title: Predictors of pediatric cochlear implantation outcomes in South Africa.
abstract: OBJECTIVE
  To identify and describe predictors of pediatric cochlear implantation outcomes in a South African population.
  
  
  METHODS
  A retrospective study of 301 pediatric cochlear implant (CI) recipients from five CI programs was conducted and cross-sectional outcome data were added at the time of data collection. Twenty potential prognostic factors were identified from the retrospective dataset, including demographical, CI, risk and family factors. Multiple regression analyses were performed to identify predictor variables that influence outcomes in terms of auditory performance (CAP scores), speech production (SIR scores), communication mode and educational placement.
  
  
  RESULTS
  Although implanted children within this sample did not have equal opportunity to access a second implant, bilateral implantation was strongly predictive of better auditory performance and speech production scores, an oral mode of communication and mainstream education. NICU admittance/prematurity were associated with poorer auditory performance and speech production scores, together with a higher probability for non-oral communication and non-mainstream education. The presence of one or more additional developmental condition was predictive of poorer outcomes in terms of speech production and educational placement, while a delay between diagnosis and implantation of more than one year was also related to non-mainstream education. Ethnicities other than Caucasian were predictive of poorer auditory performance scores and a lower probability for mainstream education.
  
  
  CONCLUSIONS
  An extensive range of prognostic indicators were identified for pediatric CI outcomes in South Africa. These predictive factors of better and poorer outcomes should guide pediatric CI services to promote optimal outcomes and assist professionals in providing evidence-based informational counseling.
authors.affiliation: Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa. Electronic address: talita.leroux@up.ac.za.
authors.forename: Talita
authors.initials: T
authors.lastname: le Roux
authors.affiliation: Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa; Speech-Language Audiology Department, Ghent University, Belgium.
authors.forename: Bart
authors.initials: B
authors.lastname: Vinck
authors.affiliation: Department of Otorhinolaryngology, University of the Free State, Bloemfontein, South Africa.
authors.forename: Iain
authors.initials: I
authors.lastname: Butler
authors.affiliation: Pretoria Cochlear Implant Unit, South Africa.
authors.forename: Nicolize
authors.initials: N
authors.lastname: Cass
authors.affiliation: Department of Statistics, University of Pretoria, South Africa.
authors.forename: Liebie
authors.initials: L
authors.lastname: Louw
authors.affiliation: Johannesburg Cochlear Implant Program, South Africa.
authors.forename: Leone
authors.initials: L
authors.lastname: Nauta
authors.affiliation: Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Soweto, South Africa.
authors.forename: Dani
authors.initials: D
authors.lastname: Schlesinger
authors.affiliation: Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa.
authors.forename: Maggi
authors.initials: M
authors.lastname: Soer
authors.affiliation: Department of Otorhinolaryngology, Steve Biko Academic Hospital, University of Pretoria, South Africa.
authors.forename: Mashudu
authors.initials: M
authors.lastname: Tshifularo
authors.affiliation: Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa; Ear Sciences Centre, School of Surgery, University of Western Australia, Nedlands, Australia; Ear Science Institute Australia, Subiaco, Australia.
authors.forename: De Wet
authors.initials: de W
authors.lastname: Swanepoel
mesh_terms: D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation; D003430:Cross-Sectional Studies; D003638:Deafness / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D013019:South Africa
keywords: Children; Cochlear implant; Outcomes; Pediatric cochlear implantation; Prognostic factors