Research in Developmental Disabilities 58 (2016) 104–113 Contents lists available at ScienceDirect Research in Developmental Disabilities Benefits of simultaneous bilateral cochlear implantation on verbal reasoning skills in prelingually deaf children Evi Jacobs a , Margreet C. Langereis a,∗ , Johan H.M. Frijns b , Rolien H. Free c , Andre Goedegebure d , Cas Smits e , Robert J. Stokroos f , Saskia A.M. Ariens-Meijer a , Emmanuel A.M. Mylanus a , Anneke M. Vermeulen a a Department of Otorhinolaryngology, Head and Neck Surgery, Hearing and Implants, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands b Department of Otorhinolaryngology, Head and Neck Surgery, Leiden Institute for Brain and Cognition, University Medical Center, Leiden, The Netherlands c Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Groningen, Groningen, The Netherlands d Department of Otorhinolaryngology, Erasmus Medical Center, Rotterdam, The Netherlands e Department of Otorhinolaryngology, Audiology, VU University Medical Center, Amsterdam, The Netherlands f Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands a r t i c l e i n f o Article history: Received 21 December 2015 Received in revised form 29 August 2016 Accepted 30 August 2016 Available online 5 September 2016 Keywords: Hearing impairment Cochlear implant Children Verbal intelligence Speech perception a b s t r a c t Background: Impaired auditory speech perception abilities in deaf children with hear- ing aids compromised their verbal intelligence enormously. The availability of unilateral cochlear implantation (CI) auditory speech perception and spoken vocabulary enabled them to reach near ageappropriate levels. This holds especially for children in spoken language environments. However, speech perception in complex listening situations and the acqui- sition of complex verbal skills remains difficult. Bilateral CI was expected to enhance the acquisition of verbal intelligence by improved understanding of speech in noise. Methods: This study examined the effect of bilateral CI on verbal intelligence of 49 deaf children (3;5–8;0 years). Relations between speech perception in noise, auditory short- term memory and verbal intelligence were analysed with multiple linear regressions. In addition, the interaction of educational setting, mainstream or special, on these relations was analysed. Results: Children with bilateral CI obtained higher scores on verbal intelligence. Signifi- cant associations were present between speech perception in noise, auditory short-term memory and verbal intelligence. Conclusion: Children with simultaneous bilateral CIs showed better speech perception in noise than children with unilateral CIs, which mediated by the auditory short-term memory capacity, enhanced the ability to acquire more complex verbal skills for BICI children in mainstream education. © 2016 Elsevier Ltd. All rights reserved. What this paper adds? The essential contribution of this study is that it identifies the link between auditory speech perception skills in challeng- ing listening environments and complex verbal cognition. Furthermore, the interaction between educational setting and ∗ Corresponding author. E-mail address: anneke.vermeulen@radboudumc.nl (A.M. Vermeulen). http://dx.doi.org/10.1016/j.ridd.2016.08.016 0891-4222/© 2016 Elsevier Ltd. All rights reserved.