United Kingdom national paediatric bilateral project: Results of professional rating scales and parent questionnaires

Abstract

Objectives: This fourteen-centre project used professional rating scales and parent questionnaires to assess longitudinal outcomes in a large non-selected population of children receiving simultaneous and sequential bilateral cochlear implants.

Methods: This was an observational non-randomized service evaluation. Data were collected at four time points: before bilateral cochlear implants or before the sequential implant, one year, two years, and three years after. The measures reported are Categories of Auditory Performance II (CAPII), Speech Intelligibility Rating (SIR), Bilateral Listening Skills Profile (BLSP) and Parent Outcome Profile (POP).

Results: Thousand and one children aged from 8 months to almost 18 years were involved, although there were many missing data. In children receiving simultaneous implants after one, two, and three years respectively, median CAP scores were 4, 5, and 6; median SIR were 1, 2, and 3. Three years after receiving simultaneous bilateral cochlear implants, 61% of children were reported to understand conversation without lip-reading and 66% had intelligible speech if the listener concentrated hard. Auditory performance and speech intelligibility were significantly better in female children than males. Parents of children using sequential implants were generally positive about their child's well-being and behaviour since receiving the second device; those who were less positive about well-being changes also generally reported their children less willing to wear the second device.

Conclusion: Data from 78% of paediatric cochlear implant centres in the United Kingdom provide a real-world picture of outcomes of children with bilateral implants in the UK. This large reference data set can be used to identify children in the lower quartile for targeted intervention.

Keywords:

• Cochlear implant
• Bilateral cochlear implant
• Binaural hearing
• Paediatric service evaluation

Acknowledgements

The authors wholeheartedly express thanks to clinicians and patients at the following cochlear implant centres: Belfast Regional Cochlear Implant Centre; The Midlands Children's Hearing Implant Programme, Birmingham; West of England Paediatric Hearing Implant Programme, Bristol; Emmeline Centre, Cambridge; Cardiff Paediatric Cochlear Implant Programme; Great Ormond Street Cochlear Implant Programme, London; St Thomas’ Hospital Hearing Implant Centre, London; The Richard Ramsden Centre for Hearing Implants, Manchester; North East Cochlear Implant Programme, Middlesbrough; Nottingham Auditory Implant Programme; The Oxford Cochlear Implant Programme; Royal National Throat Nose and Ear Cochlear Implant Programme, London; University of Southampton Auditory Implant Service and St George's Hospital Auditory Implant Service, London. The authors gratefully acknowledge the support and contributions of Tricia Kemp, Cochlear Implanted Children's Support group Coordinator and Erasmus students Ellen Joos and Robin Gransier.

Disclaimer statements

Contributors All authors contributed to the project design, planning, data collection and final report. Cullington takes responsibility for the data analysis.

Funding This work was supported by Heathcare Quality Improvement Partnership: [grant number NCA036].

Conflicts of interest H. E. Cullington undertakes paid consulting work for Cochlear Europe. Advanced Bionics pay money to University of Southampton for research projects. H. E. Cullington is the second applicant on a successful grant from the Oticon Foundation with John Culling, Cardiff. No money comes to University of Southampton. Julie Brinton undertakes paid consulting work for Advanced Bionics. Gerard O'Donoghue receives occasional non-financial support from Cochlear, MED-EL and Advanced Bionics.

Ethics approval The purpose of this project was to record outcomes of paediatric bilateral cochlear implantation in the UK using performance measures, professional rating scales and parent questionnaires. It was not hypothesis-driven. This project was designed and conducted solely to judge the current care of children receiving two cochlear implants in the UK. The project was considered a service evaluation and did not require review by the National Health Service Research Ethics Committee. A letter was provided to all participating cochlear implant centres to give to the families, detailing the scope and purpose of the service evaluation.

ORCID

H.E. Cullington http://orcid.org/0000-0002-5093-2020