Parent-reported quality of life in children with cochlear implants differs across countries

Abstract

Pediatric cochlear implantation affects communication skills and quality of life, specifically how children interact with others and feel about themselves. Numerous studies worldwide examine well-being among pediatric cochlear implant users, but none to date compare condition-specific quality of life across countries. This retrospective study compares parent-reported cochlear implant-specific quality of life summary data across 14 published studies spanning 11 countries and 9 languages. Sample size ranged from 7 to 370 participants, and children across studies varied in mean chronologic age (3.1–12.2 years), implantation age (1.5–4.6 years), and cochlear implant experience (1.3–8.2 years). Parents completed the Children with Cochlear Implants: Parental Perspectives (CCIPP) questionnaire, an instrument assessing parent-reported cochlear implant-specific quality of life, in their home language. Analysis of variance tests were run for each CCIPP subscale across studies using summary data to determine significant differences between published manuscripts. Across countries, parents of children with cochlear implants appraise communication, social relations, and self-reliance most positively, and the effects of implantation and supporting the child least positively. Cross-country analyses revealed a significant effect of study (country) on quality of life ratings in each domain, with the largest differences in the communication domain. Limited access to implant-related accommodations, cultural awareness of hearing loss, and varying parent expectations may explain country differences in parental ratings of quality of life. Culturally sensitive psychoeducation for the entire family may foster improved life satisfaction for pediatric cochlear implant users and their families.

Language Intervention Instead of Speech Intervention for Children With Cochlear Implants

“…Data on the quality of life of children with CIs and spoken language alone showed a positive impact of implantation on their communication, social relationships, self-reliance, confidence, and family well-being. Nevertheless, this positive impact is constrained, as the success of future education, further use of spoken language, and further support for a child remain parental concerns [109][110][111], indicating that the exclusive use of spoken language after cochlear implantation may still not be enough to meet developmental potential and parental expectations. Moreover, the general quality of life of children with CIs and their parents seems to be significantly lower than that of hearing children and their parents, as well as the care burden on parents of children with CIs, indicating that cochlear implantation does not necessarily eliminate psychosocial problems faced by these families [112].…”