Inconsistent device use in pediatric cochlear implant users: Prevalence and risk factors.

Objectives: Cochlear implants (CIs) afford an opportunity for children with a significant hearing loss to access spoken language through auditory input, but challenges post-implantation could impede success. Inconsistent device use occurs when a child wears their device less than full-time (<8 hours per day). Previous studies may underestimate the prevalence of inconsistent device use in pediatric CI users due to methodological issues (subjective parent report vs. objective measures).

Methods: This retrospective chart review identifies risk factors (demographic, audiologic, and device) associated with poorer daily device use in children with CI using objective datalogging. Non-parametric correlations, Mann-Whitney U, and Kruskal-Wallis H tests were used to evaluate effects of demographic, audiologic, and device factors on daily device use via datalogging.

Results: Participants included 71 children (age M = 7.0 years) with mean implantation age of 4.0 years and mean device experience of 3.0 years. Children with CIs used their device, on average, 7.6 hours/day (range: 0.1-15.5 hours). Half of the participants wore their device less than full-time. Fewer hours of device use coincided with younger chronologic age, presence of additional disabilities, lower maternal education, younger age at CI, use of Medicaid, and smaller dynamic range.

Discussion: The prevalence of inconsistent device use may exceed previous estimations based on parent report.

Conclusion: Professionals working with pediatric CI users should consider incorporating datalogging into clinical practice to counsel families at risk for poorer device use. Future studies should compare objective device use with communication outcomes in pediatric CI users.