Osiągnięcia szkolne na zakończenie nauki w szkole podstawowej użytkowników implantów ślimakowych a wiek, w którym przeprowadzono operację

Introduction: Increasing knowledge about the influence of stimulation on formation of new neuronal connections in the child’s brain and about the effect of early sensory deprivation on changes in functioning of the auditory pathway in congenital or early deafness has brought about gradual lowering of the age of eligibility for cochlear implantation. Early auditory stimulation with a cochlear implant reduces reorganisation of the deprived and immature hearing area in the brain, while stimulating the development of hearing. Cochlear implantation performed in the period of the highest plasticity of the brain facilitates auditory development similar to a normal level, and thus the development of speech and language at similar stages as in a hearing child. The results of studies associating early age of cochlear implantation with positive influence on speech and language rehabilitation encourage the anticipation of an improved level of academic performance of children provided with cochlear implants early, as hearing allows a student to acquire knowledge. The aim of the study was to investigate discrepancies in school performance at the end of primary education, as observed between children with prelingual hearing loss of a different severity (deafness, profound hearing loss and partial deafness), against the age upon cochlear implantation. Material and methods: The study group comprised 160 children with prelingual hearing loss, each provided with a cochlear implant at the Institute of Physiology and Pathology of Hearing, and excluded children with multiple disabilities, as defined in the Act on Educational System. School performance was measured against the results of the Primary School Final Exam. Furthermore, the study material included the results of authors’ own questionnaire (distributed by post), and the medical record of each subject. The questionnaire was composed of a content-related part and a demographics part. The content-related part was completed by parents based on the PSFE results they received from the Central Examination Commission, and contained questions about the overall score of their child in the exam and sub-scores in reading, writing, reasoning, using the information and practical application of knowledge. Results: For the purpose of this study, the material was divided into 4 groups, with respect to the age of a given child upon implantation: 1) 1.5–2.4 years, 2) 2.5–4.4 years, 3) 4.5–6.9 years and 4) 7–13.4 years. Further analyses revealed statistically significant discrepancies in overall scores and in reading sub-scores, relative to the age upon cochlear implantation. A post-hoc analysis showed that children implanted between 1.5 and 2.4 years of age obtained better overall scores and reading sub-scores compared to those implanted between 4.5 and 6.7 years of age. No discrepancies between other groups were observed. Conclusions: In children with prelingual deafness or profound hearing loss, the age at the moment of cochlear implantation is a factor diversifying school performance at the end of primary education. Children with partial deafness implanted after 7 years of age can obtain good academic results, despite relatively late implantation. Positive effects of cochlear implantation performed by 2 years of age on school performance, as demonstrated in the following study, substantiate the need of early medical intervention with cochlear implant in children with prelingual profound hearing loss or total deafness.