Parents Of Eligible Children Research Articles

Care of children with congenital rubella syndrome (CRS) in Indonesia.

Congenital rubella syndrome (CRS) is associated with severe birth defects, that lead to disability in later life. Hence, early detection and intervention are needed to prevent permanent disability and mortality in children with CRS. We evaluated the time to diagnosis or correction intervention related to survival rate using survival analysis. A retrospective cohort study was conducted to evaluate the follow-up of CRS-confirmed cases from 2011-2018 at a national referral hospital in Jakarta, Indonesia. Parents of eligible children who registered in the national CRS registry as laboratory-confirmed CRS cases were contacted through phone calls or home visits and interviewed about the current situation of their child's health. We also obtained clinical data from the medical records. Fifty children, age 4 to 14 years, identified with laboratory-confirmed CRS were included in this study. Half (54%) of these children were female. All were born from mothers with no previous rubella vaccination history. Ophthalmic abnormalities such as congenital cataracts (88%) were the most common birth defect. Multiple congenital abnormalities including congenital heart disease, ocular abnormalities, and auditory defects were identified in 52% of the children. Based on Kaplan-Meier analysis, 50% of children were diagnosed at four months. Ophthalmic corrections such as cataract surgery were performed earlier than heart or auditory correction, with 50% of children undergoing eye correction one month after the diagnosis. There is a vital need to implement CRS surveillance in Indonesia to know the burden of CRS and reinforce the preventive actions, including vaccination against rubella.

Hypnotherapy for procedural pain, itch, and state anxiety in children with acute burns: a feasibility and acceptability study protocol

BackgroundBurns and related procedures are painful and distressing for children, exposing them to acute and chronic sequelae that can negatively affect their physiological, psychological, and social functions. Non-pharmacological interventions such as distraction techniques are beneficial adjuncts to pharmacological agents for procedural pain, state anxiety, and itch in children with burns but have limitations (e.g. lack of research on burn-related itch, tailoring, and consensus on optimal treatment). Hypnotherapy is a non-pharmacological intervention that can be tailored for varied settings and populations with evidence of benefit for itch and superior effectiveness in comparison to other non-pharmacological interventions for children’s procedural pain and state anxiety. Thus, children with burns can benefit from hypnotherapy as an adjunct to pharmacological agents. Yet, in paediatric burns, rigorous studies of effectiveness are limited and no studies have been identified that screen for hypnotic suggestibility, an important predictor of hypnotherapy outcomes. Considering potential barriers to the delivery of hypnotherapy in paediatric burns, the proposed study will examine the feasibility and acceptability of hypnotic suggestibility screening followed by hypnotherapy for procedural pain, state anxiety, and itch in children with acute burns.MethodsAn observational mixed-methods feasibility and acceptability study will be conducted over 15 weeks. Eligible children (N = 30) aged 4 to 16 years presenting to a paediatric burns outpatient centre in a metropolitan children’s hospital in Australia with acute burns requiring dressing changes will be included. Eligible parents of children (N = up to 30) and clinicians who perform dressing changes (N = up to 20) will also be included. Child participants screened as having medium to high suggestibility as assessed by behavioural measures will receive hypnotherapy during dressing changes. A process evaluation will target feasibility and acceptability as primary outcomes and implementation (i.e. fidelity in delivery), reach, potential effectiveness, and adoption of evaluation procedures and intervention as secondary outcomes.DiscussionEthical approval was obtained from the Queensland Children’s Hospital and Health Service ethics committee. Results will be published in peer-reviewed publications and conference proceedings.The findings will guide the design of future trials on the effectiveness of hypnotherapy and inform the development of child-centred hypnotic interventions in children with burns.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12620000988954

Prevalence and associated risk factors for childhood strabismus in Lhasa, Tibet, China: a cross-sectional, school-based study

