Outcome Data Controversy

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For the past dozen years or so, outcome data for children with cochlear implants have moved from case studies showing considerable promise to both summative and evaluative data for dozens of children with profound hearing loss, including those with congenital deafness. The population of students with implants has grown steadily in schools that emphasize auditory/oral education and may constitute as many as one-half of the children currently enrolled in those programs. Part of the impetus for this trend may be the outcome research showing that many children with multichannel cochlear implants outperform children with profound hearing losses who are considered to be very good hearing aid users on a variety of speech perception and speech and language production tasks.7'16'17 This research is generally in a quantitative style and provides answers about changes in discrete test performance both pre-and postimplant. Efforts to examine the question of improvement in quality of life, as well as in social communication, have been developed through rating scales such as the Meaningful Auditory Integration Scale (MAIS), reported by Robbins et al.18 These data are generally positive but, because the subjects are drawn from families who are satisfied with their children's postimplant progress and are motivated to cooperate with researchers, interpretation of these results as applied to all children with congenital deafness must be cautious. It is more difficult to identify and report on children who do not make progress or who are not using the implant for a variety of reasons.9 Parents should be made aware that there are always two sides to the outcome question, particularly if the child is congenitally deaf.

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