Children with cochlear implants: Cognitive skills, adaptive behaviors, social and emotional skills Andrea De Giacomo a , Francesco Craig a , Alessandra D’Elia b , Francesca Giagnotti b , Emilia Matera a , Nicola Quaranta b, * a Child Neuropsychiatry Unit, Department of Basic Medical Science, Neuroscience and Sense Organs, Hospital Polyclinic of Bari, University of ‘‘Aldo Moro’’ Bari, Piazza Giulio Cesare 1, Italy b Otolaryngology Unit, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari ‘‘A. Moro’’, Italy 1. Introduction The auditory function has a crucial role in the main stages of child development. The importance of early intervention for children with hearing loss has been demonstrated persuasively in areas including speech perception, production and spoken language, cognitive skills, adaptive behavior, social and emotional outcomes that may drastically limit the quality of life of deaf people [1]. The Joint Committee on Infant Hearing [2] has advocated hearing screening for all newborns, with the goal of confirming hearing loss before 3 months of age and beginning hearing rehabilitation before 6 months of age. Several issues have a bearing on decisions about the beneficial effect of very early CI for the development of age-appropriate spoken language in infants and children. Previous studies reported that neural organization and/or structure related to speech perception/production were affected by the length of auditory deprivation, but the extent and the potential reversibility of changes in the neural architecture are presently not completely known [3]. Children with CI showed distinctive developmental patterns in basic academic skills such as language and reading compared both to children with normal hearing and to children with severe deafness, who have not been implanted [4,5]. These studies provided evidence that by decreasing the age at implantation better outcomes could be obtained in terms of spoken language and speech perception. Thus implantation should ideally occur not only early enough for normal language progress to be achieved, but also before delays could be established. The implicit corollary from all these observations is that cochlear implants (CIs) should be fitted in infants/children as soon as a correct diagnosis of severe to profound hearing loss has been obtained. Indeed the significant advantage of early interven- tion in children with significant hearing loss was demonstrated in literature. Whereas a great deal of research has been devoted to understanding hearing and spoken language development in deaf children with CIs, very little is currently known about general cognitive development after CI. Studies of some aspects of cognitive capabilities comparing children with normal hearing and children with hearing impairment revealed that the latter experience difficulties at the cognitive level [6–8]. Non-verbal intelligence is meant as fluid intelligence, consid- ered the truest measure of a person’s innate ability. It has been International Journal of Pediatric Otorhinolaryngology 77 (2013) 1975–1979 ARTICLE INFO Article history: Received 29 July 2013 Received in revised form 12 September 2013 Accepted 15 September 2013 Available online 9 October 2013 Keywords: Cochlear implant Deaf children Nonverbal intelligence Adaptive behavior Social and emotional skills ABSTRACT Objective: The aim of this study is to examine cognitive skills, adaptive behavior, social and emotional skills in deaf children with cochlear implant (CI) compared to normal hearing children. Methods: The study included twenty children affected by profound hearing loss implanted with a CI compared to 20 healthy children matched to chronological age and gender. Results: Results of this study indicated that 55% of children with CI showed a score in the normal range of nonverbal intelligence (IQ > 84), 40% in the borderline range (71 < IQ < 84) and 5% were in mild range (50 < IQ < 70). No significant differences were found after comparison with normal hearing children. Children with CI reported more abnormalities in emotional symptoms (p = .018) and peer problems (p = .037) than children with normal hearing. Age of CI was negatively correlated with IQ (p = .002), positively correlated with emotional symptoms (p = .04) and with peer problems (p = .02). Conclusions: CI has a positive effect on the lives of deaf children, especially if it is implanted in much earlier ages. ß 2013 Elsevier Ireland Ltd. All rights reserved. * Corresponding author at: Otolaryngology Unit, Department of Neuroscience and Sensory Organs, Hospital Polyclinic of Bari, University of ‘‘Aldo Moro’’ Bari, Piazza Giulio Cesare 1, Italy. Tel.: +39 080 5478850; fax: +39 080 5478752. E-mail address: nicolaantonioadolfo.quaranta@uniba.it (N. Quaranta). Contents lists available at ScienceDirect International Journal of Pediatric Otorhinolaryngology journal homepage: www.elsevier.com/locate/ijporl 0165-5876/$ – see front matter ß 2013 Elsevier Ireland Ltd. All rights reserved. http://dx.doi.org/10.1016/j.ijporl.2013.09.015