Family Dynamics Impact Cochlear Implant Outcomes

Children develop within concentric, transactional rings of environmental influence. The most proximal ring—the microsystem—contains the most potent and influential environment: the family environment. Family environment and family dynamics significantly contribute uniquely to the variability in at-risk spoken language, neurocognitive, and psychosocial outcomes in children with cochlear implants above and beyond hearing- and device-related factors. As such, families can play a protective role in optimizing outcomes in children with cochlear implants. Once a child has received a cochlear implant, many hearing- and device-related factors cannot be altered. However, family environments are malleable and can be modified by family-oriented communication and education programs. Integrated, interdisciplinary, holistic assessments and interventions that incorporate the most salient and influential environment in the child’s life—their family—have the potential of leading to new and more effective family-centered interventions for children with cochlear implants and their families.