title: Perceived qualitative benefits of cochlear implants in children with multi-handicaps.
abstract: OBJECTIVE
  To determine families' perceived benefits of cochlear implants in children with multiple-handicaps.
  
  
  METHODS
  Parents/guardians of a child with a cochlear implant for at least 3 months, under the age of 18 years and had least one additional disability were recruited for participation through rehabilitation therapists. Families who did not have a child enrolled in therapy at the study center were contacted by mail. Families were asked a number of open-ended and close-ended questions. Interviews were audiotaped and transcribed, with answers to open-ended questions coded by themes.
  
  
  RESULTS
  We interviewed 19 families of 20 children and included 15 families of 16 children who had had at least 6 months of cochlear implant experience for this study. The mean time between implantation and study was 3 years (S.D.+/-2.2) with a range of 0.5-8 years. Children were highly compliant in wearing their device. Sixty-eight percent (11/16) of the children were enrolled in additional therapies beyond speech and aural rehabilitation therapies. Fifty percent of families (8/16) indicated they had no obstacles to accessing therapies. Insurance was the most common barrier to accessing therapies (18% of respondents). All children made communication progress post-implant as described by their families. All families felt that the cochlear implant team provided enough information prior to receiving the implant to help families make the appropriate decision about implanting their child. All families said that if they were to make the decision again, they would choose to have their child implanted.
  
  
  CONCLUSIONS
  More children with multiple-handicaps are receiving cochlear implants. Very young children may undergo cochlear implantation only to be subsequently diagnosed with an additional impairment or disability at later ages. As a result, it is important to understand the specific needs of this population and the parental perceptions of benefit in order to provide the best services and opportunities for success with a cochlear implant. Although not all of the children gained gold standard speech and language outcomes, all children broadened their communication skills. In motivated families of children with additional disabilities, it is appropriate to provide them with the same opportunity to access audition and expand their communication abilities as any other child with a hearing impairment.
authors.affiliation: Division of Developmental Disabilities, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 4002, Cincinnati, OH 45229-3039, USA. susan.wilev@cchmc.org
authors.forename: Susan
authors.initials: S
authors.lastname: Wiley
authors.forename: Margaret
authors.initials: M
authors.lastname: Jahnke
authors.forename: Jareen
authors.initials: J
authors.lastname: Meinzen-Derr
authors.forename: Daniel
authors.initials: D
authors.lastname: Choo
mesh_terms: D001364:Awareness; D002648:Child; D002675:Child, Preschool; D003054:Cochlear Implants; D019988:Children with Disabilities / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000150:complications* / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010465:Perception; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014705:Verbal Behavior