Objective-To examine the results of health-related quality of life questionnaire scores from profoundly deaf children fitted with at least one cochlear implant and compare responses to normal hearing age mates and to their parents.Study design-Cross sectional study utilizing a generic quality of life questionnaire designed to be completed by both parents and children independently of each other. Setting-Questionnaires completed at various summer camps designed for children with cochlear implants in Texas and Colorado.Subjects and Methods-Eighty-eight families from 16 states were divided in to two subgroups by age of cochlear implantation: an 8-11 year old group and one 12-16 year old group. The KINDL R Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents was distributed and participants completed the questionnaire independently from their participating family member.Results-CI users in both age groups scored similarly to their normal hearing peers and their parents. Younger CI users scored their family domain lower than their normal hearing peers. Teen CI users scored the school domain lower than their parents. Among CI participants, earlier implantation and longer cochlear implant use resulted in higher Quality of Life scores.Conclusion-Children with cochlear implants experience similar quality of life as normal hearing peers. Parents are reliable reporters on the status of their child's overall quality of life.
Objective-Children with hearing loss who use cochlear implants have lower quality of life (QoL) in social situations and lower self-esteem than hearing peers. The child's QoL has been assessed primarily by asking the parent rather than asking the child. This poses a problem because parents have difficulty judging less observable aspects like self-esteem and socio-emotional functioning, the domains most affected by hearing loss.Methods-This case-control study evaluated QoL in 50 preschoolers using a cochlear implant and their parents with the Kiddy KINDL R , an established QoL measure. Children's responses were compared to a hearing control group and correlated with demographic variables. We used a questionnaire for parents and a face-to-face interview with children. T-tests were used to compare (a) paired parent-child ratings and (b) children with cochlear implants versus normal hearing. Spearman rank correlations were used to compare QoL with demographic variables.Results-Children using cochlear implants rated overall QoL significantly more positively than their parents (M D = 4.22, p=.03). Child rating of QoL did not differ significantly by auditory status (cochlear implant (82.8) vs. hearing (80.8), p=0.42). Overall QoL correlated inversely with cochlear implant experience and chronologic age, but did not correlate with implantation age.Conclusions-Preschool children using cochlear implants can assess adequately their own QoL, but parents afford valuable complementary perspective on the child's socio-emotional and physical well-being. Preschool children using cochlear implants rate overall QoL measures similar to hearing peers. A constellation of QoL measures should be collected to yield a better understanding of general QoL as well as specific domains centered on hearing loss.
Parents of children and adolescents with CIs rate overall HRQoL positively across psychosocial domains. Significantly less positive ratings of education and effects of implantation may result from limited access to CI-related accommodations and varying parent expectations, warranting further exploration to maximize psychosocial and performance outcomes in pediatric CI users.
Nearly one third of school-age children report being bullied, primarily enduring teasing or rumors. Children with hearing loss (HL) are at increased risk of victimization due to being “different” from the general population. This project assesses effects of auditory status on bullying by comparing incidence and type of bullying in 87 youth and adolescents with HL (7–18 years) to published national data from peers in the general population. All participants wore auditory technology (i.e., hearing aids or cochlear implants), communicated orally, and participated in mainstream education. Each participant completed the 2009 National Crime Victimization Survey’s School Crime Supplement. Adolescents with HL endured significantly higher incidence of bullying versus the general population (50.0% vs. 28.0%), particularly for exclusion (26.3% vs. 4.7%) and coercion (17.5% vs. 3.6%). Children younger than 12 years with HL report lower rates of bullying (38.7%) than adolescents with HL, but rates did not differ significantly. Future research should explore risk and protective factors for peer victimization in youth and adolescents with HL to reduce long-term consequences on quality of life.
Children with hearing loss are at risk for lower self-esteem due to differences from hearing peers relative to communication skills, physical appearance, and social maturity. This study examines the influence of generic factors unrelated to hearing loss (e.g., age, gender, temperament) and specific factors associated with hearing loss (e.g., age at identification, communication skills) on how children with hearing loss wearing cochlear implants or hearing aids appraise self-esteem. Fifty children with hearing loss wearing cochlear implants or hearing aids participated (Mean age: 12.88 years; mean duration of device use: 3.43 years). Participants independently completed online questionnaires to assess communication skills, social engagement, self-esteem, and temperament. Children with hearing loss rated global self-esteem significantly more positively than hearing peers, t = 2.38, p = .02. Self-esteem ratings attained significant positive correlations with affiliation (r = .42, p = .002) and attention (r = .45, p = .001) temperaments and a significant negative association with depressive mood (r = − .60, p < .0001). No significant correlations emerged between self-esteem and demographic factors, communication skills, or social engagement. Because successful communication abilities do not always co-occur with excellent quality of life, clinicians and professionals working with children with hearing loss need to understand components contributing to self-esteem to improve identification, counseling, and external referrals for children in this population.
SRI-Q allows tracking of global development of speech recognition over time as children progress through a hierarchy of speech perception measures and complements the more detailed assessments obtained from individual tests within the hierarchy.
This report provides an overview of many research projects conducted by the Dallas Cochlear Implant Program, a joint enterprise between The University of Texas at Dallas, The University of Texas Southwestern Medical Center and Children’s Medical Center. The studies extend our knowledge of factors influencing communication outcomes in users of cochlear implants. Multiple designs and statistical techniques are used in the studies described including both cross sectional and longitudinal analyses. Sample sizes vary across the studies and many of the samples represent large populations of children from North America. Multiple statistical techniques are used by the team to analyze outcomes. The team has provided critical information regarding electrode placement, signal processing, and communication outcomes in users of cochlear implants.
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