There are relatively few clinical psychologists working in paediatric cochlear implant centres in the UK and in this respect we lag behind other countries such as the USA and The Netherlands. In an effort to promote the added value our profession can offer teams, the clinical psychologists working in paediatric CI centres have put together good practice guidelines. This article outlines the rationale for putting together the guidelines, highlights the unique contribution clinical psychologists can offer, outlines the evidence base for psychological input in this clinical population, and offers a fictional case study for illustration.
ObjectiveIn contrast to previous clinical practice, current guidelines recommend bilateral cochlear implantation in children, resulting in a cohort of children who initially received one implant, but have subsequently had a second, contralateral implant. This study aimed to explore satisfaction and quality of life in children implanted simultaneously or sequentially. DesignA novel measure of satisfaction and quality of life following paediatric bilateral cochlear implantation (the Brief Assessment of Parental Perception; BAPP) was developed and preliminary validation undertaken as part of a large, national project of bilateral implantation. Children's parents completed the measure yearly for up to three years following implantation. Study SampleChildren from 14 UK implant centres were recruited into the study; data were available for 410 children one year post-implantation. ResultsThe BAPP was found to have good face and convergent validity, and internal consistency. Results indicated very high levels of satisfaction with the devices, and improvements in quality of life. However there was evidence that children implanted sequentially were less willing to wear their second implant in the first two years than those children receiving simultaneous implants. ConclusionSimultaneous and sequential cochlear implants have a positive impact on the quality of life of deaf children. 2 IntroductionIn 2009, the United Kingdom National Institute for Health and Care Excellence (NICE) recommended that all suitable children be offered simultaneous bilateral cochlear implants (NICE, 2009). NICE also advised that children who were unilaterally implanted prior to the guidance should be offered a second implant if appropriate. When the guidance was published, NICE recommended that an audit of bilateral cochlear implantation be conducted. A consortium of 14 cochlear implant centres in the United Kingdom was formed to identify appropriate assessment measures to assess the benefit children receive from bilateral cochlear implants. This National Paediatric Bilateral Project (NPBP) consortium identified a number of clinical outcomes to be assessed: localisation of sound, speech recognition in quiet and background noise, speech production, listening, vocabulary, surgical data including complications, and parental perceptions of quality of life (Cullington, Bele, Brinton et al, 2013). One existing measure of quality of life (QoL), the Paediatric Cochlear Implantation: Parent Outcome Profile (POP; O'Neill, Lutman, Archbold, et al, 2004) was adopted for the project, the results of which, along with the clinical outcomes, are reported elsewhere. However, the need for an additional, brief, QoL of life measure was identified, and the development of this, along with selected results obtained from the project, form the focus of this paper. Quality of Life AssessmentQuality of life measures take two primary forms; generic and condition specific. Although there are a range of generic paediatric QoL measures available, they may not be suit...
Overall the group format and psychological focus were well received in this typically surgical setting and emphasized the importance of involving the young person in the decision-making process. This positive feedback also opens up the opportunity to use a group format in other assessment processes.
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