Objectives: The aim of this study was to explore the possibility that specific nonverbal, visual cognitive abilities may be associated with outcomes after pediatric cochlear implantation. The study therefore examined the relationship between visual sequential memory span and visual sequential reasoning ability, and a range of speech, phonological processing, vocabulary knowledge, and reading outcomes in children with cochlear implants.
Design: A cross-sectional, correlational design was used. Sixty-six children aged 5 to 12 years completed tests of visual memory span and visual sequential reasoning, along with tests of speech intelligibility, phonological processing, vocabulary knowledge, and word reading ability (the outcome variables). Auditory memory span was also assessed, and its relationship with the other variables examined.
Results: Significant, positive correlations were found between the visual memory and reasoning tests, and each of the outcome variables. A series of regression analyses then revealed that for all the outcome variables, after variance attributable to the age at implantation was accounted for, visual memory span and visual sequential reasoning ability together accounted for significantly more variance (up to 25%) in each outcome measure.
Conclusions: These findings have both clinical and theoretical implications. Clinically, the findings may help improve the identification of children at risk of poor progress after implantation earlier than has been possible to date as the nonverbal tests can be administered to children as young as 2 years of age. The results may also contribute to the identification of children with specific learning or language difficulties as well as improve our ability to develop intervention strategies for individual children based on their specific cognitive processing strengths or difficulties. Theoretically, these results contribute to the growing body of knowledge about learning and development in deaf children with cochlear implants.
This study examined the association between nonverbal, visual sequential reasoning and visual memory span with a variety of speech, language, and literacy outcomes after pediatric cochlear implantation. These nonverbal measures predicted up to a quarter of the variance in outcomes, over-and-above that accounted for by the age of the child at implantation. This finding is especially useful for clinicians working with implanted children who need to identify those at risk of poor outcomes, as the nonverbal cognitive tests used can be administered to very young deaf children, before they are able to undertake traditional verbally administered tests.
Great Ormond Street Hospital for Children, London, England, United Kingdom.
Address for correspondence: Lindsey Edwards, Great Ormond Street Hospital for Children, Cochlear Implant Programme, Great Ormond Street, London WC1N 3JH, England, United Kingdom. E-mail: Lindsey.Edwards@gosh.nhs.uk