title: Pediatric cochlear implants:  additional disabilities prevalence, risk factors, and effect on language outcomes.
abstract: OBJECTIVE
  To determine the prevalence of additional disabilities in a pediatric cochlear population, to identify medical and radiologic conditions associated with additional disabilities, and to identify the effect of additional disabilities on speech perception and language at 12 months postoperatively.
  
  
  METHODS
  Retrospective case review.
  
  
  METHODS
  Tertiary referral center and cochlear implant program.
  
  
  METHODS
  Records were reviewed for children 0 to 16 years old inclusive, who had cochlear implant-related operations over a 12-month period.
  
  
  METHODS
  Diagnostic and rehabilitative.
  
  
  METHODS
  Additional disabilities prevalence; medical history and radiologic abnormalities; and the effect on Categories of Auditory Performance (CAP) score at 12 months postoperatively.
  
  
  RESULTS
  Eighty-eight children having 96 operations were identified. The overall prevalence of additional disabilities (including developmental delay, cerebral palsy, visual impairment, autism and attention deficit disorder) was 33%. The main conditions associated with additional disabilities were syndromes and chromosomal abnormalities (87%), jaundice (86%), prematurity (62%), cytomegalovirus (60%), and inner ear abnormalities including cochlea nerve hypoplasia or aplasia (75%) and semicircular canal anomalies (56%). At 12 months postoperatively, almost all (96%) of the children without additional disabilities had a CAP score of 5 or greater (speech), compared with 52% of children with additional disabilities. Children with developmental delay had a median CAP score of 4, at 12 months compared with 6 for those without developmental delay.
  
  
  CONCLUSIONS
  Additional disabilities are prevalent in approximately a third of pediatric cochlear implant patients. Additional disabilities significantly affect the outcomes of cochlear implants.
authors.affiliation: The Sydney Children's Network, Westmead, The University of Sydney, Sydney, Australia. Catherine.birman@gmail.com
authors.forename: Catherine S
authors.initials: CS
authors.lastname: Birman
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Elliott
authors.forename: William P R
authors.initials: WP
authors.lastname: Gibson
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002547:Cerebral Palsy / Q000150:complications; D002648:Child; D002675:Child, Preschool; D025063:Chromosome Disorders / Q000150:complications / Q000453:epidemiology; D019929:Cochlear Implantation / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D003054:Cochlear Implants; D003638:Deafness / Q000601:surgery; D002658:Developmental Disabilities / Q000150:complications / Q000453:epidemiology; D019988:Children with Disabilities; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007804:Language Development; D008279:Magnetic Resonance Imaging; D008297:Male; D012307:Risk Factors; D013067:Speech Perception / Q000502:physiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome