Parental perspectives on decision-making and outcomes in pediatric bilateral cochlear implantation

Objective: Bilateral cochlear implantation is becoming standard care to improve outcomes for children with profound or severe to profound hearing loss. This study examined parents' perceptions of the decision process and of the benefits of two implants. Design: The study adopted a qualitative approach, examining parents' views through individual semi-structured interviews. Study sample: The participants consisted of the parents of 15 children at one centre in Ontario, Canada, where 26 children had received bilateral implants. Children ranged in age from 1.8 to 11.9 years and their experience with two implants ranged from 0.3 to 4.2 years. Results: Parents described decision-making as relatively straightforward. However, many parents shared concerns related to surgery. Primary reasons for choosing two implants were neuroplasticity, preference for a backup device, and maximizing potential through technology. Expected outcomes included better speech understanding in noise and the ability to locate the source of sounds. Perceived benefits of bilateral implantation included improved speech understanding in noise, the availability of a backup implant, and parents' assurance that they had provided their children with the best possible access to hearing. Conclusions: Overall, parents were satisfied with the second implant and identified benefits that are not easily quantifiable through traditional clinical measures.