title: Adapting to bilateral cochlear implants: early post-operative device use by children receiving sequential or simultaneous implants at or before 3.5 years.
abstract: OBJECTIVE
  To classify adaptation difficulties, or lack thereof, experienced by a clinical population of young bilateral cochlear implant recipients.
  
  
  METHODS
  Forty-six of the first 48 children sequentially or simultaneously implanted at ≤3.5 years at the Melbourne Clinic participated. Classification into categories was based on daily use of both implants at 2 months post-switch-on, with follow-up information obtained at 12 months.
  
  
  RESULTS
  The 37 Category 1 children wore both implants full time at 2 months, and 35 still did so at 12 months. The two Category 2 children used both implants 4 hours daily at 2 months, but achieved full-time use within 12 months. The five Category 3 children used both implants for ≤1 hour, with only three achieving full-time use within 12 months. The two Category 4 children did not use two implants at 2 months, and one still did not wear both implants at 12 months. There were weak/modest but significant relationships between category and each of time between implants and age at bilateral implantation.
  
  
  CONCLUSIONS
  Ninety-five percent of simultaneously and 70% of sequentially implanted children demonstrated full-time use within 2 months, and nearly all continued to do so at 12 months. Full-time use maximizes opportunities to develop listening skills. Monitoring device use is necessary for all children, especially when significant change occurs. For those experiencing difficulty in adapting, bilateral implant use usually increased over 12 months. Pre-operative counselling must include discussion of possible adaptation difficulties and raise the potential negative influence of age at bilateral implantation and time between implants.
authors.affiliation: Audiology, Hearing and Speech Sciences, Department of Otolaryngology, The University of Melbourne, Australia. kgalvin@unimelb.edu.au
authors.forename: Karyn Louise
authors.initials: KL
authors.lastname: Galvin
authors.forename: Kathryn Clare
authors.initials: KC
authors.lastname: Hughes
mesh_terms: D000222:Adaptation, Physiological; D000367:Age Factors; D001299:Audiometry; D001315:Australia; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods* / Q000523:psychology; D003054:Cochlear Implants; D015331:Cohort Studies; D003638:Deafness / Q000175:diagnosis / Q000601:surgery*; D004558:Electric Stimulation / Q000295:instrumentation; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011182:Postoperative Care / Q000379:methods; D011474:Prosthesis Design; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome