Benefit of Cochlear Implantation in Children with Multiple-handicaps: Parent's Perspective (original) (raw)
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Parental perception of benefits from cochlear implantation in children with multiple impairments
INTRODUCTION Multiple impairments/ disabilities means concomitant impairments, the combination of which causes such severe educational problems that they cannot be accommodated in special education programs solely for one of the impairments. Multiply impaired children are identified as having a special nature of multiple handicaps such that their effects are not simply additive, but rather they interact with each other in ways not thoroughly understood to create a complex array of secondary consequences. Approximately 30-40 per cent of children with sensorineural hearing loss (SNHL) have additional ABSTRACT Background: Cochlear implantation (CI) in children with hearing impairment and an additional disability was not included in candidacy criteria earlier. With advances in technology and by taking into consideration the rehabilitation-pedagogic point of view, it is made possible to implant such children. In the Indian context, very few studies have documented benefits of CI in children with multiple impairments, whether measured or perceived by parents or families. Considering the number of children with additional impairments being implanted, it will be useful to conduct such a study, aimed at obtaining parents' perceptions about benefits of cochlear implants in children with multiple impairments. Methods: The present study is a survey of 31 children (3-15 years) using CI and having multiple disabilities. An ICF based questionnaire was developed and used to record parents' perception of benefits in terms of language development, speech perception, social interaction, communication skills (non-verbal and verbal), education, general tasks and demands, interpersonal interactions and relationships and family dynamics. Results: Benefits were reported by all parents in all the domains i.e. listening, communication, learning and applying knowledge, interpersonal interactions and relationships and environmental factors. However, more parents reported consistent benefits in listening and interpersonal interactions. Most parents reported overall benefits from cochlear implantation in their children with multiple impairments. Conclusions: Results of this study can be helpful in estimating outcomes from CI in children with multiple impairments. Such information can be used during pre-CI counselling to facilitate development of realistic parental expectations about the benefits of CI in their children with multiple impairments. As results are based on parental reports, overestimation of perceived benefits may be present in some instances.
Perceived qualitative benefits of cochlear implants in children with multi-handicaps
International Journal of Pediatric Otorhinolaryngology, 2005
Objective: To determine families' perceived benefits of cochlear implants in children with multiple-handicaps. Methods: Parents/guardians of a child with a cochlear implant for at least 3 months, under the age of 18 years and had least one additional disability were recruited for participation through rehabilitation therapists. Families who did not have a child enrolled in therapy at the study center were contacted by mail. Families were asked a number of open-ended and close-ended questions. Interviews were audiotaped and transcribed, with answers to open-ended questions coded by themes. Results: We interviewed 19 families of 20 children and included 15 families of 16 children who had had at least 6 months of cochlear implant experience for this study. The mean time between implantation and study was 3 years (S.D. AE 2.2) with a range of 0.5-8 years. Children were highly compliant in wearing their device. Sixty-eight percent (11/16) of the children were enrolled in additional therapies beyond speech and aural rehabilitation therapies. Fifty percent of families (8/16) indicated they had no obstacles to accessing therapies. Insurance was the most common barrier to accessing therapies (18% of respondents). All children made communication progress post-implant as described by their families. All families felt that the cochlear implant team provided enough information prior to receiving the implant to help families make the appropriate decision about implanting their child. All families said that if
Factors influencing the quality of life of children with cochlear implants
Brazilian Journal of Otorhinolaryngology, 2020
Introduction: The multidimensional impact of hearing loss on the various demands of life in children using cochlear implants is represented by variables that can influence the hearing, language and quality of life outcomes of this population. Objective: To evaluate the factors influencing the quality of life of children with cochlear implantation, considering age, hearing age, age at evaluation, hearing skills, spoken language, family degree of receptiveness, schooling and socioeconomic status of the parents. Methods: Participated 30 children using cochlear implants, aged 6 to 12 years and their respective parents. The children were evaluated by the categories auditory performance, by language category, and by the children with cochlear implants: perspectives parents questionnaire. Parents were assessed by the family involvement scale. Results: The cochlear implant impacted the quality of life of the children, with more significant results on the increase of the social relations domain and the decrease of the family support domain. Overall, the increase of the age in the evaluation, better hearing and language skills, the mother's level of schooling and the family receptiveness correlated with the quality of life of children with cochlear implants. Conclusion: The influencing factors that correlated with the quality of life of the implanted children were the child's older age at the evaluation, the better hearing and language skills, the mother's level of schooling and the family receptiveness.
Pediatric Health, Medicine and Therapeutics, 2015
The number of children with hearing loss with additional disabilities receiving cochlear implantation has increased dramatically over the past decade. However, little is known about their auditory and speech and language development following implantation. The purpose of this review is to evaluate the effects of cochlear implantation on the most common genetic and developmental disorders in children with hearing loss. Benefits of cochlear implantation for children with autism spectrum disorder, developmental delay, CHARGE syndrome, cerebral palsy, learning disorders, Usher syndrome, Waardenburg syndrome, and attention deficit/ hyperactivity disorder are reviewed. Our review indicates that children with hearing loss and additional disabilities benefit from cochlear implantation, especially when implanted early. Thus, early interventions seem as important for these children as for deaf children without additional disabilities. Comparisons of outcomes across these disabilities indicate that children with little to no cognitive impairment (eg, Waardenburg sydrome, attention deficit hyperactivity disorder) have better outcomes than those with greater deficits in intellectual functioning (eg, autism, CHARGE syndrome). In addition, parents of children with hearing loss and additional disabilities report higher levels of parenting stress and greater child behavior problems than those without comorbid diagnoses. However, these parents are as sensitive when interacting with their children as parents with typically developing children using cochlear implantation. Given these results, it is critical to evaluate these children's developmental milestones to provide early implantation and intervention, appropriately counsel families regarding realistic expectations for the implant, and facilitate family adaptation.
