Health-related quality of life of Austrian children and adolescents with cochlear implants

Background and objective: As shown by many studies, deaf children benefit considerably by cochlear implants (CI), concerning oral language and integration in mainstream schools. This had lead to the general, view of a good quality of life of these children. Unfortunately so far nearly no studies on quality of life, and specialty no studies on health-related quality of life (HRQoL) of children with cochlear implants, have been published. The present study with the objective for first, initial information on health-related quality of life of Austrian pupils with cochlear implants is a first step to fill this gap. Methods: Forty-four Austrian pupils, out of 65 candidates, age 8-16, with a hearing experience of at least 3 years with implants, and their parents were surveyed in the CI Center, Salzburg (cross sectional study). Basic medical and audiological data were available for all pupils. Because of reading comprehension difficulties 15 pupils were excluded. Parents and children were surveyed with the KINDLR, a generic instrument for health-related quality of life of children and adolescents. Main outcome measures were the HRQoL-total scores (mean, transformed to 100, standard deviation). In addition, 95% confidence intervals, effect sizes, t scores (one- and two-sided t-tests), rank order correlations and coefficients of determination were calculated. Results: The HRQoL-totat score of the children with CI (n = 18), age 8-12 was below the standard for hearing children (P < 0.001). It differed from the total score of the parent rating (P < 0.0001). The difference between the parent ratings of non-excluded and of excluded children (n = 12) was not significant. The total score of the adolescents (n = 11), age 13-16 was within the norm, with no significant difference between adolescent and parents. The total scores correlate with parent-child agreement in the ratings, with outcomes of audiological speech tests, length of time of deafness, and age at implantation. Conclusions: Children with CI experience a lower health-related quality of life, compared to hearing children, with a low parent-child agreement. The findings of this study point to a normal subjective health of adolescents with Cl. (c) 2005 Elsevier Ireland Ltd. All rights reserved.