Perceived improvements and challenges following sequential bilateral cochlear implantation in children and adults

Objective: Semi-structured interviews were conducted with sequentially implanted bilateral cochlear-implant (biCI) recipients to examine functional aspects of communication that are affected by listening with one versus two CIs. Design: Participants were 15 adult biCI recipients and parents of 30 children (categorized into three groups by age) with biCIs. All CI users had sequential placement of biCIs with at least six months’ experience with the first CI before activation of the second device, and at least three months’ experience with both CIs prior to the interview. The parent/paediatric and adult interviews were all conducted by the same examiner. Electronic transcripts of the interview responses were coded for perceived changes or lack thereof in 23 behaviours following biCI. Extent of reported benefit was quantified for each subject within and across these behaviours and at the group level as a function of age. Results: Most adults and parents of children reported multiple functional changes following biCI use, and changes often translated to enhanced social communication. Nearly all participants were consistent users of biCIs, and were satisfied with their perceived gains in communicating in everyday settings. Most reported ongoing challenges listening in noisy settings. Although many reports on children paralleled those of adults, developmental differences were apparent. Thirteen percent of adults and twenty percent of parents of children in each of the respective groups reported low levels of change. Conclusions: Results suggest that many biCI users experience meaningful functional benefits that may be underestimated by traditional outcome measures. We suggest the need to expand measurement approaches to better quantify the nature of these benefits.