Cochlear Implantation: Role of Language, Income, and Ethnicity

Abstract

Objective: To compare postcochlear implantation (CI) speech perception (SP) outcomes between a non-English speaking ethnic minority study group and an English speaking ethnic majority control group. Method: We performed a retrospective case-control study at an academic tertiary care children’s hospital. Records were reviewed of 49 children who underwent CI from February 2005 to September 2011. Children with abnormal cognitive function (n = 12), postsurgical complications (n = 1), or incomplete SP testing (n = 24) were excluded. The remaining 12 cases (implantation age 1-10 years; mean, 4.3 years) were reviewed for language, income, ethnicity, and SP scores. Their scores were compared to those from the Childhood Development after Cochlear Implantation (CDaCI) study. The CDaCI is a demographically balanced and multicenter-based pediatric cohort from which publications are beginning to define normative post-CI SP outcomes. Both groups had equivalent neurological status and age. Results: Of our 12 children, 7 were Hispanic, 2 white, 2 multi-ethnicity, and 1 Russian. Four were non-English speaking, 5 spoke English as a second language, and 7 were bilingual. Three received bilateral CI. Early Speech Perception (ESP) scores were collected at 6 and 12 months. At both follow-up intervals the study group performed significantly worse than the control group. (6-month P =.048, 12-month P = .01) Conclusions: This study suggests that among pediatric CI recipients, those from predominantly non-English speaking, socioeconomically disadvantaged backgrounds develop SP at slower than normal rates. Future interventions should be directed at overcoming these obstacles.