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EBP Compendium: Summary of Systematic Review

New Zealand Ministry of Health
The Effectiveness of Early Cochlear Implantation for Infants and Young Children with Hearing Loss

Ali, W., & O'Connell, R. (2007).
NZHTA Technical Brief, 6(5).

Indicators of Review Quality:

The review addresses a clearly focused question Yes
Criteria for inclusion of studies are provided Yes
Search strategy is described in sufficient detail for replication Yes
Included studies are assessed for study quality Yes
Quality assessments are reproducible Yes

Description: This is a systematic review of peer-reviewed literature examining the effectiveness of cochlear implantation among children at a young age (under 2 years old) compared with implantation of children at an older age.

Question(s) Addressed:

What is the effectiveness of cochlear implantation at a younger age compared to implantation at a later age on audiological performance, communication, education, and quality of life?

Population: Children (2 years of age and older)

Intervention/Assessment: Cochlear implantation

Number of Studies Included: 16

Years Included: 1996 - 2007



  • Treatment
      • Cochlear Implants: Age/Duration of Implantation
        • “In general, implantation at a younger age improves the effectiveness of cochlear implantation in terms of audiological performance and communication outcomes. This is particularly evident when cochlear implantation occurs before the age of 24 months, which is more effective than implantation after 24 months. “…a cochlear implant should not be assumed to be an appropriate intervention for each profoundly deaf child under this age. It is essential to perform prior assessment of the child and family so as to explore factors that may affect the outcomes and explain the implications to the parents” (p. iv).
        • “It is possible that those implanted at an older age (above 24 months) develop at a slower rate but eventually reach equivalent developmental milestones” (p. iii). “It is not clear whether implantation prior to the age of 12 months improves effectiveness when compared to implantation after 12 months of age” (p. iii).The harms and benefits (e.g., surgical outcomes and complications) other than effectiveness compared to an older age of implantation will need to be considered.
        • "It is unclear what effect cochlear implantation at a younger age has on long-term outcomes such as educational achievement, and quality of life” (p. iii).

Keywords: Hearing Loss, Deafness, Cochlear Implants

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Added to Compendium: March 2012

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