Measuring communicative performance with the FAPCI instrument: preliminary results from normal hearing and cochlear implanted children

Abstract

Objective: To develop preliminary "growth curves" of Functioning after Pediatric Cochlear Implantation (FAPCI) scores using a cross-sectional sample of normal hearing children and to compare these curves to trajectories of FAPCI scores in children receiving cochlear implants.

Methods: Quantile regression was used to develop growth curves from the FAPCI scores of a cross-sectional sample of 82 normal hearing children (age range 7 months-5 years). Trajectories of FAPCI scores from a longitudinal cohort of 75 children with cochlear implants (age range 1-5 years) were compared to these growth curves.

Results: FAPCI scores were positively associated with increasing age in normal hearing children with a rapid increase in scores observed at earlier ages followed by a plateau at age 3 years. FAPCI trajectories for cochlear-implanted children varied with age at implantation and did not reach a plateau until age 5-6 years.

Conclusion: Normal hearing children demonstrated increasing FAPCI scores with age, and these preliminary growth curves allow for the interpretation of a cochlear-implanted child's FAPCI scores in comparison to normal hearing children. Additional research using a larger, longitudinal cohort of normal hearing children will be needed to develop definitive normative FAPCI trajectories.

Figure 1

Cross-sectional FAPCI scores from 82 NH children. Solid line denotes the smoothed (lowess) average of FAPCI scores across age. FAPCI scores range from a minimum of 23 to a maximum of 115.

Figure 2

FAPCI growth curves derived from 82 NH children. FAPCI scores can range from a minimum of 23 to a maximum of 115. The solid line is the median, the long-dashed lines are the 25th and 75th percentiles, and the short-dashed lines are the 10th and 90th percentiles.

Figure 3

FAPCI score trajectories in CI children implanted at age <2 years (dashed) and age ≥2 years (solid) compared to growth curves from NH children.

Figure 4

Mean FAPCI trajectories for CI children implanted at age <2 years (dashed) and age≥2 years (solid) compared to NH children. FAPCI scores range from a minimum of 23 to a maximum of 115.

Figure 5

FAPCI trajectories for 2 hypothetical CI children (Child A [dashed] and Child B [solid line]). Both children are implanted at 18 months (arrow), and FAPCI scores are measured annually after implantation.