Behavioral and electrophysiological changes following an auditory-cognitive telerehabilitation program in children with cochlear implants.

BACKGROUND

Children with cochlear implants (CIs) may continue to experience auditory-cognitive difficulties that affect everyday listening. Telerehabilitation may increase access to auditory training, but evidence combining behavioral and electrophysiological outcomes remains limited. This study characterized pre-to-post behavioral and neural changes over an eight-week auditory-cognitive telerehabilitation period in children with CIs and normal-hearing (NH) peers.

METHODS

Thirty children aged 7-12 years participated in this quasi-experimental pre-post study: 15 bilateral CI users and 15 age-matched normal-hearing peers. All participants completed an 8-week auditory-cognitive telerehabilitation program (İŞİTGEL). Behavioral outcomes included simple auditory reaction time and Test of Attention in Listening measures, including attend-frequency and attend-location reaction times, involuntary orienting, and conflict resolution. Electrophysiological outcomes were assessed using auditory P300 latency and amplitude. Cognitive and language measures were used to characterize baseline performance and support sensitivity analyses.

RESULTS

Significant main effects of time were found for simple reaction time, attend-frequency reaction time, and attend-location reaction time, reflecting faster behavioral responses over the study period.P300 latency also decreased significantly, whereas P300 amplitude did not change. Sensitivity analyses adjusting for baseline nonverbal intelligence and processing speed supported the robustness of the main behavioral and electrophysiological findings.

CONCLUSIONS

Across the eight-week study period, both CI and NH groups showed faster behavioral responses and shorter P300 latency These findings support the feasibility of multimodal outcome assessment in pediatric auditory rehabilitation. Because no untreated control group was included, the observed changes cannot be attributed specifically to İŞİTGEL. Larger randomized controlled trials are needed to determine treatment-specific effects.