Cognitive development in children with cochlear implants
Reviewed by Yovina Khiroya-Morjaria

This systematic review investigates the comparative cognitive outcomes in children using bilateral versus unilateral cochlear implants, as well as those using cochlear implants versus hearing aids. The review synthesises findings from 30 studies involving a total of 11,986 children and follows PRISMA guidelines, enhancing its methodological transparency and reliability. The review addresses three core questions, each comparing different hearing device types or implantation strategies. Its conclusions have meaningful clinical implications. Notably, the findings suggest that bilateral cochlear implants offer superior cognitive outcomes compared to unilateral implants. Similarly, children with cochlear implants generally outperform those with hearing aids in cognitive tasks – especially when implantation occurs early. However, even with these interventions, children with cochlear implants still tend to fall behind their normal-hearing peers in some cognitive domains. One of the most striking findings is the importance of early diagnosis and intervention. Implantation before the age of two appears to significantly enhance outcomes in both language development and executive functioning. A potential limitation of the review is its lack of attention to the geographical or linguistic context of the included studies. Cognitive outcomes can vary depending on language input and cultural expectations, which may influence the generalisability of the results. This is an area worth acknowledging or exploring further in future work. In my opinion, this is a timely and well-structured review that addresses key questions in paediatric audiology and cognitive development. It provides a robust and accessible synthesis for clinicians, researchers and policymakers working with children with hearing loss. From personal experience, the emphasis on early intervention resonates with current best practices in audiology. The review reinforces the importance of timely identification and individualised management plans, especially when considering cochlear implantation.

Cognitive development in children using cochlear implants and hearing aids compared to normal-hearing peers: A systematic review.
Al-Momani M.
HEAR BALANCE COMMUN
2025;23(1):1–9.