Children with complex needs and cochlear implants: The parent's perspective
Cochlear Implants International, 2013
Objectives: This study qualitatively explored parents' perspectives en their experiences of, access to, and outcomes from, cochlear implantation for their child with complex needs. Methods: Purposive sampling was used to recruit 10 parents of children with varying additional disabilities. The age range of the children was between 2 and 11 years at the time. A semi-structured interview format was used to collect data and the interviews were audio recorded and transcribed for analysis. Thematic content analysis was used to explore the data. Results: Individual themes were clustered together to form four main themes describing parents' perspectives and experience. The four main themes were: 'Assessment process', 'Reported benefits of cochlear implantation', 'Wearing the processor' and 'Educational issues'. Discussion: The findings from the study indicate how cochlear implantation was valued by the parents of children with complex needs. They appreciated changes in their child's communication and social changes where the child was more included in family life. Challenges relating to delays in the assessment process were reported. Similarly, the difficulties associated in accessing the technology were identified and perceived by some parents as discriminatory. Conclusion: Cochlear implantation has come a long way over the years. This study provides a useful insight into the issues raised by parents of deaf children with complex needs. A need for further research in this area of implantation was identified to ensure wider access to this technology for those who may benefit from it and to improve the implantation process for this group of children.
Parents Perceived Quality of Life for Children with Cochlear Implants
International Journal of Otolaryngology and Head & Neck Surgery
The purpose of the study is to identify the important aspects of quality of life assessed in children with cochlear implant. Parental Perspective questionnaire with modified in Bangla was used as a data collection tool in this study. Data was collected through face to face interview with 25 parents of children with Cochlear Implant (CI) attended at Bangabandhu Sheikh Mujib Medical University, Dhaka. Among 25 cochlear implant children, the boys (12) and girls (13) were nearly the same. Results indicated that the majority of the children had difficulties with communication with known people (48.00%) and before implantation children with CI obtained no benefit at all from hearing aids (76.00%). However, the research finding shows that they are largely satisfied with the outcomes from implantation. Improvement of social relationship, family well-being, within the family, educational condition, and self-reliance was satisfactorily reported by the parents. This study would help the clinician, speech pathologist, children and parents to raise awareness about the impact of CI and its treatment.
Quality of life of parents and siblings of children with cochlear implants
Journal of otology, 2019
This study examined the quality of life (QoL) of the parents and siblings of hearing-impaired children with cochlear implants (CIs). Design: This is a cross-sectional, questionnaire-based study. The questionnaire consists of three sub-domainsinteraction, emotional well-being and support for the hearing-impaired child and the overall QoL-and two open-ended questions for participants to provide comments and suggestions to enhance their family's QoL. A total of 63 questionnaires were e-mailed or mailed to families who met the inclusion criteria.
Factors that affect the social well-being of children with cochlear implants
Cochlear Implants International, 2008
The aim of the study was to identify factors associated with the level of social well-being for cochlear implanted children and to estimate effect-related odds ratios for the children's well-being. Another aim was to analyse associations between speech and language level and the level of social well-being. Data relate to 167 children with cochlear implants. In structural interviews, parents rated their children's level of social well-being regarding the degree of their child's personal-social adjustment. Five different factors were considered. Logistic regression models and proportional odds models were used to analyse the relationship between the considered factors and the assessments. The analyses showed that the communication mode at home was the most highly associated factor. A statistically signifi cant association was found between the level of social well-being and speech understanding, speech production and vocabulary. Children who were exposed to a spoken language had considerably better odds of having a high level of social well-being compared to children with a mixture of spoken language and sign support or sign language. Copyright
The children speak: An examination of the quality of life of pediatric cochlear implant users
Otolaryngology - Head and Neck Surgery, 2010
To examine the results of health-related qualityof-life questionnaire scores from profoundly deaf children fitted with at least one cochlear implant (CI) and to compare their responses with those of normal-hearing mates of similar age and 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 CIs in Texas and Colorado. SUBJECTS AND METHODS: Eighty-eight families from 16 states were divided into two subgroups by age of cochlear implantation: an eight-to 11-year-old group and a 12-to 16-year-old group. The KINDL-R Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents was distributed, and CI participants completed the questionnaire independently of 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 compared with their normal-hearing peers. Teen CI users scored the school domain lower compared with their parents. Among CI participants, earlier implantation and longer CI use resulted in higher quality-of-life scores. CONCLUSION: Children with CIs experience quality of life similar to that of normal-hearing peers. Parents are reliable reporters on the status of their child's overall quality of life.