BackgroundTo estimate the prevalence of strabismus and associated risk factors among grade one school children in Lhasa, Tibet, China.MethodsThe Lhasa Childhood Eye Study (LCES) was a cross-sectional, school-based childhood study conducted in Grade one students from primary schools in Lhasa, Tibet, China. Comprehensive ophthalmic examinations and basic systemic examinations were evaluated. A questionnaire survey containing information about children, as well as parents’ information, was sent to the corresponding parents of eligible children. The prevalence of strabismus and its 95% confidence interval was estimated. Univariate and multivariate logistic regression analyses were conducted to determine the associated risk factors.ResultsA total of 1942 eligible grade one students were enrolled, of which 1856 participants completed all examinations. The average age was 6.83 ± 0.46 years, 53% of participants were boys and 1762 were the Tibetan Minority. Over all, the prevalence of strabismus was 68/1856 (3.7%) (95%CI: 2.81,4.52), with no difference between the ages, genders, ethnicities and body mass index, while tilting one’s head when writing may be a risk factor for strabismus (P = 0.004). Strabismus students had mean best corrected visual acuity of 0.16 ± 0.28(LogMAR), over 50% patients with esotropia were hyperopic, and participants who had stereopsis impairments showed a significant difference between esotropia and exotropia (P = 0.026).ConclusionsThe prevalence of strabismus in LCES was 3.7%, which is higher than previous reports from Chinese childhood epidemiology studies. Strabismus is a common contributing factor to amblyopia. Tilting one’s head when writing may be a risk factor. Esotropia is more likely to affect stereopsis and be associated with the refractive state of hyperopia.Trial registrationThe study has finished the clinical registration on Chinese Clinical Trial Registry. (http://www.chictr.org.cn, ChiCTR1900026693).

Asthma management in school: parents’ and school personnel perspectives

Objective: Effective asthma management at school can help students with asthma stay healthy, learn better and participate fully during their school day. This study sought to understand school-based asthma care from the perspective of parents and school personnel to improve asthma care at school. Methods: A cross-sectional study was conducted in Hartford, CT. School personnel from 59 schools and 322 parents/guardians were invited to participate. Four cross-sectional surveys using Likert-type scales assessed parental and school personnel satisfaction, confidence in managing asthma, policy awareness, management of asthma during physical activity, and perceived gaps surrounding school-based asthma care. Results: 263/322 (82%) eligible parents of children with asthma (mean age 8.5 ± 4.3, 56% Hispanic, 30% African American) completed surveys. Thirty six school nurses (62%), 131 teachers (8%), 14 coaches (14%), and 17 school principals (29%) participated. 90% of parents were satisfied with asthma management in school. School nurses were more aware of asthma policies than teachers (74% vs. 24%, p < 0.001). 34% of school nurses, 30% of teachers and 36% of coaches were unaware of asthma-related absences. 14% of physical education teachers/coaches reported no asthma training. Conclusion: In this convenience sample of parents and school personnel, parents reported overall satisfaction regarding the asthma care their children receive at school, yet a number of gaps pertaining to school-based asthma care were identified. Increased asthma training and enhanced communication among school personnel is needed to address these gaps. National guidelines and resources are readily available to improve asthma care at school.

Oral prednisolone for acute otitis media in children: protocol of a pilot randomised, open-label, controlled study (OPAL study)

BackgroundAcute otitis media (AOM) is an acute inflammation of the middle ear commonly found in children, for which antibiotics are frequently prescribed. However, antibiotics are beneficial for only one third of AOM cases, and then, with only modest benefit. Since antibiotic use leads to risk of side effects and resistance, effective alternative treatments are required. Corticosteroids are a candidate because of their anti-inflammatory effects, although evidence of their efficacy and harms is insufficient. Accordingly, we plan a large, rigorous clinical trial to test this. Initially, we will test pre-specified methods and procedures (including the overall process, resources, management, and scientific components) in a pilot study of corticosteroids for AOM, which will inform a future, definitive trial.MethodsThis is a pilot pragmatic, randomised, open-label, single-blind, controlled study of corticosteroids as either monotherapy or an addition to antibiotics in 60 children aged 6 months to 12 years with AOM in two cities (Jakarta and Bekasi) in Indonesia. We will randomise eligible children to prednisolone or control. We will also stratify by disease severity and randomise those with mild AOM to expectant observation plus prednisolone or observation alone and those with severe AOM to prednisolone plus antibiotic or antibiotic alone. Our outcomes are to determine (1) recruitment rates, (2) the success of the study procedures, (3) the ability to measure planned outcomes of the proposed main study, (4) the compliance to study visits and study medication, and (5) verification of the sample size calculation for the main study. We will also assess middle ear effusion using tympanometry as part of a mechanistic sub-study.DiscussionThis study will test all procedures in preparation for the main study, including several potential obstacles and challenges from the perspective of participating physicians, nurses, pharmacists, and the parents of eligible children. This information will be useful for developing strategies to overcome practical and procedural issues. This study may also provide information about the effects of corticosteroids on middle ear effusion in AOM.Trial registrationStudy registry number: ACTRN12618000049279. Name of registry: the Australian New Zealand Clinical Trials Registry (ANZCTR). Date of registration: 16 January 2018.

