Abstract
Background/Objectives: Receptive vocabulary is essential for children's language, academic, and cognitive development. While cochlear implants (CIs) help children with severe to profound hearing loss develop spoken language, their vocabulary skills often fall behind their typical hearing (TH) peers, although early implantation and auditory-verbal therapy (AVT) can help narrow this gap. Children with CIs and other developmental difficulties face additional challenges, but can still progress, with outcomes depending on the disabilities' type and severity. Limited research exists on Arabic-speaking children with CIs, where cultural factors may delay intervention, and outcomes vary widely. It remains unclear how well these children develop receptive vocabulary compared to hearing peers and which factors influence their progress. Methodology: A multicenter, cross-sectional study in six GCC hospitals compared 103 children with CIs to a control group of 94 children with TH. Children with CIs were divided into those with and without additional difficulties. Receptive vocabulary was evaluated utilizing the Peabody Picture Vocabulary Test, Fifth Edition. Results: Children with CIs in the GCC scored lower (mean 89.5; SD = 20.5) than the TH control group (mean 104; SD = 16.8). Children with CIs without additional difficulties (mean 97.7; SD = 18.8) scored similarly to TH, while children with CIs and additional difficulties scored significantly lower (mean 76.7; SD = 15). Age at switch-on and presence of additional difficulties significantly affected receptive vocabulary outcomes. Conclusions: Children with CI who have no additional disabilities can reach receptive vocabulary levels similar to typical hearing peers, while those with extra difficulties show very diverse outcomes and continue to face challenges.