Parental decision-making in considering cochlear implant technology for a deaf child

Abstract

Objectives: Advances in cochlear implant (CI) technology have increased the complexity of treating childhood deafness. We compare parental decision-making, values, beliefs, and preferences between parents of eligible and ineligible children in considering cochlear implants. Methods: Surveys were obtained from 83 hearing parents of deaf children. A subset of 50 parents also underwent semi-structured interviews. Nine hypothetical outcomes, ranging from mainstream success to poor mainstream outcome were created to measure parents’ overall preferences and preference for specific outcomes for their child who is deaf. Results: Among parents of eligible children ( n=50), approximately 2/3 considered implantation ( n=33). The other 1/3 did not consider implantation. Parents who were eligible but did not consider implantation placed significantly lower priority on mainstream success over bilingual success ( P<0.03), and on the child’s ability to speak versus sign ( P<0.02). They also showed significantly higher concerns on the cost of services in general and on the availability of resources offered at the local school district (both P<0.05). Parents of ineligible children ( n=30) rarely considered implantation, even if they showed similar aspirations in mainstream outcomes ( P=0.003). Semi-structured interview data supported these findings. Conclusions: The decision to consider cochlear implantation is strongly influenced by the eligibility and by professionals’ recommendations. However, for some parents, the decision goes beyond eligibility and is determined by parental preferences, goals, values, and beliefs. This highlights the importance of careful audiologic evaluation and professionals’ awareness of and sensitivity to parental goals, values, and beliefs in evaluating the child’s candidacy.