title: Demographic factors influencing educational placement of the hearing-impaired child with a cochlear implant.
abstract: OBJECTIVE
  To analyze educational placement settings of Israeli children with cochlear implants (CIs) and evaluate the prognostic influence of the following demographic variables on mainstreaming: age at implantation, experience with CI, socioeconomic status, ethnicity, and parents' educational level.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  The study population comprised 245 children with severe-to-profound hearing impairment and at least 1 year of experience with a unilateral CI. Mean age at implantation was 4.5 ± 3.9 years, and mean duration of CI use was 5.4 ± 2.8 years.
  
  
  METHODS
  Follow-up review and statistical analysis of available data on educational placement after cochlear implantation.
  
  
  METHODS
  Placement in mainstream education.
  
  
  RESULTS
  Regular schools were attended by 89 children (36.3%) and special education schools by 156 (63.7%). Variables found to be significantly associated with mainstream educational placement were younger age at implantation, higher level of parental education, higher socioeconomic status, and ethnicity. Multivariate analysis using a logistic regression model revealed that the factor with the highest positive correlation with mainstreaming was parental education level.
  
  
  CONCLUSIONS
  Our results show that parental education, a variable that the health system cannot control, significantly influences postimplantation results in term of educational placement and can thus limit the chances of implanted children to achieve mainstream placement even when identified and implanted at an early age.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Bnai-Zion Medical Center, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Noam
authors.initials: N
authors.lastname: Yehudai
authors.forename: Naama
authors.initials: N
authors.lastname: Tzach
authors.forename: Talma
authors.initials: T
authors.lastname: Shpak
authors.forename: Tova
authors.initials: T
authors.lastname: Most
authors.forename: Michal
authors.initials: M
authors.lastname: Luntz
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation; D003054:Cochlear Implants; D004519:Education, Special; D004522:Educational Status; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000534:rehabilitation*; D006801:Humans; D007557:Israel; D008282:Mainstreaming, Education; D008297:Male; D010290:Parents; D012189:Retrospective Studies; D012959:Socioeconomic Factors