title: Cognitive and outcome measures seem suboptimal in children with cochlear implants - a cross-sectional study.
abstract: OBJECTIVE
  This study investigates whether cognition as a single variable significantly influences the hearing and speech outcomes of children with cochlear implants (CIs). More specifically, it identifies various types of cognitive disorders among children with CI, comparing these children's cognitive abilities to the outcomes of CI in terms of hearing and speech performance.
  
  
  METHODS
  Cross-sectional cognitive testing of children with CIs.
  
  
  METHODS
  West Danish CI Centre, Aarhus University Hospital, Denmark.
  
  
  METHODS
  Fifty-eight CI children underwent postoperative cognitive evaluation. Cognitive tests included Bayley Scales of Infant Development (Bayley-III), Snijders-Oomen Nonverbal Intelligence Test Revised (SON-R) and Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV), depending on the age of the child. Outcome measures of hearing and speech capacity after CI consisted of Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR) and Peabody Picture Vocabulary Test-4 (PPVT-4).
  
  
  RESULTS
  Only PPVT-4 correlated significantly with cognition scores. Over time, the value of CAP and SIR seems limited by a pronounced ceiling effect.
  
  
  CONCLUSIONS
  The most widely used outcome tests after CI, that is CAP and SIR, may not reflect cognitive disabilities sufficiently due to pronounced ceiling effects. International guidelines suggesting a panel of robust age-matched tests are warranted to optimise rehabilitation programmes as well as the counselling of parents.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus C, Denmark.
authors.forename: N
authors.initials: N
authors.lastname: Udholm
authors.affiliation: Audiology Clinic, Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus C, Denmark.
authors.forename: K
authors.initials: K
authors.lastname: Aaberg
authors.affiliation: Institution for Communication and Handicap, Aarhus University Hospital, Aarhus C, Denmark.
authors.forename: C
authors.initials: C
authors.lastname: Bloch
authors.affiliation: Audiology Clinic, Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus C, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Sandahl
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus C, Denmark.|Department of Clinical Medicine, Aarhus University, Denmark.|Department of Otorhinolaryngology, Regional Hospital Holstebro, Denmark.
authors.forename: T
authors.initials: T
authors.lastname: Ovesen
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003054:Cochlear Implants; D003072:Cognition Disorders / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D003718:Denmark; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D017063:Outcome Assessment, Health Care