Educational and Employment Achievements in Prelingually Deaf Children Who Receive Cochlear Implants

Objective: To investigate the educational and employment achievements of prelingually deaf children who undergo cochlear implantation. Design: Prospective study. Data were examined within groups defined by current age and additional disabilities. Multivariate analyses were used to identify variables influencing grade failure and communication mode. Setting: Tertiary referral center. Participants: One hundred prelingually deaf children who received cochlear implants before 6 years of age and who also had at least 4 years of follow-up. Intervention: Interview of parents using a standardized questionnaire. Main Outcome Measures: The type of schooling, form of communication, employment status, age at which the child learned to read and write, number of grade failures, and educational support required. Results: Mainstream schooling, regardless of educational level, was the standard experience for children without additional disabilities (16 of 24 [67%] in the 12- to 15-year age group to 20 of 24 [83%] in the 8- to 11-year age group). Four of 8 participants older than 18 years (50%) had a university-level education; the remainder had vocational training. Delayed reading and writing skills were experienced by 19 of 74 participants (26%) and, depending on the age group, 42% to 61% of participants (10 of 24 in the 8- to 11-year age group to 11 of 18 in the 16- to 18-year age group) had failed a grade. The number of grade failures was associated with communication mode at the time of the survey. Age at implantation, preoperative communication mode, and educational support influenced the final communication mode. In children with additional disabilities, the level of academic achievement and employment status varied. Conclusions: Despite significant differences in the grade failure rate between the children with cochlear implants and the general population, the participants in the present study ultimately achieved educational and employment levels similar to those of their normal-hearing peers. To minimize these delays and improve academic success in mainstream education, early oral education and early cochlear implantation are important.