title: Parent versus child assessment of quality of life in children using cochlear implants.
abstract: OBJECTIVE
  Children with hearing loss who use cochlear implants have lower quality of life (QoL) in social situations and lower self-esteem than hearing peers. The child's QoL has been assessed primarily by asking the parent rather than asking the child. This poses a problem because parents have difficulty judging less observable aspects like self-esteem and socio-emotional functioning, the domains most affected by hearing loss.
  
  
  METHODS
  This case-control study evaluated QoL in 50 preschoolers using a cochlear implant and their parents with the Kiddy KINDL(®), an established QoL measure. Children's responses were compared to a hearing control group and correlated with demographic variables. We used a questionnaire for parents and a face-to-face interview with children. T-tests were used to compare (a) paired parent-child ratings and (b) children with cochlear implants versus normal hearing. Pearson rank correlations were used to compare QoL with demographic variables.
  
  
  RESULTS
  Children using cochlear implants rated overall QoL significantly more positively than their parents (M(Difference)=4.22, p=.03). Child rating of QoL did not differ significantly by auditory status (cochlear implant (82.8) vs. hearing (80.8), p=.42). Overall QoL correlated inversely with cochlear implant experience and chronologic age, but did not correlate with implantation age.
  
  
  CONCLUSIONS
  Preschool children using cochlear implants can assess adequately their own QoL, but parents afford valuable complementary perspective on the child's socio-emotional and physical well-being. Preschool children using cochlear implants rate overall QoL measures similar to hearing peers. A constellation of QoL measures should be collected to yield a better understanding of general QoL as well as specific domains centered on hearing loss.
authors.affiliation: The University of Texas at Dallas, Callier Advanced Hearing Research Center, 1966 Inwood Road, Dallas, TX 75235, USA. warnerczyz@utdallas.edu
authors.forename: Andrea D
authors.initials: AD
authors.lastname: Warner-Czyz
authors.forename: Betty
authors.initials: B
authors.lastname: Loy
authors.forename: Peter S
authors.initials: PS
authors.lastname: Roland
authors.forename: Liyue
authors.initials: L
authors.lastname: Tong
authors.forename: Emily A
authors.initials: EA
authors.lastname: Tobey
mesh_terms: D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000367:Age Factors; D016022:Case-Control Studies; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000009:adverse effects / Q000379:methods*; D003054:Cochlear Implants; D003638:Deafness / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D010290:Parents; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011788:Quality of Life; D012016:Reference Values; D012647:Self-Assessment; D012737:Sex Factors; D011795:Surveys and Questionnaires
references.citation: J Abnorm Child Psychol. 1982 Sep;10(3):307-24
references.pmid: 7175040
references.citation: Int J Pediatr Otorhinolaryngol. 2005 Aug;69(8):1031-41
references.pmid: 16005345
references.citation: Int J Obes Relat Metab Disord. 2001 May;25 Suppl 1:S63-5
references.pmid: 11466592
references.citation: Brain Inj. 2008 Mar;22(3):215-21
references.pmid: 18297593
references.citation: Int J Pediatr Otorhinolaryngol. 1999 Oct 5;49 Suppl 1:S183-7
references.pmid: 10577802
references.citation: Ann Otol Rhinol Laryngol Suppl. 2000 Dec;185:103-5
references.pmid: 11140975
references.citation: Int J Pediatr Otorhinolaryngol. 2005 Aug;69(8):1089-101
references.pmid: 15946746
references.citation: J Abnorm Child Psychol. 1975;3(1):41-8
references.pmid: 1165336
references.citation: Eur Arch Otorhinolaryngol. 2006 Mar;263(3):267-70
references.pmid: 16025257
references.citation: Ear Hear. 1998 Oct;19(5):339-54
references.pmid: 9796643
references.citation: J Speech Lang Hear Res. 2009 Feb;52(1):141-52
references.pmid: 18664684
references.citation: BMC Complement Altern Med. 2007 Apr 23;7:10
references.pmid: 17451595
references.citation: Am J Otol. 1996 Nov;17(6):866-73
references.pmid: 8915415
references.citation: Ear Hear. 2003 Feb;24(1 Suppl):69S-81S
references.pmid: 12612482
references.citation: Qual Life Res. 2001;10(4):347-57
references.pmid: 11763247
references.citation: JAMA. 1994 Aug 24-31;272(8):619-26
references.pmid: 7726894
references.citation: Ann Otol Rhinol Laryngol. 1997 Mar;106(3):210-4
references.pmid: 9078932
references.citation: Ann Otol Rhinol Laryngol Suppl. 2000 Dec;185:111-4
references.pmid: 11140978
references.citation: J Asthma. 2004 Jun;41(4):497-505
references.pmid: 15281336
references.citation: J Dev Behav Pediatr. 2001 Aug;22(4):248-56
references.pmid: 11530898
references.citation: Ann Otol Rhinol Laryngol Suppl. 1995 Apr;165:31-48
references.pmid: 7717632
references.citation: Ambul Pediatr. 2004 Sep-Oct;4(5):411-7
references.pmid: 15369416
references.citation: Psychol Bull. 1987 Mar;101(2):213-32
references.pmid: 3562706
references.citation: Int J Audiol. 2005 Jul;44(7):400-7
references.pmid: 16136790
references.citation: J Pediatr Psychol. 2006 Mar;31(2):127-38
references.pmid: 16467313
references.citation: Laryngoscope. 2000 Jan;110(1):156-60
references.pmid: 10646733
references.citation: Arch Dis Child. 2007 May;92(5):434-9
references.pmid: 17449526
references.citation: BMC Fam Pract. 2006 Jan 17;7:3
references.pmid: 16417628
references.citation: J Speech Hear Disord. 1986 Feb;51(1):53-62
references.pmid: 3945060
references.citation: J Craniofac Surg. 2008 May;19(3):580-7
references.pmid: 18520368
references.citation: Complement Ther Med. 2008 Feb;16(1):15-21
references.pmid: 18346624
references.citation: Arch Otolaryngol Head Neck Surg. 1999 Nov;125(11):1214-8
references.pmid: 10555692
references.citation: Ear Hear. 2006 Apr;27(2):161-86
references.pmid: 16518144
references.citation: Int J Pediatr Otorhinolaryngol. 2007 Mar;71(3):435-45
references.pmid: 17161471
references.citation: J Adv Nurs. 2007 Apr;58(1):1-10
references.pmid: 17394611
references.citation: Laryngoscope. 2006 May;116(5):723-8
references.pmid: 16652078
references.citation: Ear Hear. 2007 Dec;28(6):729-39
references.pmid: 17982361
references.citation: Am J Epidemiol. 1992 May 1;135(9):1029-41
references.pmid: 1595689
references.citation: Br J Educ Psychol. 1985 Jun;55 ( Pt 2):111-8
references.pmid: 4027171
references.citation: Ambul Pediatr. 2004 Jul-Aug;4(4 Suppl):387-94
references.pmid: 15264944
references.citation: JAMA. 2000 Aug 16;284(7):850-6
references.pmid: 10938174
references.citation: Am J Public Health. 1984 Jun;74(6):580-4
references.pmid: 6721013