title: Barriers to early cochlear implantation.
abstract: Identify variables associated with paediatric access to cochlear implants (CIs).
  
  
  
  Part 1. Trends over time for age at CI surgery (N = 802) and age at hearing aid (HA) fitting (n = 487) were examined with regard to periods before, during, and after newborn hearing screening (NHS). Part 2. Demographic factors were explored for 417 children implanted under 3 years of age. Part 3. Pre-implant steps for the first 20 children to receive CIs under 12 months were examined.
  
  
  
  Part 1. Age at HA fitting and CI surgery reduced over time, and were associated with NHS implementation. Part 2. For children implanted under 3 years, earlier age at HA fitting and higher family socio-economic status were associated with earlier CI. Progressive hearing loss was associated with later CIs. Children with a Connexin 26 diagnosis received CIs earlier than children with a premature / low birth weight history. Part 3. The longest pre-CI steps were Step 1: Birth to diagnosis/identification of hearing loss (mean 16.43 weeks), and Step 11: MRI scans to implant surgery (mean 15.05 weeks) for the first 20 infants with CIs under 12 months.
  
  
  
  NHS implementation was associated with reductions in age at device intervention in this cohort.
authors.affiliation: a The University of Melbourne, Department of Audiology and Speech Pathology , Parkville, Victoria , Australia ;|b The Royal Victorian Eye and Ear Hospital , East Melbourne, Victoria , Australia ;|c The HEARing CRC , Carlton, Victoria , Australia.
authors.forename: Shani
authors.initials: S
authors.lastname: Dettman
authors.affiliation: a The University of Melbourne, Department of Audiology and Speech Pathology , Parkville, Victoria , Australia ;|b The Royal Victorian Eye and Ear Hospital , East Melbourne, Victoria , Australia ;|c The HEARing CRC , Carlton, Victoria , Australia.
authors.forename: Dawn
authors.initials: D
authors.lastname: Choo
authors.affiliation: a The University of Melbourne, Department of Audiology and Speech Pathology , Parkville, Victoria , Australia ;|b The Royal Victorian Eye and Ear Hospital , East Melbourne, Victoria , Australia ;|c The HEARing CRC , Carlton, Victoria , Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Dowell
mesh_terms: D000293:Adolescent; D001307:Auditory Perception; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000295:instrumentation* / Q000379:methods / Q000639:trends; D003054:Cochlear Implants / Q000639:trends; D000072259:Connexin 26; D017630:Connexins / Q000235:genetics; D005820:Genetic Testing; D006297:Health Services Accessibility; D006309:Hearing; D006310:Hearing Aids / Q000639:trends; D006311:Hearing Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D006320:Hearing Tests; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D015997:Neonatal Screening; D019986:Persons with Hearing Disabilities / Q000523:psychology / Q000534:rehabilitation*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors; D061665:Time-to-Treatment / Q000639:trends; D016896:Treatment Outcome
chemical_list: D017630:Connexins; C000607042:GJB2 protein, human; D000072259:Connexin 26
keywords: Cochlear implant; demographics; hearing aids; newborn hearing screening; paediatric