{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T13:08:47Z","timestamp":1793452127103,"version":"4.5.0"},"reference-count":32,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"\n \n <\/jats:sec>\n \n BACKGROUND AND OBJECTIVES<\/jats:title>\n Infants with profound hearing loss are typically considered for cochlear implantation. Many insurance providers deny implantation to children with developmental impairments because they have limited potential to acquire verbal communication. We took advantage of differing insurance coverage restrictions to compare outcomes after cochlear implantation or continued hearing aid use.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n Young children with deafness were identified prospectively from 2 different states, Texas and California, and followed longitudinally for an average of 2 years. Children in cohort 1 (n = 138) had normal cognition and adaptive behavior and underwent cochlear implantation. Children in cohorts 2 (n = 37) and 3 (n = 29) had low cognition and low adaptive behavior. Those in cohort 2 underwent cochlear implantation, whereas those in cohort 3 were treated with hearing aids.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Cohorts did not substantially differ in demographic characteristics. Using cohort 2 as the reference, children in cohort 1 showed more rapid gains in cognitive, adaptive function, language, and auditory skills (estimated coefficients, 0.166 to 0.403; P \u2264 .001), whereas children in cohort 3 showed slower gains (\u22120.119 to \u22120.243; P \u2264 .04). Children in cohort 3 also had greater increases in stress within the parent-child system (1.328; P = .02), whereas cohorts 1 and 2 were not different.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Cochlear implantation benefits children with deafness and developmental delays. This finding has health policy implications not only for private insurers but also for large, statewide, publicly administered programs. Cognitive and adaptive skills should not be used as a \u201clitmus test\u201d for pediatric cochlear implantation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2021-055459","type":"journal-article","created":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T08:09:03Z","timestamp":1653379743000},"source":"Crossref","is-referenced-by-count":18,"title":["Cochlear Implants for Deaf Children With Early Developmental Impairment"],"prefix":"10.1542","volume":"149","author":[{"given":"John S.","family":"Oghalai","sequence":"first","affiliation":[{"name":"aCaruso Department of Otolaryngology\u2013Head and Neck Surgery, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Bortfeld","sequence":"additional","affiliation":[{"name":"bDepartment of Psychological Sciences, University of California, Merced, Merced, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi M.","family":"Feldman","sequence":"additional","affiliation":[{"name":"cDepartment of Pediatrics, Stanford University, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niharika","family":"Chimalakonda","sequence":"additional","affiliation":[{"name":"dThe Doctors Clinic, Port Orchard, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Emery","sequence":"additional","affiliation":[{"name":"eTexas Children\u2019s Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet S.","family":"Choi","sequence":"additional","affiliation":[{"name":"aCaruso Department of Otolaryngology\u2013Head and Neck Surgery, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane","family":"Zhou","sequence":"additional","affiliation":[{"name":"aCaruso Department of Otolaryngology\u2013Head and Neck Surgery, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2022,5,24]]},"reference":[{"key":"2023110214105762800_B1","unstructured":"Centers for Disease Control and Prevention\n . 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