional disability score as an adjunct to traditional candidacy assessments.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Hospital for Sick Children, 555 University Avenue, Toronto, M5G 1X8, Canada. keith.trimble@utoronto.ca
authors.forename: Keith
authors.initials: K
authors.lastname: Trimble
authors.forename: Laura C
authors.initials: LC
authors.lastname: Rosella
authors.forename: Evan
authors.initials: E
authors.lastname: Propst
authors.forename: Karen A
authors.initials: KA
authors.lastname: Gordon
authors.forename: Vicky
authors.initials: V
authors.lastname: Papaioannou
authors.forename: Blake C
authors.initials: BC
authors.lastname: Papsin