Socioeconomic status and pediatric cochlear implant usage during COVID-19.

OBJECTIVE: COVID-19 (COVID) delayed access to speech and hearing services. The objective of this study was to identify interactions between socioeconomic status (SES) and cochlear implant (CI) usage during COVID. METHODS: Consecutive pediatric patients (age 0-17) with CI and audiology visits between 2019 and 2022 at a tertiary care children's hospital were reviewed. Age, sex, race, insurance type, and proxy measures for SES using zip code were recorded. Hours spent with CI on and in different listening environments were compared between pre-COVID (1/1/2019-12/31/2019), COVID (4/1/2020-3/31/2021), and most recent (6/1/2021-5/31/2022) time periods. RESULTS: Most patients were male (32/59, 54 % ears of 48 patients) and White, non-Hispanic (45/59, 76 %). Median age at implant was 2.0 years (range:0.6-12.2). There were no significant differences in hours spent with CI on during COVID compared with pre-COVID. However, children spent more time listening to louder noises (70-79 dB and ≥80 dB) recently compared with during COVID (p = 0.01 and 0.006, respectively). During COVID, children living in areas with greater educational attainment showed smaller reductions in total hours with CI on (ß = 0.1, p = 0.02) and hours listening to speech in noise (ß = 0.03, p = 0.005) compared with pre-COVID. In the most recent time period, children of minority race (ß = -3.94 p = 0.008) and those who were older at implant (ß = -0.630, p = 0.02) were more likely to experience reductions in total hours with CI on compared with during COVID. CONCLUSION: Interventions which mitigate barriers of implant use and promote rich listening home-environments for at risk populations should be implemented during challenging future social and environmental conditions.

Audiovisual Interactions in Stereo Sound Localization for Individuals With Unilateral Hearing Loss.

This study investigated the effects of unilateral hearing loss (UHL), of either conductive or sensorineural origin, on stereo sound localization and related visual bias in listeners with normal hearing, short-term (acute) UHL, and chronic UHL. Time-delay-based stereophony was used to isolate interaural-time-difference cues for sound source localization in free field. Listeners with acute moderate (<40 dB for tens of minutes) and chronic severe (>50 dB for more than 10 years) UHL showed poor localization and compressed auditory space that favored the intact ear. Listeners with chronic moderate (<50 dB for more than 12 years) UHL performed near normal. These results show that the auditory spatial mechanisms that allow stereo localization become less sensitive to moderate UHL in the long term. Presenting LED flashes at either the same or a different location as the sound source elicited visual bias in all groups but to different degrees. Hearing loss led to increased visual bias, especially on the impaired side, for the severe and acute UHL listeners, suggesting that vision plays a compensatory role in restoring perceptual spatial symmetry.