title: Compliance with cochlear implantation in children subsequently diagnosed with autism spectrum disorder.
abstract: OBJECTIVE
  To assess the compliance with cochlear implantation (CI) in children subsequently diagnosed with autism spectrum disorder (ASD).
  
  
  METHODS
  This was a retrospective case review and survey performed at a tertiary referral centre. Children meeting the criteria for CI who were implanted between 1989 and 2015 and who subsequently received a diagnosis of ASD were included. The primary outcome measure was to assess compliance with CI in children subsequently diagnosed with ASD. Secondary outcome measures included assessment of pre-CI risk factors that may have identified children at higher risk of a subsequent diagnosis of ASD, as well as the benefit obtained by these children following CI.
  
  
  RESULTS
  1050 children were implanted between 1989 and 2015. Of these, 22 children were diagnosed with ASD after receiving their CI. The average age at implantation was 2.6 years (median 3, range 1-8 years). The average age for diagnosis of ASD was 5 years, approximately 2 years (median 22 months, range 2-85 months) following CI. Of these, 16/22 (712.7%) regularly use their CI. 6/22 (27.2%) children became non-users of their implant. Some degree of verbal communication was used by 13/22 (59%) of our studied group.
  
  
  CONCLUSIONS
  There is a range of level of disabilities in ASD, with some relatively minor social communication difficulties through to severe language, cognitive, and behavioural difficulties. Compliance with CI is variable and appears to correlate with the severity of the ASD. Preoperative counselling should include information about the possible impact of later diagnosed disabilities such as ASD on performance.
authors: a The Richard Ramsden Centre for Auditory Implants, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre , UK.
authors: Monica Rodriguez
authors: MR
authors: Valero
authors: b Paediatric ENT Department , Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre , UK.
authors: Mira
authors: M
authors: Sadadcharam
authors: a The Richard Ramsden Centre for Auditory Implants, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre , UK.
authors: Lise
authors: L
authors: Henderson
authors: a The Richard Ramsden Centre for Auditory Implants, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre , UK.
authors: Simon R
authors: SR
authors: Freeman
authors: a The Richard Ramsden Centre for Auditory Implants, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre , UK.
authors: Simon
authors: S
authors: Lloyd
authors: a The Richard Ramsden Centre for Auditory Implants, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre , UK.
authors: Kevin M
authors: KM
authors: Green
authors: a The Richard Ramsden Centre for Auditory Implants, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre , UK.|b Paediatric ENT Department , Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre , UK.|c Respiratory and Allergy Centre, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences , University of Manchester , UK.
authors: Iain A
authors: IA
authors: Bruce
mesh_terms: D000067877:Autism Spectrum Disorder / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000523:psychology*; D003638:Deafness / Q000523:psychology* / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010349:Patient Compliance; D011183:Postoperative Complications / Q000523:psychology*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Asperger's; Autistic spectrum disorder; Children; Cochlear implant; Compliance; Hearing loss; Outcomes