Brief Assessment of Parental Perception (BAPP): Development and validation of a new measure for assessing paediatric outcomes after bilateral cochlear implantation.

OBJECTIVE: In 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. DESIGN: A 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 SAMPLE: Children from 14 UK implant centres were recruited into the study; data were available for 410 children one year post-implantation. RESULTS: The 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. CONCLUSION: Simultaneous and sequential cochlear implants have a positive impact on the quality of life of deaf children.

Factors associated with poor use of sequential bilateral cochlear implants in young people: a preliminary audit of poor users.

Six cases of poor sequential bilateral cochlear implant use (partial and complete non-use) were explored through a semi-structured interview, as part of a service evaluation and development audit to improve the quality of a paediatric implant service for sequential users. Themes associated with poor use include: (1) appearance issues, (2) unrealistic expectations of both the benefits and the challenges of adjustment, (3) poor personal motivation for the implant and for engagement in rehabilitation, and (4) dislike of the sound. Feedback from young people highlighted the importance of careful counselling about their expectations of sequential implantation, outcomes and challenges, systemic support and self-directed rehabilitation.

Children's experience of tinnitus: a preliminary survey of children presenting to a psychology department.

Tinnitus has been much researched within adult populations with consideration of prevalence as well as the impact of tinnitus on individual's lives. Although the literature highlights the prevalence of tinnitus in children, there is little information on its effects from a psychological perspective. This small-scale preliminary study looked at 24 children (50% with normal hearing and 50% with a hearing loss) who presented to the Psychology Department with troublesome tinnitus. In line with adult studies, preliminary results suggested that tinnitus can have as marked an effect on children's lives as it is reported to have on adults. Insomnia, emotional distress, listening and attention difficulties are the main psychological factors associated with tinnitus in children. These, in turn, may have an effect upon their school performance. Differences were found between children with normal hearing and those with some degree of hearing loss. Overall, children with normal hearing found tinnitus more troublesome and presented with higher levels of anxiety than those with some level of hearing impairment. The present study suggests that children who complain of tinnitus should be taken seriously. In terms of management, individual intervention packages were found to be useful in alleviating anxiety and other associated factors. Recommendations are made on areas for future research.

Study of written communication between general practitioners and departments of child psychiatry.

Previous studies have pointed to the general dissatisfaction with written communication between general practitioners and medical specialists, in terms of quality and usefulness to both groups. This study examined the letters of referral from general practitioners to two child psychiatry departments and the replies of the psychiatric staff, and looked at the information exchanged in the light of the needs of both groups. It was concluded that the requirements of both psychiatric staff and general practitioners were being met to a limited extent, but that there was room for improvementon both sides.