Cancer disclosure-account from a pediatric oncology ward in Egypt.

Informing the child about his/her diagnosis and treatment plan is essential; research has shown that it is related to the patient's quality of life and adherence to medication. For 7months during 2008 (February to September), 2 study-specific questionnaires were constructed and administered to 304 parents of children diagnosed with cancer at the Children's Cancer Hospital Egypt. Among the 313 eligible parents of children diagnosed with cancer, 304 (97%) answered the first questionnaire and 281 (92%) answered the second questionnaire. We found that nearly three-quarters (72%) of the parents had their child's cancer diagnosis communicated by the physician. Among the 72%, the rate of the children present with the parent or parents during the disease disclosure conversation was 39% (n=85/219). The majority of the children were in the age group 5-18years (55%). Our findings indicate that cancer disclosure at the Children's Cancer Hospital is to a certain degree common; yet even when disclosure does take place, it is mainly in the absence of the child. Moreover, the information provided during the conversation may not be fully comprehended by the parent or the child because of the physician's misleading use of terms when disclosing the disease. Therefore, better practice should be developed for disease disclosure, and proper communication should be established between the patients and the provider; patient autonomy should also have an influence in the clinical practice.

Children with congenital limb deficiency in Norway: issues related to school life and health-related quality of life. A cross-sectional study

Purpose: To describe clinical features, issues related to school life and health-related quality of life (HRQOL) for children with congenital limb deficiency (CLD) and compare these children to Norwegian school children on HRQOL.Method: Cross-sectional study. In 2010, a postal questionnaire, designed for this study and the Paediatric Quality of Life Inventory (PedsQL), was sent to 154 eligible parents of children with CLD, aged 6–18 years and registered at TRS National Resource Centre for Rare Disorders in Norway.Results: Response rate 44% (n = 67), median age 11 years, 42% were girls. Of the total group, 46 had unilateral upper limb deficiency (UULD) and 21 had multiple/lower limb deficiency (MLD/LLD). The most common UULD was below-elbow deficiency, of these, 65% used grip-improving devices, and 35% used prostheses. Children with UULD-reported PedsQL score similar to Norwegian schoolchildren (NSC). The MLD/LLD group was heterogeneous; most had below-elbow/knee deficiency. In this group, PedsQL scores were reduced for physical and social functioning compared with NSC. Compared with children with UULD, more children with MLD/LLD were restricted in participation because of pain and fewer participated in physical education with peers.Conclusions: Most children with CLD participated with their peers and managed well in everyday life. Children with MLD/LLD seemed to have more challenges than children with UULD. Approximately one-third of all the children had assistive devices and/or practical assistance in school.Implications for RehabilitationMost children with upper-limb deficiency (UULD) in Norway manage well in everyday life and have HRQOL equal to other Norwegian children. Many choose grip-improving devices instead of prostheses. Their preferences should be respected and taken into account as the need for new assistive devices arise.For children with pronounced disabilities, access to, and use of, assistive devices, adaptions and practical assistance may be important for participation. Cooperation with the child and the parents is necessary to find useful measures.Physical education and practical subjects may provide special challenges, both for children and their teachers. Children themselves often find good solutions and the tasks should be planned ahead in cooperation with them.

Long-Term Outcomes and Risk Factors Associated With Acute Encephalitis in Children.

