Cochlear Implantation in Children with Autism Spectrum Disorder: A Narrative Review

Background/Objectives: Cochlear implantation (CI) represents a well-established intervention for the management of severe to profound sensorineural hearing loss. The co-occurrence of severe hearing loss and Autism Spectrum Disorder (ASD) presents unique diagnostic and therapeutic challenges that significantly impact post-implantation outcomes. This review aims to synthesize the current literature on cochlear implantation in children with Autism Spectrum Disorder (ASD), including diagnostic, audiological, rehabilitative, and functional outcome considerations. Methods: A structured search of PubMed and Scopus was performed for English-language articles published between January 2000 and January 2026, focusing on audiological assessment, rehabilitation challenges, multidisciplinary management, and post-implant functional outcomes in this population. Results: The findings synthesized in this review suggest that cochlear implantation in children with Autism Spectrum Disorder must be interpreted within a broader communicative-ecological framework rather than through auditory metrics alone. These findings highlight a multidimensional model of post-implant outcomes, shaped by the dynamic interplay between auditory access, social engagement, family context, and language-learning environments. Conclusions: Most children with ASD and severe-to-profound hearing loss show improvements in speech perception and production after cochlear implantation, although outcomes are highly variable. A multidisciplinary approach, through coordinated collaboration among specialists, enhances family engagement, optimizes compliance with care plans, and ultimately contributes to improved clinical and developmental outcomes. ASD should not be considered a contraindication for CI; however, careful individual assessment, realistic parental counseling, and a multidisciplinary approach availability to evaluation and rehabilitation are essential.