Patterns of Cochlear Implant Use and Speech Exposure in Children With Single-Sided Deafness Compared to Bimodal Devices in the Post-Pandemic Period
Bibliographic record
Abstract
OBJECTIVES: This study evaluated whether Coronavirus disease 2019 (COVID-19)-related decreases in device use and speech exposure in children with unilateral cochlear implants (CIs) persisted post-pandemic. It was hypothesized that CI use is lower in children with single-sided deafness (SSD) than in children using bimodal devices and that speech exposure has recovered to pre-pandemic levels. DESIGN: Datalogs (n = 608) from children with unilateral CIs (n = 111) and good hearing in their non-implanted ear (unaided pure tone average <60 dB) were analyzed across the pre-pandemic, peri-pandemic (during the pandemic), and post-pandemic periods. Participants were separated into children with single-sided deafness using a CI (SSD-CI group, n = 70), and children using a CI and contralateral hearing aid (bimodal devices group, n = 41). They were further divided by age at the start of the pandemic (preschool-aged and school-aged). Datalogs were collected from October 1, 2013 to April 1, 2024, and included daily CI use, speech duration, and speech-in-noise sounds captured by the CI. RESULTS: CI use was lower in the SSD-CI group (mean ± SD = 5.78 ± 3.06 hours/day) than in the bimodal devices group (7.24 ± 3.75 hours/day, p = 0.013). In addition, of 17 children lost to follow-up, 14 were in the SSD-CI group. Preschool-aged children showed a steeper increase in CI use over time from CI activation in the bimodal devices group (slope ± SE = 0.96 ± 0.14 hours/day per year) than the SSD-CI group (0.15 ± 0.19 hours/day per year, p < 0.001). CI use declined more rapidly over time in school-aged children in the SSD-CI group (-0.63 ± 0.09 hours/day per year) compared to the bimodal devices group (-0.07 ± 0.09 hours/day per year, p < 0.001). Speech exposure was similar in the SSD-CI (3.13 ± 1.83 hours/day) and bimodal devices (3.82 ± 2.11 hours/day) groups ( p = 0.08). In preschool-aged children, speech exposure increased from the pre-pandemic (3.11 ± 1.44 hours/day) to the peri-pandemic (3.51 ± 2.21 hours/day, p = 0.011) and post-pandemic period (4.53 ± 1.84 hours/day, p < 0.001) in line with increased daily CI use. In school-aged children, speech exposure decreased from the pre-pandemic (3.38 ± 1.76 hours/day) to the peri-pandemic period (2.94 ± 2.16 hours/day, p = 0.002), remaining low post-pandemic (2.91 ± 2.45 hours/day, p = 0.69). The proportion of speech exposure measured by the CI decreased from the pre-pandemic period (52.5% ± 12.2%, p = 0.99) to the peri-pandemic period (44.7% ± 16.1%, p = 0.008) and returned to pre-pandemic levels post-pandemic (51.9% ± 17.3%, p = 0.55). CONCLUSIONS: Daily CI use varies widely in children with good residual hearing in their non-implanted ear and is at greater risk for decline over time in the SSD-CI group compared to the bimodal device users. Reduced CI use in school-aged children with SSD leads to decreased hours of speech exposure through the CI. The percentage of speech exposure logged by the CI confirms that speech access declined during the pandemic but reveals an encouraging return to pre-pandemic levels after restrictions were lifted.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".