title: Pediatric cochlear implantation: role of language, income, and ethnicity.
abstract: OBJECTIVE
  To compare post-cochlear implantation (CI) early speech perception (ESP) outcomes between a non-English speaking, ethnic minority study group and an English speaking, ethnic majority control group.
  
  
  METHODS
  We performed a retrospective case-control study at an academic tertiary care children's hospital. Records were reviewed of 49 children who underwent CI from February 2005 to September 2011. Children with abnormal cognitive function (n=12), post-surgical complications (n=1), or incomplete SP testing (n=24) were excluded. The remaining 12 cases (mean implant age 4.3 y) were reviewed for language, income, ethnicity, and ESP scores. Their scores were compared to a subset of patients (n=18; mean implant age 2.2 y) serving as control from the Childhood Development after Cochlear Implantation (CDaCI) study at 1 year follow up where standard ESP testing was performed. Briefly, CDaCI includes a demographically balanced and multicenter-based pediatric cohort from which publications are beginning to define normative post-CI SP outcomes.
  
  
  RESULTS
  Of our 12 children, 7 were Hispanic, 2 Caucasian, 2 multi-ethnicity and 1 Russian. 4 were non-English speaking, 5 spoke English as a second language, and 7 were bilingual. Three received bilateral CI. Mean early speech perception (ESP) scores (reported on a scale of 1-4) collected at 6 and 12 months in the study group were 1.71 and 1.75, respectively; in the control group, 3.83 and 3.92. At both follow up intervals the study group performed significantly worse than the control group (6 mo P=0.048, 12 mo P=0.01).
  
  
  CONCLUSIONS
  This study suggests that among pediatric CI recipients, those from predominantly non-English speaking, socioeconomically disadvantaged backgrounds develop SP at slower than normal rates. Future interventions should be directed at overcoming these obstacles.
authors: Albert Einstein College of Medicine. Electronic address: derek.wu@med.einstein.yu.edu.
authors: Derek
authors: D
authors: Wu
authors: Department of Otorhinolaryngology - Head and Neck Surgery, Texas Children's Hospital/Baylor College of Medicine, 5253 Fannin Street Apt 2202, Houston, TX 77004, USA. Electronic address: elenabethwillis@gmail.com.
authors: Elena Willis
authors: EW
authors: Woodson
authors: Department of Radiology, Pennsylvania Hospital, 800 Spruce Street, Philadelphia, PA 19106, USA. Electronic address: jonmasur@gmail.com.
authors: Jonathan
authors: J
authors: Masur
authors: Department of Otorhinolaryngology - Head and Neck Surgery, Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, 3400 Bainbridge Avenue, Greenberg Medical Arts Pavilion, 3rd Floor, Bronx, NY 10467, USA. Electronic address: jbent@montefiore.org.
authors: John
authors: J
authors: Bent
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation; D003054:Cochlear Implants; D003638:Deafness / Q000208:ethnology* / Q000628:therapy*; D005006:Ethnicity; D005260:Female; D006801:Humans; D007223:Infant; D007802:Language; D007804:Language Development; D008297:Male; D008913:Minority Groups; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013067:Speech Perception
keywords: Cochlear implant; Pediatrics; Socioeconomic; Speech perception