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ffect outcome was found in the complex needs group (35% vs 8%). Our study suggests that children with complex needs have comparable long-term QoL scores to those without and seem to particularly benefit in the domains of learning and emotion. Complications are higher in this group and there remains an increased risk of further development of medical conditions following early implantation, which may influence progress. Our study suggests that children with complex needs have comparable long-term QoL scores to those without and s