Relationships between caregiver decisions about communication approach and language outcomes for children using cochlear implants*

With regard to parents making communication approach decisions for their children with hearing loss, Crowe et al. (2014) suggested that key themes were: feasibility; sources of information; child characteristics; and, future opportunities. For children using cochlear implants (CI/s), the present study aimed to understand parental preferences regarding communication, the sources of information they used, and child language outcomes. Demographic and language data were available for 162 children using CI/s (mean age at CI 3.74 years; SD 3.83). Standard scores (SS) were reported for the PPVT-3/ PPVT-4. To enable inclusion of a more diverse group of children (including those with additional needs) data from the PPVT, PLS, CDI and RI-TLS were coded; receptive and expressive Categories of Linguistic Performance (CLIP; Dettman et al., 2017). Caregivers completed a one-off questionnaire; Parental Views about Communication (PVaC). Chi-square analyses explored the distribution and strength of caregiver responses to PVaC questions about the use of spoken language/Auslan within a Bilingual-Bicultural approach. Correlations between child/family characteristics, child language and parental preferences were explored. Parents’ decisions regarding communication with their children using CI/s were driven by multiple sources of information and influence. Changes in a child’s communication approach before and after hearing diagnosis and, following CIs were unrelated to child language outcomes or family characteristics but were influenced to an extent by parent values and child preferences. Of importance to the field, parents/caregivers require unbiased support from professionals to learn about their needs and to seek information (Young, 2002). Consistent with Watson et al. (2007) child preferences were influential on parental decision making; the present study demonstrated that child language and cognitive skills were also influential.