Case studies reveal significant deficits in IQ and adaptive functioning in bilingual children with IDD, indicating the need for multilingual assessment strategies.
Objective The neuropsychological assessment of intellectual developmental disorder (IDD) in children with single sided deafness (SSD) resulting from microtia and aural atresia in genetic disorders is a complex process. Indeed, this process becomes more challenging when evaluating children from other linguistic groups given that language barriers may further exacerbate communication difficulties, particularly in bilingual or non-native English-speaking children. Method A case series of two patients will be presented where IDD was previously missed by their clinical and educational teams. Case 1 is an 11-year-old, right-handed, bilingual Hispanic male with a history of behavioral difficulties. Case 2 is a 12-year-old, right-handed, trilingual male with a history of DiGeorge Syndrome and developmental delays. Both cases had microtia, aural atresia, hemifacial microsomia, and utilized a bone-anchored hearing aid (BAHA). The referrals were for academic concerns. They both completed a comprehensive neuropsychological evaluation with gold standard measures (e.g., WISC-V, WIAT-4). Results Both children exhibited well-below average IQ and adaptive functioning deficits leading to a diagnosis of IDD, likely due to syndromic and genetic concerns. In both cases, the cognitive deficits observed could not be attributed to the SSD or to issues with language proficiency. Conclusion Targeted bilingual assessment is crucial for accurately understanding a child’s cognitive profile, particularly in children with SSD. Assessing in only one language can lead to misinterpretation of results, contributing to missed diagnoses. These cases highlight how IDD was overlooked in children with SSD, emphasizing the need for implementing multilingual evidence-based neuropsychological strategies.
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Magana et al. (2025) studied this question.
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