Habilitation developmental disorders and cochlear implantation ― communicative development with CI in a child diagnosed with intellectual disability and ASD―

Abstract

In this study, we present the case of a 13-year-old girl diagnosed with autism spectrum disorder and moderate intellectual disability before receiving cochlear implantation. The patient was diagnosed with hearing loss at 20 months of age and started wearing a hearing aid from 2 years and 1 month. Her eye contact was abnormal, facial expression was poor, and she showed remarkable hyperkinesia and strong preferences. She was diagnosed with ASD at 3 years and 9 months, entered a facility for ASD children from 3 years 11 months, and began sensory integrated occupational therapy. Her hearing ability worsened and she underwent CI surgery at 4 years 5 months. She frequently refused to wear the CI, and we carried out mapping and practices to keep her cochlear implant. Although attention to others was weak before surgery, her interpersonal relations developed as a result of being assigned to caretakers after surgery and wanting to play with their brother. She became used to wearing a CI processor at the age of 11, and her ability to understand letters also improved. Although she did not achieve acquisition of spoken language, she wrote words on request as a means of communication. At the age of 13, her responsiveness has improved such that she responds to questions with short sentences using letters. Since CI surgery was performed after diagnosis of ASD, caregivers' understanding of her and the CI was satisfactory. In addition to CI wearing training, our method of rehabilitation considering behavioral characteristics of ASD was effective for the development of communication.