Parent-perceived challenges related to the pediatric cochlear implantation process and support services received in South Africa.

OBJECTIVE: To determine and describe parent-perceived challenges related to the pediatric cochlear implantation process and support services received. METHOD: A multicenter survey study across six cochlear implant (CI) programs in South Africa (SA) was conducted. The study sample included 82 parents of pediatric (≤18 years) CI recipients with at least 12 months CI experience. A self-administered questionnaire was developed for the purpose of this study, exploring parental challenges regarding the CI process, education of their implanted children and the support services received. RESULTS: The financial implications of cochlear implantation, including CI device maintenance, were identified by parents as the most prominent challenge. Financing issues were the highest scoring reason that attributed to the delay between diagnosis of hearing loss and cochlear implantation, as well as the greatest barrier to bilateral implantation. Parent-perceived educational challenges included finding adequate educational settings specific to the individual needs of their child and a shortage of trained teachers equipped to support children with CIs. The presence of one/more additional developmental conditions and grade repetition were associated with more pronounced parent-perceived educational challenges. Parents considered speech-language therapy as the most critical support service for their implanted children to achieve optimal outcomes, while parent guidance was indicated to be the most critical support service required for parents of pediatric CI recipients. CONCLUSION: A greater understanding of parent-perceived challenges will guide CI professionals to promote optimal outcomes, evidence-based service delivery and on-going support to pediatric CI recipients and their families. Study results imply a call for action regarding financial and educational support for pediatric CI recipients in SA.

Predictors of health-related quality of life in adult cochlear implant recipients in South Africa.

OBJECTIVE: To identify and describe predictors of health-related quality of life (HRQoL) outcomes for adult cochlear implant (CI) recipients in South Africa. DESIGN: A retrospective study of adult CI recipients was conducted and cross-sectional HRQoL outcome data were added at the time of data collection, using the Nijmegen Cochlear Implant Questionnaire (NCIQ). Twenty-two potential predictive factors were identified from the retrospective dataset, including demographic, hearing loss, CI and risk-related factors. Multiple regression analyses were performed to identify predictor variables that influence HRQoL outcomes. STUDY SAMPLE: The study sample included 100 adult CI recipients from four CI programs, implanted for at least 12 months. RESULTS: History of no tinnitus prior to CI, bilateral implantation and mainstream schooling were strongly predictive of better overall HRQoL outcomes. Factors such as age, age at implant, gender, onset of hearing loss, duration of CI use and presence of risk factors did not predict HRQoL scores. CONCLUSION: A range of significant prognostic indicators were identified for HRQoL outcomes in adult CI recipients. These predictors of HRQoL outcomes can guide intervention services' informational counselling.

Predictors of pediatric cochlear implantation outcomes in South Africa.

OBJECTIVE: To identify and describe predictors of pediatric cochlear implantation outcomes in a South African population. METHODS: A retrospective study of 301 pediatric cochlear implant (CI) recipients from five CI programs was conducted and cross-sectional outcome data were added at the time of data collection. Twenty potential prognostic factors were identified from the retrospective dataset, including demographical, CI, risk and family factors. Multiple regression analyses were performed to identify predictor variables that influence outcomes in terms of auditory performance (CAP scores), speech production (SIR scores), communication mode and educational placement. RESULTS: Although implanted children within this sample did not have equal opportunity to access a second implant, bilateral implantation was strongly predictive of better auditory performance and speech production scores, an oral mode of communication and mainstream education. NICU admittance/prematurity were associated with poorer auditory performance and speech production scores, together with a higher probability for non-oral communication and non-mainstream education. The presence of one or more additional developmental condition was predictive of poorer outcomes in terms of speech production and educational placement, while a delay between diagnosis and implantation of more than one year was also related to non-mainstream education. Ethnicities other than Caucasian were predictive of poorer auditory performance scores and a lower probability for mainstream education. CONCLUSION: An extensive range of prognostic indicators were identified for pediatric CI outcomes in South Africa. These predictive factors of better and poorer outcomes should guide pediatric CI services to promote optimal outcomes and assist professionals in providing evidence-based informational counseling.