Factors associated with poor outcomes of children with encephalitis are not well known. We sought to determine whether electroencephalography (EEG) findings, magnetic resonance imaging (MRI) abnormalities, or the presence of seizures at presentation were associated with poor outcomes. A retrospective review of patients aged 0 to 21 years who met criteria for a diagnosis of encephalitis admitted between 2000 and 2010 was conducted. Parents of eligible children were contacted and completed 2 questionnaires that assessed current physical and emotional quality of life and neurological deficits at least 1 year after discharge. During the study period, we identified 142 patients with an International Classification of Diseases 9th Revision diagnosis of meningitis, meningoencephalitis, or encephalitis. Of these patients, 114 met criteria for a diagnosis of encephalitis, and 76 of these patients (representing 77 hospitalizations) had complete data available. Forty-nine (64%) patients were available for follow-up. Patients admitted to the intensive care unit were more likely to have abnormal EEG results (P = .001). The presence of seizures on admission was associated with ongoing seizure disorder at follow-up. One or more years after hospitalization, 78% of the patients had persistent symptoms, including 35% with seizures. Four (5%) of the patients died. Abnormal MRI findings and the number of abnormal findings on initial presentation were associated with lower quality-of-life scores. Encephalitis leads to significant morbidity and death, and incomplete recovery is achieved in the majority of hospitalized patients. Abnormal EEG results were found more frequently in critically ill children, patients with abnormal MRI results had lower quality-of-life scores on follow-up, and the presence of seizures on admission was associated with ongoing seizure disorder and lower physical quality-of-life scores.

O-035 The Characteristics Of Children Identified With Parent Reported Diagnosed Developmental Difficulties Screened As Part Of An Autism Prevalence Study

Background and aims A protocol was developed to screen 7,951 children 6–11 years for Autism Spectrum Disorders (ASDs) enrolled at national schools in three regions (Galway, Waterford and Cork) in the Republic of Ireland. Methods A study booklet completed by parents of eligible children, including: demographics, developmental history, and a screening instrument, Social Communication Questionnaire – Lifetime Form (SCQ: Rutter et al ., 2003). Results Study booklets were primarily completed by children’s mothers 4,474, 86%. Thirteen percent 694 of primary caregivers reported developmental disorders. Of these 411, 59% had been diagnosed, 245, 35% undiagnosed 38, 5% or on a waiting list for assessment. Sixty six percent, 234 of these children’s parents expressed developmental concerns on or before the child’s fourth birthday. Awareness of developmental difficulties during early childhood was highest among the parents of children with a diagnosis of: ASD 48, 89%; Dyspraxia 48, 77%; ADHD 30, 71%. Significant differences in parental awareness were not observed for study children’s gender or age group. Neither was maternal awareness of difficulties in their child’s development and behaviour related to their level of education, social class, ethnic or cultural background or nationality. Conclusions Excluding developmental difficulties diagnosed at birth maternal concerns relating to children’s development was highest for children with a diagnosis of Autism Spectrum Disorders on or before the child’s fourth birthday. This is an important finding given that almost ½ of SCQ questions relate to children’s development at 4–5 years of age.

PO-0810 Parental Socio-economic Characteristics And Social Communication Questionnaire Scores For Primary School Children Screened As Part Of An Autism Prevalence Study

Background and aims To describe SCQ scores based on parental socio-economic characteristics for primary school children 6–11 years, 7951 screened as part of an autism prevalence study in three urban regions of the Republic of Ireland (Galway, Waterford, Cork). Methods A study booklet was completed by parents of eligible children included: demographics, developmental history, and a screening instrument, Social Communication Questionnaire – Lifetime Form (SCQ: Rutter et al ., 2003). Results The majority of study booklets were completed by mothers 4,474 (86%). Overall the highest mean total SCQ scores were for mothers of children educated to primary or secondary level education 42%, 2195; 5.54 ± 4.98 working in skilled and semi skilled manual occupations 25%, 807; 5.44 ± 4.63 or described their ethic cultural background as Irish traveller other white background 528 11%; 5.97 ± 5.34, African other black background 301, 6%; 6.72 ± 50.2. There were no significant differences in mean SCQ scores where mothers expressed concerns at any stage of their child’s development with and without diagnosed developmental disorders in relation to mothers educated to primary or secondary level education, working in skilled and semi skilled manual occupations, or those who described their ethic cultural background as Irish traveller other white background. Conclusions Mother’s first language and level of education may have been contributing factors relating to a proportion of observed high scores. However a number of the mothers of these children who expressed developmental concerns at any stage of the child’s development required further screening and/or referral for ADOS/ADI-R assessment.

