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Advancing Pediatric Cochlear Implant Care Through a Multidisciplinary Telehealth Model: Insights from Implementation
Chrisanda Marie Sanchez1,2, Jennifer Coto1,2, Jordan Ian McNair1,2
1Department of Otolaryngology, University of Miami, Miami, FL 33136, USA.
Insights
Virtual multidisciplinary care for pediatric cochlear implant (CI) patients significantly improves family satisfaction and streamlines care. This team-based telehealth model enhances communication and reduces appointment burdens for both CI candidates and established users.
Area of Science:
- Pediatric audiology
- Telehealth
- Multidisciplinary care
Background:
- Multidisciplinary care is standard for pediatric cochlear implant (CI) evaluation and ongoing management.
- CI care requires multiple appointments for candidacy assessment, expectation setting, and psychosocial support.
- Coordinated follow-up is crucial for established CI users' auditory, educational, and psychosocial needs.
Purpose of the Study:
- To evaluate family satisfaction and perspectives on a virtual, team-based multidisciplinary care model.
- To assess the model's effectiveness for both pediatric CI candidates and established CI users.
Main Methods:
- Thirty-nine children and families participated in telehealth consultations (audiology, LSL therapy, psychology, education).
- Virtual multidisciplinary team meetings were held pre-implantation and at six months post-activation for candidates, and post-consultation for established users.
- Post-visit surveys measured satisfaction and perceived benefits of the virtual multidisciplinary approach.
Main Results:
- All caregivers reported high satisfaction (100%) with the virtual model, rating care quality as "very good" or "excellent."
- Listening and Spoken Language (LSL) therapy was most beneficial (70% Pre-CI, 45% Established CI).
- Most families preferred ongoing team-based care every six months (55-80%) and exclusively remote meetings (95-100%).
Conclusions:
- A virtual multidisciplinary model provides high-quality, family-centered care for pediatric CI evaluations and management.
- This integrated approach supports the child, strengthens the family system, improves communication, and streamlines care.
- Families highly value the convenience, clarity, and collaboration of virtual team visits, emphasizing the need for routine check-ins to maximize outcomes.
Background/Objectives:
Multidisciplinary care is the gold-standard approach for delivering comprehensive pediatric healthcare. For children undergoing cochlear implant (CI) evaluation, multiple appointments are required to assess candidacy, set realistic expectations, and counsel families on rehabilitation and the psychosocial impact of hearing loss. Established pediatric CI users also need coordinated follow-up to address ongoing auditory, educational, and psychosocial needs. This study evaluated the satisfaction and family perspectives of the implementation of a virtual, team-based multidisciplinary model for both CI candidates and established CI users.
Methods:
Thirty-nine children and their families participated in discipline-specific telehealth consultations, including audiology, listening and spoken language (LSL) therapy, psychology, and educational services, followed by a 60 min multidisciplinary team meeting. Team meetings occurred during pre-implantation and at six months post-activation for CI candidates. Team meetings for established CI users were scheduled following completion of individual consultations. Providers summarized findings from their individual visits before transitioning to a caregiver-led discussion. Post-visit surveys assessed satisfaction and perceived benefit from the multidisciplinary model.
Results:
Thirty-nine dyads were enrolled (11 Pre-CI; 28 Established CI). Caregivers were predominantly mothers (89.7%), most identified as Hispanic (55.3%) and White (71.1%). Over half of children identified as Hispanic (59%) and White (71.8%); most were diagnosed with hearing loss at birth (55.9%). Satisfaction with the virtual model was uniformly high: 100% of caregivers were satisfied or very satisfied, and most rated care quality as "very good" or "excellent." LSL therapy was most frequently rated as the most beneficial visit (70% Pre-CI; 45% Established CI). Caregivers strongly preferred ongoing team-based care, with 55-80% reporting that they would like it to occur every six months and 95-100% preferring remote meetings.
Conclusions:
A virtual multidisciplinary model offers a high-quality, family-centered approach for both CI evaluations and ongoing management of established CI users. By integrating simultaneous team-based sessions, this model not only supports the 'whole child' but also strengthens the family system by improving communication, streamlining care, and reducing the burden of multiple in-person appointments. Families consistently report high levels of satisfaction with the convenience, clarity, and collaboration provided through virtual team visits. Incorporating routine check-ins with families is essential to ensure their needs are addressed, reinforce progress, and guide timely, targeted interventions that maximize each child's developmental outcomes.
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