Examining the impact of cochlear implantation on the early gross motor development of children with a hearing loss.

Abstract

As deaf children are now implanted at a very early age, the influence of a cochlear implant (CI) on the early motor development of children with a hearing loss becomes relevant. Forty-eight children with a hearing loss were included in this controlled prospective follow-up study and were subdivided into a CI group (n = 23) receiving a CI during the follow-up period and a control group (n = 25) receiving no CI during the follow-up period. All children were assessed around the ages of 6 (T1), 12 (T2), 18 (T3), and 24 (T4) months with a motor test battery consisting of the Peabody Developmental Motor Scales-2 (PDMS-2), Alberta Infant Motor Scales (AIMS) (only at T1 and T2), and Ghent Developmental Balance Test (GDBT) (only at T3 and T4). In addition, collic vestibular-evoked myogenic potential testing was performed in all children. Group differences in PDMS-2 Gross Motor Quotient (GMQ), Fine Motor Quotient, AIMS z score, and GDBT z score were analyzed using Linear Mixed Model (LMM) analysis for repeated measures. For PDMS-2 GMQ, the LMM revealed significant effects for group (p = 0.04), test moment (p < 0.001), and for the interaction between these two factors (p = 0.035). Contrasts indicated that the CI group showed a greater deterioration in PDMS-2 GMQ between T2 and T3 compared with that showed by the control group (p = 0.002). The LMM for PDMS-2 Fine Motor Quotient and AIMS z score showed no significant effects. For GDBT z score, the LMM pointed out significant effects for group (p = 0.013) and test moment (p < 0.001), but no significant interaction between these two factors. Contrasts indicated that the CI group performed significantly weaker than the control group at both test moments (T3 and T4; all p < 0.012) and that both groups showed a significant recovery in GDBTz scores between T3 and T4 (all p < 0.012). This study shows that the trajectory of gross motor development can be changed in children with a hearing loss after a cochlear implantation. Implanted children show a drop in their gross motor performance within the age range of 6 to 18 months, at which period the majority of the implantations took place, with a tendency of recovery toward the age of 2 years. However, longer follow-up will be necessary to trace whether the implanted children catch up their motor delay in comparison with nonimplanted children with a hearing loss at later age.