Candidacy and the Children's Implant Profile: is our selection appropriate?

This study has two aims: first, to determine whether our paediatric Cochlear Implant Programme uses a modified version of the Children's Implant Profile (ChIP) in a consistent manner to inform candidacy decisions; and second, to establish whether our ratings of concern on the ChIP are predictive of speech discrimination, speech production and language outcomes. Retrospective data were collated over a 6-year period. For each ChIP category, ratings of 'no concern', 'mild moderate concern' or 'great concern' were agreed for each child, and scores of 0, 1 or 2 were assigned respectively. During the period of study, of 147 children assessed, 63% were considered to be suitable for cochlear implantation. A forward stepwise logistic regression showed that degree of concern on five of the ChIP factors significantly predicted the decision to implant. At 1 year and 3 years after switch-on, the total ChIP score significantly predicted some speech perception outcomes, as did the degree of concern pre-implant regarding speech and language abilities and functional hearing. These concerns were also significantly predictive of receptive language ability and speech intelligibility ratings 3 years after implantation.