Long-Term Outcomes of Cochlear Implants in Philoprogenitive Families: Addressing Disparities

Background: In recent years, the critical role of parental involvement in the success of pediatric cochlear implants (CIs) has become increasingly evident. However, the impact of family structure—specifically, the presence of multiple CI-using siblings and CI-experienced parents—on outcomes is not fully understood. Investigating these dynamics has the potential to improve auditory rehabilitation strategies in complex family settings. Objective: This study aims to evaluate the influence of the number of siblings with CIs and parental CI experience on pediatric speech perception outcomes following cochlear implantation. Methods: We retrospectively collected data from 2018 to 2023 on families with multiple pediatric CI recipients and a control group comprising families with a single CI child. The analysis focused on evaluating the effects of sibling number, birth order, and parental CI experience on speech perception outcomes 5 years postimplantation. The primary outcome was the speech perception score, measured using the Hebrew version of the Arthur Boothroyd word test (HAB), a validated word recognition test. A multivariate analysis was conducted to evaluate the impact of various factors on speech perception outcomes, accounting for potential confounders within this intricate context. Results: The cohort included 140 children, 102 from 41 philoprogenitive families (a mean of 3 siblings per family, range 2 to 6), and 38 children from families with a single CI recipient as controls. The presence of fewer CI-recipient siblings was associated with significantly better speech perception outcomes 5 years postimplantation ( P =0.03). Children with CI-experienced parents had an earlier median age at surgery (1.1 vs. 1.8 y, P =0.017) and significantly improved speech perception scores (17.2, 95% CI: 0.48-33.8, P =0.04). Conclusions: Fewer siblings with CIs and the presence of CI-experienced parents were associated with earlier intervention and better speech outcomes. These findings highlight the need for a family-centered approach to cochlear implantation to address disparities and enhance outcomes in pediatric CI recipients.