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Comparisons of IQ in Children With and Without Cochlear Implants

Longitudinal Findings and Associations With Language

Cejas, Ivette1; Mitchell, Christine M.2; Hoffman, Michael3; Quittner, Alexandra L.4 and the CDaCI Investigative Team

doi: 10.1097/AUD.0000000000000578
Research Articles

Objectives: To make longitudinal comparisons of intelligence quotient (IQ) in children with cochlear implants (CIs) and typical hearing peers from early in development to the school-age period. Children with additional comorbidities and CIs were also evaluated. To estimate the impact of socioeconomic status and oral language on school-age cognitive performance.

Design: This longitudinal study evaluated nonverbal IQ in a multicenter, national sample of 147 children with CIs and 75 typically hearing peers. IQ was evaluated at baseline, prior to cochlear implantation, using the Bayley Scales of Infant and Toddler Development and the Leiter International Performance Scale. School-age IQ was assessed using the Wechsler Intelligence Scales for Children. For the current study, only the Perceptual Reasoning and Processing Speed indices were administered. Oral language was evaluated using the Comprehensive Assessment of Spoken Language.

Results: Children in the CI group scored within the normal range of intelligence at both time points. However, children with additional comorbidities scored significantly worse on the Processing Speed, but not the Perceptual Reasoning Index. Maternal education and language were significantly related to school-age IQ in both groups. Importantly, language was the strongest predictor of intellectual functioning in both children with CIs and normal hearing.

Conclusion: These results suggest that children using cochlear implants perform similarly to hearing peers on measures of intelligence, but those with severe comorbidities are at-risk for cognitive deficits. Despite the strong link between socioeconomic status and intelligence, this association was no longer significant once spoken language performance was accounted for. These results reveal the important contributions that early intervention programs, which emphasize language and parent training, contribute to cognitive functioning in school-age children with CIs. For families from economically disadvantaged backgrounds, who are at-risk for suboptimal outcomes, these early intervention programs are critical to improve overall functioning.

1Department of Otolaryngology, University of Miami, Coral Gables, FL

2School of Public Health, Johns Hopkins University, Baltimore, MD

3Department of Psychology, University of Miami, Coral Gables, FL

4Miami Children’s Research Institute, Miami, FL.

5The CDaCI Investigative Team are listed in the Acknowledgments section.

Received June 23, 2017; accepted February 5, 2018.

Clinical Centers, Johns Hopkins University, The Listening Center, Baltimore: Charles Della Santina, MD, PhD; Dawn Marsiglia, MA, University of Miami, Miami: Ivette Cejas, PhD; Diane Martinez, AuD; Fred Telischi, MD; Rachel Glover; Christina Sarangoulis.

University of Michigan, Ann Arbor, Teresa Zwolan, PhD; Caroline Arnedt, AuD, University of North Carolina, Carolina Children’s Communicative Disorders Program, Chapel Hill: Holly F.B. Teagle, AuD; Jennifer Woodard, AuD; Hannah Eskridge, MSP, University of Southern California, Center for Childhood Communication, Los Angeles: Laurie S. Eisenberg, PhD; Karen Johnson, PhD; Laurel Fisher, PhD; Dianne Hammes Ganguly, MA, University of Texas at Dallas, Callier Center for Communication Disorders, Dallas: Andrea Warner-Czyz, PhD; Ann Geers, PhD; Kathryn Wiseman, BS; Lana Britt, AuD.

Data Coordinating Center, Johns Hopkins University, Welch Center for Prevention, Epidemiology & Clinical Research, Baltimore: Nae-Yuh Wang, PhD; Christine M. Mitchell, ScM; Thelma Grace; Patricia Bayton.

Psychometrics Center, Nicklaus Children’s Research Institute, Miami: Alexandra Quittner, PhD.

Executive Committee, Laurie S. Eisenberg, PhD (chair); Alexandra L. Quittner, PhD; Ann Geers, PhD; Nae-Yuh Wang, PhD; Christine M. Mitchell, ScM.

Dr. Cejas is on the AG Bell Board of Directors, MED-EL pediatric advisory board, and consults with ASHA, and has a research agreement and consultancy with Advanced Bionics. Ms. Mitchell has received support from Advanced Bionics through a research contract to her institution. The other authors do not have any conflicts of interest with regard to this study.

Address for correspondence: Ivette Cejas, PhD, The Barton G Kids Hear Now Cochlear Implant Family Resource Center, University of Miami Ear Institute, 1120 NW 14th Street, CRB 5th Floor, Miami, FL 33136. E-mail:

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