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Executive functions in preschool and school-age cochlear implant users: do they differ from their hearing peers? A systematic review and meta-analysis

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Abstract

Purpose

Executive functions (EF) play a fundamental role in planning and executing goal-driven behaviours. The purpose of this systematic review and meta-analysis was to investigate EF skills mastered by preschool/school-age cochlear implanted children (CIC) without morpho-functional abnormalities and to compare their outcomes with typically hearing children (THC).

Methods

Bibliographic search for observational studies of any language/date up to 16 December 2022 was performed with the following electronic databases: PubMed, Scopus, and Web of Science. After removal of duplicates, 2442 records were subjected to a three-stage screening process and 83 potentially eligible articles were identified. A total of 15 studies was included in the final analysis: 9 articles directly meeting the eligibility criteria plus 6 more studies thanks to the authors sharing their data set, specifically for participants who met present inclusion criteria.

Results

Meta-analysis showed a statistically significant difference only for verbal short-term memory, whereas group differences for visuospatial short-term memory and verbal/visuospatial working memory were not significant. For fluency skills, meta-analysis revealed statistical significance for the semantic fluency task but not for the rapid naming test. Qualitative analysis reflected group similarities in flexibility but CIC’s difficulties in auditory attention/planning skills. Controversial findings for inhibitory control skills were observed.

Conclusions

EF performance comparisons between CIC and THC show inter-skill and inter-test variances. Due to the paucity of existing studies, present findings should be interpreted with caution. Future research in this domain is strongly recommended.

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Data availability statement

The data sets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Sense Organs, Sapienza University of Rome, Rome, Italy

    Maria Nicastri, Laura Ranucci, Ilaria Giallini, Antonio Greco & Patrizia Mancini

  2. Department of Audiology, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey

    Hilal Dincer D’Alessandro

  3. Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy

    Valentina Baccolini, Giuseppe Migliara, Antonio Sciurti & Corrado De Vito

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  1. Maria Nicastri
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Correspondence to Hilal Dincer D’Alessandro.

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Nicastri, M., Dincer D’Alessandro, H., Baccolini, V. et al. Executive functions in preschool and school-age cochlear implant users: do they differ from their hearing peers? A systematic review and meta-analysis. Eur Arch Otorhinolaryngol 281, 579–600 (2024). https://doi.org/10.1007/s00405-023-08260-x

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