Academic journal article American Annals of the Deaf

A Comparison of the Anticipated Benefits and Received Outcomes of Pediatric Cochlear Implantation: Parental Perspectives

Academic journal article American Annals of the Deaf

A Comparison of the Anticipated Benefits and Received Outcomes of Pediatric Cochlear Implantation: Parental Perspectives

Article excerpt

FINDINGS OF A STUDY that investigated parents' expectations and experiences of their children's outcomes with cochlear implants are presented. A survey completed by 247 parents whose children had received implants in eastern Australia compared parents' reports of their preimplant expectations with their experiences of postimplant outcomes on several items related to communication, academic, and psychosocial domains. Quantitative findings derived from the survey data were extended and elaborated on by qualitative findings from interviews with 27 of the parents. The findings indicated that parents' relatively high expectations of their children's outcomes largely had been met, although a tenth of survey respondents reported that their expectations had not been met. It appeared that professionals generally provided parents with realistic expectations. The qualitative findings revealed a complex interaction among parents' expectations, hopes, and determination that their children would do well with the implant. Implications for professionals are discussed.

With the growing incidence of pediatrie cochlear implantation in most developed countries in the last two decades, and the increasing trend toward cochlear implants being considered the best response to profound and, increasingly, severe levels of hearing loss in infants and children, parental expectations of cochlear implantation for their deaf children are likely to be high. It is important for cochlear implant programs and others informing or advising parents to have as full an understanding as possible of parents' expectations of the outcomes of implantation for their children and of the ongoing demands on families associated with implantation. In addition, knowledge of implanted children's outcomes across a range of functional settings as perceived by parents is important.

Of the myriad studies investigating children's outcomes reported in the literature, a large proportion have focused on speech perception and spoken language development. Broader measures, including educational, employment, and psychosocial outcomes, as well as family expectations and experiences, have received less attention in research studies (Spencer & Marschark, 2003; Swanwick & Tsverik, 2007; Thoutenhoofd et al., 2005). Thoutenhoofd and colleagues pointed out that "very few studies attempt to assess the child's ability to perceive and produce spoken language in their day-to-day lives, after implantation, rather than in clinical tests" (p. 243). They also asserted that parents' perspectives, which may more closely reflect the functional outcomes of children in everyday situations than assessments made in clinical settings, were underrepresented in the literature. Others also have suggested the necessity of including broader outcome measures, particularly parental report, in the assessment of the outcomes of implantation in young children (Lin et al., 2008).

The relative invasiveness of cochlear implantation compared to hearing aids, the high level of parents' emotional and resource investment in their children's cochlear implantation, and parents' expectations of success from the implant mean that it is vital to examine a full range of outcomes. In the present study, we explore the broader areas of functional communication, educational, and psychosocial outcomes, as well as family expectations and experiences and the concordance between anticipated and experienced outcomes.

Research has indicated that many parents have high expectations of the outcomes of cochlear implantation for their children (Christiansen & Leigh, 2002; Weisel, Most, & Michael, 2007; Zaidman-Zait & Most, 2005). The importance of realistic parental expectations is recognized by researchers and cochlear implant programs; as Weisel and colleagues have said, "If expectations from and attitudes toward the CI [cochlear implant] are so high, perhaps unrealistically high, then the effects of CI, good as they are, will likely fail to meet them" (p. …

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