title: Cochlear implantation in children with cerebral palsy.
abstract: OBJECTIVE
  Few studies have looked at the outcomes of children with complex needs following cochlear implantation. Increasing evidence supports the case for implantation in these children. To date there is very little evidence available evaluating the role of cochlear implantation in children with cerebral palsy. In this paper we look at the Manchester Cochlear Implant Programme's experience of implantation in 36 children with cerebral palsy.
  
  
  METHODS
  A retrospective review of prospectively collected data for all children with cerebral palsy was undertaken. Cognitive and physical disability was scored by members of the cochlear implant team. A modified version of Geers and Moogs 1987 Speech Reception Score was used to assess outcome. Data was analysed looking at the relationship between cognitive and physical impairment, age at implantation and the SRS outcomes.
  
  
  RESULTS
  This study demonstrated that children with cerebral palsy and a mild cognitive impairment do significantly better following implantation than those with a severe impairment (p=0.008). Children with mild physical impairment did not appear to do significantly better than those with moderate or severe impairments (mild versus severe p=0.13). Age at implantation was not a significant prognostic factor in this study group.
  
  
  CONCLUSIONS
  Children with complex needs are increasingly being referred for consideration of cochlear implantation. Further research is required to help guide candidacy, but each case must be considered individually. Higher functioning does appear to be the most important prognostic indicator regarding outcome but the effect of modest improvement in sound perception should not be underestimated.
authors: Manchester Auditory Implant Centre, University of Manchester, Oxford Road, Manchester M13 9PL, UK. richardsteven@doctors.org.uk
authors: Richard A
authors: RA
authors: Steven
authors: Kevin M J
authors: KM
authors: Green
authors: Stephen J
authors: SJ
authors: Broomfield
authors: Lise A
authors: LA
authors: Henderson
authors: Richard T
authors: RT
authors: Ramsden
authors: Iain A
authors: IA
authors: Bruce
mesh_terms: D000367:Age Factors; D001307:Auditory Perception; D002547:Cerebral Palsy / Q000150:complications / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007804:Language Development; D008297:Male; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013065:Speech Intelligibility; D013067:Speech Perception; D016896:Treatment Outcome; D006113:United Kingdom