Abstract

Sensorineural hearing loss (SNHL) in childhood significantly impacts development, yet cochlear implants (CIs) have revolutionized auditory rehabilitation. While their benefits for speech perception are established, their broader impact on emotional, cognitive, and mental development requires synthesis. This systematic review evaluated how cochlear implantation influence these developmental domains in children with SNHL compared to hearing aid users or normal-hearing (NH) peers. Following a systematic search of databases from 2010 to 2025, 15 studies were included. The evidence indicated that CIs, particularly when received early (before age 3-4 years), facilitate significant improvements, enabling cognitive and IQ scores comparable to NH peers. However, persistent challenges were evident in specific areas. Children with CIs often lag in social competence, prosocial behavior, and complex executive functions like verbal working memory and attention regulation. Key moderators of positive outcomes included early implantation, strong language proficiency, bilateral implantation, and high parental involvement and education. While emotional quality of life is often similar to peers, social quality of life remains lower, especially in special education settings. The findings suggested that CIs enabled remarkable developmental catch-up, but do not fully reach normalization in all domains. Therefore, a paradigmatic shift is needed towards holistic rehabilitation with a primary focus on social-pragmatic, executive, and emotional regulation alongside auditory-verbal training, so that children with CIs attain holistic well-being in addition to hearing.

Key words: Cochlear implants, child development, systematic review, neurocognitive outcomes, psychosocial functioning, language proficiency