The Communicative benefits of cochlear implantation for children with hearing loss and autism spectrum disorder: a review

Introduction: It has been suggested that autism spectrum disorder (ASD) occurs more frequently in children with hearing loss than in the general population. However, little is known about effective intervention for children who have this dual diagnosis. This review of the literature examined the communicative benefits of audiological intervention (in the form of cochlear implantation) for these children. Materials and methods: A literature search of 15 databases was conducted, which identified 46 peer-reviewed journal articles that described communication skills in children with a dual diagnosis of hearing loss and ASD. From this set, three articles that reported both pre- and post-cochlear implantation data were selected for review. A search of references cited in these and other papers reporting outcomes for children with hearing loss and additional disabilities resulted in the addition of four more articles to the review set. Results: Speech perception and/or language outcomes were available for 14 individual children and two small groups (comprising 4 and 8 participants respectively). Improvements from pre- to post-implant were observed for both groups, but significant for only one. Improvements were also reported for 11 of the 14 individual children, with greater improvements seen in children using some spoken language at the post-implant assessment compared to those using gesture only. Parent feedback regarding the benefits of cochlear implants was generally positive. Conclusion: Children with a dual diagnosis of severe-to-profound hearing loss and ASD appeared to benefit from audiological intervention with cochlear implants, although individual child outcomes were variable and studies did not include “no intervention” control groups. Future research would be strengthened through the use of more effective assessment procedures, and the inclusion of further information on children’s cognitive ability and the nature and severity of their ASD.