title: School performance and wellbeing of children with CI in different communicative-educational environments.
abstract: OBJECTIVE
  This study aimed to evaluate the long term effects of CI on auditory, language, educational and social-emotional development of deaf children in different educational-communicative settings.
  
  
  METHODS
  The outcomes of 58 children with profound hearing loss and normal non-verbal cognition, after 60 months of CI use have been analyzed. At testing the children were enrolled in three different educational settings; in mainstream education, where spoken language is used or in hard-of-hearing education where sign supported spoken language is used and in bilingual deaf education, with Sign Language of the Netherlands and Sign Supported Dutch. Children were assessed on auditory speech perception, receptive language, educational attainment and wellbeing.
  
  
  RESULTS
  Auditory speech perception of children with CI in mainstream education enable them to acquire language and educational levels that are comparable to those of their normal hearing peers. Although the children in mainstream and hard-of-hearing settings show similar speech perception abilities, language development in children in hard-of-hearing settings lags significantly behind. Speech perception, language and educational attainments of children in deaf education remained extremely poor. Furthermore more children in mainstream and hard-of-hearing environments are resilient than in deaf educational settings. Regression analyses showed an important influence of educational setting.
  
  
  CONCLUSIONS
  Children with CI who are placed in early intervention environments that facilitate auditory development are able to achieve good auditory speech perception, language and educational levels on the long term. Most parents of these children report no social-emotional concerns.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Hearing and Implants, Radboud University Medical Center, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands. Electronic address: margreet.langereis@radboudumc.nl.
authors.forename: Margreet
authors.initials: M
authors.lastname: Langereis
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Hearing and Implants, Radboud University Medical Center, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
authors.forename: Anneke
authors.initials: A
authors.lastname: Vermeulen
mesh_terms: D002648:Child; D019929:Cochlear Implantation; D003054:Cochlear Implants; D003142:Communication; D003638:Deafness / Q000534:rehabilitation* / Q000601:surgery; D060345:Education of Persons with Hearing Disabilities / Q000379:methods*; D004522:Educational Status; D006304:Health Status; D006801:Humans; D007804:Language Development; D008282:Mainstreaming, Education; D009426:Netherlands; D012813:Sign Language; D013067:Speech Perception; D013997:Time Factors
keywords: Children; Cochlear implant; Education; Hearing impaired; Language; Wellbeing