title: Cochlear implantation in children with complex needs - outcomes.
abstract: OBJECTIVE
  Prospective review of the assessment and outcomes of children with complex needs receiving cochlear implants (CIs) at the Yorkshire Cochlear Implant Service (YCIS).
  
  
  METHODS
  Nineteen children with complex needs were assessed pre-implant and 12 months post-implant switch-on using appropriate developmental-related audiology, categories of auditory performance (CAP), meaningful auditory information scale (MAIS), listening progress score (LiP), and meaningful use of speech scale (MUSS). Outcomes were compared with 230 children at the YCIS without complex needs.
  
  
  RESULTS
  Average CAP scores improved from 0.4 to 3.0, compared with 4.2 in the control group. MAIS scores as completed by parent and teacher improved to 62 and 57%, respectively, compared with the control group who achieved 82 and 70% at 12 months. LiP scores improved from 11 to 65% compared with the control which increased from 22 to 81%. MUSS scores as assessed by parent and teacher improved to 35 and 31%, respectively, at 12 months compared with 52 and 51% in the control group.
  
  
  CONCLUSIONS
  CIs in children have been shown to be cost effective and provide benefits in auditory and speech perception; however, there are few reports specifically relating to outcomes in children with complex needs. Improvement was seen across all outcome measures although less than in children without additional needs. Consideration should be given to the use of quality-of-life measurements as the development of oral communication may not be a realistic goal or accurately reflect benefits gained by the use of CIs in this patient group.
authors.affiliation: Yorkshire Cochlear Implant Service, Bradford Royal Infirmary, Bradford BD9 6RJ, UK. amyrafferty@doctors.org.uk
authors.forename: Amy
authors.initials: A
authors.lastname: Rafferty
authors.forename: Jane
authors.initials: J
authors.lastname: Martin
authors.forename: David
authors.initials: D
authors.lastname: Strachan
authors.forename: Chris
authors.initials: C
authors.lastname: Raine
mesh_terms: D001307:Auditory Perception; D016022:Case-Control Studies; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis / Q000534:rehabilitation; D002675:Child, Preschool; D019929:Cochlear Implantation; D015897:Comorbidity; D003638:Deafness / Q000150:complications* / Q000534:rehabilitation*; D002658:Developmental Disabilities / Q000175:diagnosis / Q000534:rehabilitation; D019988:Children with Disabilities; D004519:Education, Special; D005260:Female; D006801:Humans; D007223:Infant; D007805:Language Development Disorders / Q000175:diagnosis / Q000534:rehabilitation; D008297:Male; D019303:Multilingualism; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life; D013063:Speech Discrimination Tests; D013067:Speech Perception; D006113:United Kingdom