Prelingually deaf children with cochlear implants (CIs) have about 2 to 5 times more risk for delays in specific domains of executive functioning (EF) than normal-hearing (NH) children, with about 25% to 40% of children with CIs showing delays in specific EF subdomains. This chapter reviews the rationale and evidence for two theoretical approaches to explaining this elevated risk for EF delay: language-focused approaches and biopsychosocial systems theories, such as the auditory neurocognitive model. Research supporting language-focused approaches, which attribute risk of EF delays entirely to language delays, has significant limitations. Furthermore, results from an extensive data set of EF outcomes in CI users are inconsistent with language-focused approaches. In contrast, biopsychosocial systems theories, which attribute risk for EF delay to a system of factors, including auditory experience, language, family environment/experiences, fluid intelligence, and psychosocial influences, provide the strongest evidence and potential for explaining EF delays and outcomes in children with CIs.
Speech Intelligibility and Psychosocial Functioning in Deaf Children and Teens with Cochlear Implants