Refinement of the symptom screening in pediatrics tool (SSPedi).

Background:Objective was to evaluate and refine a new instrument for paediatric cancer symptom screening named the Symptom Screening in Pediatrics Tool (SSPedi).Methods:Respondents were children 8–18 years of age undergoing active cancer treatment and parents of eligible children. Respondents completed SSPedi once and then responded to semi-structured questions. They rated how easy or difficult SSPedi was to complete. For items containing two concepts, we asked respondents whether concepts should remain together or be separated into two questions. We also asked about each item's importance and whether items were missing. Cognitive probing was conducted in children to evaluate their understanding of items and the response scale. After each group of 10 children and 10 parents, responses were reviewed to determine whether modifications were required. Recruitment ceased with the first group of 10 children in which modifications were not required.Results:Thirty children and 20 parents were required to achieve a final version of SSPedi. Fifteen items remain in the final version; the score ranges from 0 to 60.Conclusions:Using opinions of children with cancer and parents of paediatric cancer patients, we successfully developed a symptom screening tool that is easy to complete, is understandable and demonstrates content validity.

Prevalence Of IgE-Mediated Food Sensitisation and Food Allergy In Unselected 12-36 Month Old South African Children

METHODS: This cross-sectional study recruited 12-36 month old toddlers from randomly selected registered creches in Cape Town. Parents of eligible children in the creche completed a questionnaire and the children had skin prick tests (SPT) for cow’s milk, egg, soya, wheat, peanut, hazelnut and fish (cod). Participants with SPT test >1 mm, who were not tolerant to that food had an OFC to assess for IgE-mediated food allergy. Parents choosing not to participate completed a non-participant questionnaire to control for bias.

Moderate lead exposure and elementary school end-of-grade examination performance

PurposeThis study investigated the association between moderate lead poisoning in early childhood with performance on a comprehensive set of end-of-grade examinations at the elementary school level in two urban school districts. MethodsChildren born between 1996 and 2000 who resided in Milwaukee or Racine, WI, with a record of a blood lead test before the age of 3 years were considered for the analysis. Children were defined as exposed (blood lead level ≥10 and <20 μg/dL) or not exposed (BLL < 5 μg/dL). Parents of eligible children were mailed surveys to consent to participation and elicit information on potential confounders. On consent, children were matched to educational records for fourth grade Wisconsin Knowledge and Concepts Examinations. Seemingly unrelated regression was used to evaluate the relation between scaled scores on all sections of the examination (math, reading, language arts, science, and social studies) with exposure status, controlling for demographics, social status indicators, health indicators, and district-based poverty indicators. ResultsA total of 1133 families responded to the survey and consented to have educational records released; 43% of children were considered exposed. After controlling for demographic and socioeconomic covariates, lead exposure was associated with significantly lower scores in all sections of the Wisconsin Knowledge and Concepts Examinations (range: science, β = −5.21, P = .01; reading, β = −8.91, P = .003). Children who were black, had a parent with less than a high-school education, and were classified by parents as having less than excellent health had significantly lower performance on all examination components. ConclusionsChildren with moderate lead poisoning in early childhood performed significantly lower on all components of elementary school end-of-grade examinations compared with unexposed children. Household level social status and childhood health indicators partially explain decreased examination scores.

Why do parents enrol their children in research: a narrative synthesis

ObjectiveRecent legislation mandating the inclusion of children in clinical trials has resulted in an increase in the number of children participating in research. We reviewed the literature regarding the reasons...

Parental attitude towards childhood HBV vaccination in The Netherlands

In The Netherlands, children with at least one parent born in a hepatitis B virus (HBV) endemic country are offered HBV vaccination within the National Immunization Programme (NIP) since 2003. However, in the eligible group the HBV vaccine coverage is lower than the DPT-IPV-Hib coverage. We therefore conducted a questionnaire survey in order to determine the acceptance of HBV vaccination among parents of eligible children. Given the possibility that universal HBV vaccination will be introduced in the Netherlands, we also assessed the attitude towards universal HBV vaccination among parents whose children are currently not eligible for HBV vaccination. Participants were selected based on the registered vaccination status of their child. Only 13 of 83 parents (16%) within the HBV-eligible group whose child was registered as ‘incompletely vaccinated’ for HBV reported that they refused a vaccine for their child. Risk factors for HBV refusal were a low risk perception of HBV, a high socioeconomic status and one parent born in The Netherlands. Within the non-eligible group, we found that 9% (95% CI: 3–22%) of the parents whose child was fully vaccinated with DPT-IPV-Hib had a negative attitude towards universal HBV vaccination. Considering the recent recommendation of the Dutch Health Council to introduce universal HBV vaccination, this resistance deserves further attention.

