Parent versus child assessment of quality of life in children using cochlear implants

Int J Pediatr Otorhinolaryngol. 2009 Oct;73(10):1423-9. doi: 10.1016/j.ijporl.2009.07.009. Epub 2009 Aug 11.


Objective: Children with hearing loss who use cochlear implants have lower quality of life (QoL) in social situations and lower self-esteem than hearing peers. The child's QoL has been assessed primarily by asking the parent rather than asking the child. This poses a problem because parents have difficulty judging less observable aspects like self-esteem and socio-emotional functioning, the domains most affected by hearing loss.

Methods: This case-control study evaluated QoL in 50 preschoolers using a cochlear implant and their parents with the Kiddy KINDL(®), an established QoL measure. Children's responses were compared to a hearing control group and correlated with demographic variables. We used a questionnaire for parents and a face-to-face interview with children. T-tests were used to compare (a) paired parent-child ratings and (b) children with cochlear implants versus normal hearing. Pearson rank correlations were used to compare QoL with demographic variables.

Results: Children using cochlear implants rated overall QoL significantly more positively than their parents (M(Difference)=4.22, p=.03). Child rating of QoL did not differ significantly by auditory status (cochlear implant (82.8) vs. hearing (80.8), p=.42). Overall QoL correlated inversely with cochlear implant experience and chronologic age, but did not correlate with implantation age.

Conclusions: Preschool children using cochlear implants can assess adequately their own QoL, but parents afford valuable complementary perspective on the child's socio-emotional and physical well-being. Preschool children using cochlear implants rate overall QoL measures similar to hearing peers. A constellation of QoL measures should be collected to yield a better understanding of general QoL as well as specific domains centered on hearing loss.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adaptation, Physiological
  • Adaptation, Psychological
  • Age Factors
  • Case-Control Studies
  • Child, Preschool
  • Cochlear Implantation / adverse effects
  • Cochlear Implantation / methods*
  • Cochlear Implants
  • Deafness / diagnosis
  • Deafness / surgery
  • Female
  • Hearing Loss, Sensorineural / diagnosis
  • Hearing Loss, Sensorineural / surgery*
  • Humans
  • Male
  • Parents*
  • Patient Satisfaction / statistics & numerical data
  • Quality of Life*
  • Reference Values
  • Self-Assessment*
  • Sex Factors
  • Surveys and Questionnaires