Impact of Socioeconomic Status and Family Language on Implanted Children's Communication Mode

Examination of the influence of socioeconomic status (SES) and family language on communication mode after cochlear implant (CI).

Data on 176 children implanted at < 37 months were obtained from medical records including insurance type as a representation of SES, family language (English-only/Spanish-bilingual/Spanish requiring interpreter), habilitation (Oral only/Includes sign), age at CI(s), bilateral or unilateral CI, open-set speech perception (Yes/No).

Communication mode (Oral only/Includes sign) was the outcome of interest. Mean age at first CI = 20.8 months (6.7-36.8); mean follow-up = 5.8 years (1.1-10.4). Inferential statistical analyses, including regression analysis, were performed.

Oral-only communication was obtained in 84.9% of commercially insured compared to 33.7% of Medicaid-eligible children (p ≤ 0.001). Higher SES (commercially insured) with English-only parents more likely used oral-only communication than the other parental language groups (90.3% vs. 75.0% and 33.3%; p ≤ 0.001). All parental language groups of Medicaid-funded children had low rates of oral-only communication. SES accounted for most variance in whether oral-only communication was achieved, followed by open-set speech perception and age of first implant. Together, these accounted for 44% of variance (R ² = 0.439). Parental language did not significantly contribute to the prediction of oral-only communication mode.

SES is a major contributing factor to spoken language outcomes in children receiving CIs through age 3 years. Children from bilingual Spanish-English or Spanish-only speaking families are less likely to use only spoken language than those from English-only families, but this difference appears to be influenced by lower SES and older age of implantation and not necessarily by exposure to other languages.