Burden and Economic Cost of Group A Streptococcal Pharyngitis

Our aim was to describe the morbidity, medical costs, and nonmedical costs associated with group A streptococcal pharyngitis in school-aged children. Our study population included parents of children diagnosed as having group A streptococcal pharyngitis at 2 pediatric practice sites in the Boston, Massachusetts, metropolitan area. Telephone interviews were conducted with parents of eligible children, who were asked questions about health care utilization, medications, and time missed from work or school, for calculation of medical and nonmedical costs associated with illness. One hundred thirty-five parents completed interviews between October 2005 and January 2006. Older children were significantly more likely to present with headache, compared with those < or = 5 years of age. No significant differences between older and younger children were found for rates of sore throat, fever, abdominal pain/nausea/vomiting, or rash. Children missed a mean of 1.9 days (range: 0-7 days) of school/day care, and 42% of parents missed a mean of 1.8 days of work. A second parent or caregiver also missed a mean of 1.5 days in 14% of families. The total societal cost per case of group A streptococcal pharyngitis was $205 (medical: $118; nonmedical: $87). The societal cost of group A streptococcal pharyngitis is substantial, with almost one half being attributable to nonmedical costs. Through extrapolation from this experience, the total cost of group A streptococcal pharyngitis among children in the United States ranges from $224 to $539 million per year.

Evaluation of a targeted immunisation program for Aboriginal and Torres Strait Islander infants in an urban setting

A conjugate pneumococcal vaccination program for Aboriginal and Torres Strait Islander children in an urban setting initially achieved poor uptake. A targeted intervention was developed to raise awareness among hospital staff, in general practice and in parents of eligible children. An evaluation of the intervention found moderate levels of increased awareness, use of promotional materials and an increase in vaccination. However, significant structural barriers remained.

Parental HIV serodiscordance: Implications for the care of the HIV seropositive child in a resource-poor setting

This prospective study compared the care and support provided for symptomatic HIV seropositive children of HIV serodiscordant parents (only the mother of the child is HIV infected) with children of seroconcordant parents (both parents are HIV infected) during admission and after discharge from a tertiary health institution in southwestern Nigeria. Information was collected from parents of eligible children by semi-structured questionnaires and observation of the children and their parents while on admission and at home. Of the 51 couples who met the study criteria, there were 27 seroconcordant couples and 24 serodiscordant couples. The children from serodiscordant couples were more frequently discharged against medical advice, abandoned, lost to follow-up, cared for by their mothers alone and were not up-to-date with their immunization schedule when compared with children from seroconcordant parents. These were statistically significant (p < 0.05). There was a higher mortality among these children and their mothers (p < 0.05). Paternal reasons for not providing adequate care for the children from serodiscordant parents included fear of being infected, doubt of child's paternity and waste of family resources on a ‘child who is dying’. None of the children from both groups received support from governmental and non-governmental agencies. It is concluded that the care of sick HIV seropositive children of serodiscordant parents poses special challenges for clinicians working in Nigeria where there is no social support system.

ASTHMA MEDICATION USE AND DISEASE BURDEN IN CHILDREN IN A PRIMARY CARE POPULATION

Lozano PA, Finkelstein JA, Hecht J, et al. Arch Pediatr Adolesc Med. 2003;157:81–88 To describe the use of asthma medications and the disease burden among children with persistent asthma and to estimate asthma control. A total of 638 children (3–15 years of age) with persistent asthma, drawn from private insurance claims and pharmacy databases, who were recruited for the Pediatric Asthma Care Patient Outcomes Research Team II study from 42 primary care practices in 3 urban locales were studied. A single telephone interview with parents of eligible children was used to assess 1) classes …

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

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.