The Effect of Saccular Dysfunction on Non-Verbal Cognition and Auditory Perceptual Outcome Measures in Pediatric Cochlear Implantees

Abstract

Vestibular impairment affects major attributes of cognition, and cognition is pivotal to speech-language development. Therefore, cochlear implant (CI) recipients having vestibular deficits might have deficient cognitive abilities and thereby reduced post-implantation outcomes. The present study aimed to compare non-verbal cognition of perdiatric unilateral cochlear implantees with saccular dysfunction (CI-SD), without saccular dyfunction (CI-NSF) and typically developing children (TDC). Additionally the study compared the auditory perceptual outcome measures, speech perception, and their growth between two time points in children with CI. The study included 30 children, 10 each in CI-NSF, CI-SD, and TDC groups. Kaufman Assessment Battery for Children-II (KABC-II) was used for cognitive assessment. Further, the children with CI were assessed using the Revised Categories of Auditory Performance (R-CAP) Scale, Infant-Toddler Meaningful Auditory Integration Scale (IT- MAIS), Integrated Scales of Development (ISD), and Modified Early Speech Perception Test in Kannada (MESP-K) at two time points separated by 3 months of intensive auditory training. The TDC and CI-NSF group performed significantly better than the CI-SD group on the overall non-verbal cognitive abilities. No significant difference was observed in the overall cognitive abilities of CI-NSF and TDC groups. The performance on R-CAP, IT-MAIS, ISD, and MSEP- K was better in the CI-NSF group than the CI-SD group on both the time points. The average growth rate for R-CAP was significantly better in CI-NSF group than CI-SD group, while relative growth rate was significantly better only for speech domain of ISD in CI-SD group. Though not significant, all the average and relative growth rates were greater in the CI-NSF group, except for the expressive and speech domain of ISD. Growth rates for MESP-K total did not show statistically significant difference between the two groups. Therefore, intact saccular function after CI is pivotal for cognitive performance, speech performance and overall outcomes.