Sound Opportunities: Factors That Impact Referral for Pediatric Cochlear Implant Evaluation.

OBJECTIVES/HYPOTHESIS: To identify barriers to and opportunities for referral among children who could be considered for cochlear implantation. STUDY DESIGN: Retrospective review. METHODS: Audiological and medical records were reviewed on all children who had diagnostic or hearing aid care through a statewide healthcare system over 5-year span to identify children who met newly established clinical cochlear implant (CI) referral criteria. Data were collected for 869 potential CI candidates regarding demographic, socio-economic, audiological, medical, and family factors that may influence referral. A binomial logistic regression was completed to investigate the potential contributions of these predictors toward referral for a CI evaluation. RESULTS: Children who met traditional candidacy criteria of severe-to-profound bilateral hearing loss were referred at very high rates, while nontraditional candidates were referred less frequently. Factors influencing referral included race, age, insurance source, hearing thresholds, audiologist, physician, and family request. CONCLUSIONS: Results suggest that bilateral traditional candidates are being referred at high percentages; however, current practices and trends in pediatric cochlear implantation should be shared with families and providers to increase referral rates for nontraditional candidates. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:E2904-E2910, 2021.