title: Access to and Uptake of Cochlear Implantation Among Children in North Carolina.
abstract: BACKGROUND
  Cochlear implantation (CI) is a highly effective intervention for children with advanced hearing loss who cannot benefit from amplification. Despite the established benefits of CI, it is likely that not all children who are potential candidates for CI receive this intervention. The purpose of this study was to determine the percentage of North Carolina children who are candidates for and end up undergoing CI, and to detect whether barriers exist that prevent access to care for unimplanted candidates.
  
  
  METHODS
  This study was a retrospective analysis of 1,501 children whose families were served by BEGINNINGS from January 1, 2009 through December 31, 2013. All families of children identified as potential CI candidates who were able to participate in the study (n = 141) were contacted by BEGINNINGS parent educators who queried parents about their child's use of technology and any reasons for lack of use of technology.
  
  
  RESULTS
  Overall, 60.9% of children diagnosed with profound, severe-profound, severe, moderate-severe, or moderate-profound hearing loss received at least 1 cochlear implant. For children with profound hearing loss, 88.9% had a least 1 cochlear implant. Common reasons for the decision not to perform CI included parental preference and anatomical issues unfavorable to CI.
  
  
  CONCLUSIONS
  Some information was not included in the database, including socioeconomic status and the child's age at the time of intervention.
  
  
  CONCLUSIONS
  The rate of CI for North Carolina children who have advanced hearing loss is greater than 60% and significantly higher for children with greater degrees of impairment. No significant financial or geographic barriers to CI were identified. We hypothesize that the high rate of CI for appropriate candidates in North Carolina is due in part to parental access to counseling and education provided through BEGINNINGS.
authors.affiliation: consultant, Yale Alberg & Associates; former executive director (1999-2014), BEGINNINGS, Raleigh, North Carolina.
authors.forename: Joni
authors.initials: J
authors.lastname: Alberg
authors.affiliation: resident physician in otolaryngology, Head and Neck Surgery Residency Program, Duke University Medical Center, Durham, North Carolina.
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Crowson
authors.affiliation: director, Duke Cochlear Implant Program, Duke University Medical Center, Durham, North Carolina debara.tucci@duke.edu.
authors.forename: Debara L
authors.initials: DL
authors.lastname: Tucci
mesh_terms: D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D034381:Hearing Loss / Q000534:rehabilitation*; D006801:Humans; D007223:Infant; D008297:Male; D009657:North Carolina; D012189:Retrospective Studies; D016896:Treatment Outcome