title: Variations in gains in auditory performance from pediatric cochlear implantation.
abstract: OBJECTIVE
  To investigate variations in gains in auditory performance in children with cochlear implants.
  
  
  METHODS
  The auditory performance of 98 children was measured with the Category of Auditory Performance survey instrument. All data were collected prospectively. Variables used to explain gain in Category of Auditory Performance were age at implantation, sex, the duration of "untreated" deafness, the year in which implantation occurred, health care inputs, and cause of hearing impairment. The data were analyzed by ordered probabilistic regression analysis.
  
  
  RESULTS
  Gain in Category of Auditory Performance was observed to be negatively related to age at implantation, the year in which implantation took place, and the number of medical consultations the child received. None of the other variables were significant determinants of gain in Category of Auditory Performance.
  
  
  CONCLUSIONS
  This study demonstrates the value of examining incremental gain from implantation rather than simply examining outcome levels. It was found that pediatric implantation is subject to diminishing returns. This suggests that further relaxation of entry criteria to implant programs should be undertaken only after careful consideration. The study also confirmed that age at implantation is an important determinant of outcomes. Greater gain in Category of Auditory Performance was experienced by those who underwent implantation at a younger age. This finding has implications for screening, as well as for purchasers and providers of implant services, highlighting the importance of responding in a timely fashion to identified need.
authors.affiliation: School of Policy Studies, University of Ulster at Jordanstown, Newtownabbey, Northern Ireland, UK. C.Oneill2@ulst.ac.uk
authors.forename: Ciaran
authors.initials: C
authors.lastname: O'Neill
authors.forename: G M
authors.initials: GM
authors.lastname: O'Donoghue
authors.forename: S M
authors.initials: SM
authors.lastname: Archbold
authors.forename: T P
authors.initials: TP
authors.lastname: Nikolopoulos
authors.forename: T
authors.initials: T
authors.lastname: Sach
mesh_terms: D001309:Auditory Threshold / Q000502:physiology*; D002648:Child; D019929:Cochlear Implantation; D003638:Deafness / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D015233:Models, Statistical; D011446:Prospective Studies