Comparison of Clinician Versus Parental Perspectives of Outcomes in Cochlear Implantees: A South Indian Experience.

Abstract

Outcomes of cochlear implantation (CI) are generically assessed using standard validated measures like CAP, SIR, MAIS and MUSS scales. Although this reflects the improvement in auditory verbal skills among the implantees with habilitation over one year, the overall perception of their skill development may vary between the parents of these children and the clinicians who provide the habilitation. This study aimed to compare the CAP and SIR scores sequentially over habilitation and further analyzes the correlation between clinician assessment (with CAP/SIR scores) and parental perspective (with MAIS/MUSS scores), at the end of one year of habilitation. 388 children aged 1-6years who underwent unilateral CI were included in the study. Their baseline CAP and SIR scores were recorded post implantation. All children received 1year of intensive auditory verbal therapy and their 12month CAP, SIR, MAIS and MUSS scores were then recorded. The baseline CAP/SIR scores were compared with 12month CAP/SIR scores and then their 12month CAP/SIR scores were correlated with 12month MAIS/MUSS scores respectively. There was significant difference between baseline and the 12month CAP/SIR scores (p < 0.001). There was strong positive correlation between CAP and SIR scores after 12months of habilitation (r = 0.7), while there was moderate positive correlation between CAP and MAIS scores (r = 0.59) and between SIR and MUSS scores (r = 0.49) respectively. Though the parents note significant improvement in child's communication abilities, the parental perspective of final outcomes does not always match with the clinician's assessments at the end of habilitation, as highlighted by the moderate correlations. A more precise method of holistic assessment is lacking currently and stands warranted.