Early Deafness, Cochlear Implants Associated With Cognitive Delays in Children

William Kronenberger, Ph.D., HSPP Professor and Director, Section of Psychology Acting Vice Chair of Administration Department of Psychiatry Indiana University School of Medicine Riley Child and Adolescent Psychiatry ClinicMedicalResearch.com Interview with:
William Kronenberger, Ph.D., HSPP
Professor and Director, Section of Psychology
Acting Vice Chair of Administration
Department of Psychiatry
Indiana University School of Medicine
Riley Child and Adolescent Psychiatry Clinic

MedicalResearch: What are the main findings of the study?

Dr. Kronenberger: The main findings of the study are that children with cochlear implants had two to five times the risk of delays in executive functioning compared to children with normal hearing.  Executive functioning is the ability to regulate and control thinking and behavior in order to focus and achieve goals; it is important for everything from learning to social skills.  The areas of executive functioning that were most affected in children with cochlear implants were working memory, controlled attention, planning, and concept formation.  Approximately one-third to one-half of the sample of children with cochlear implants had at least mild delays in these areas, compared to one-sixth or fewer of the normal-hearing sample.  We think that reduced hearing experience and language delays cause delays in executive functioning to occur at higher rates in children with cochlear implants.

MedicalResearch: Were any of the findings unexpected?

Dr. Kronenberger: From a mainstream, historical perspective of hearing loss and cochlear implantation, the results are unexpected because the focus on delays for children after cochlear implantation has been on hearing and spoken language.  We are now discovering that there are additional downstream effects of early deafness and spoken language delays experienced by children with cochlear implants, such as delays in executive functioning.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Kronenberger: The primary message is that we need to be aware of the risk of executive functioning delays in children with cochlear implants so that we can detect these delays early and intervene to reduce or eliminate them.  It has been well established that cochlear implants provide access to sound that for many deaf children has a marked positive impact on functioning, such as allowing the development of spoken language skills and enhancing interaction with the hearing environment.  However, like many medical devices, cochlear implants require some learning and therapies to allow for the use of their full potential.  It is widely accepted, for example, that speech and language therapies are needed and beneficial for children with cochlear implants.  Our findings indicate that like speech and language functioning, executive functioning is also delayed following cochlear implantation.  Therefore, early detection and intervention to reduce executive functioning delays can further enhance adjustment after cochlear implantation.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Kronenberger: We need to learn more about what causes executive functioning delays in children following cochlear implantation so that we can address the fundamental causes of the delays, and we need to develop and test therapies to improve executive functioning after cochlear implantation.  Our research team is currently engaged in research in both of those areas.

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