The Effect of Family Structure on the Cochlear Implant Experience of Children

Purpose: The purpose of this study was to investigate how family structure, family support, living arrangements, and patient demographics may impact the pediatric cochlear implant (CI) experience. This study aims to understand if these factors create barriers to care and affect the outcomes of children with CIs. Method: This study utilized a retrospective case series design, examining pediatric CI cases conducted at a free-standing medical center in Central Florida between January 2014 and September 2023. Data collected included demographic information, family structure, health care information, and time event data. Statistical analysis included nonparametric methods (Kruskal–Wallis or Spearman rank-order correlation) and Fisher's exact test or Gamma testing, as appropriate. Results: A total of 103 patients underwent CI. Median ages at presentation and implantation were 22 months and 46 months, respectively. The median time from presentation to implantation was 18 months. Children with one parent presented later (54 months) than those with two parents (21 months). Children in multiple-adult households received CIs younger than those in single-adult households. Racial disparities were evident with median ages of implantation: White (29 months), Black (72 months), Asian (120 months), and other (46 months). White children in multiple-adult households presented at 15 months and received implants at 28 months, compared to Black children who presented at 38 months and received implants at 79 months. Conclusions: Children in Central Florida are experiencing significant variation in the timing of CI presentations. Family structure, living arrangements, and race are major contributors to these delays. A deeper understanding of the barriers to timely pediatric hearing health care is needed.