Factors Associated with Limited and Non-Use of Cochlear Implants in Children

Abstract

Cochlear implants (CI) have significantly improved auditory access and communication outcomes for children with severe to profound hearing loss. Despite these benefits, a subset of pediatric CI recipients demonstrate limited use (less than 8 hours per day) or complete non-use of their devices over time, which degrades expected rehabilitative outcomes. The present study aimed to examine the rate of limited and non-use of cochlear implants among children and to explore the contributing factors through parent-reported data. A total of 212 children with at least three years of cochlear implant experience was included. Participants were categorized as full-time users, limited users, or non-users based on reported daily usage duration. Descriptive analysis revealed that while the majority were full-time users, a notable proportion showed limited or non-use. Analysis of 25 cases of limited and non-users identified several influencing domains, including medical and audiological challenges, psychological and cognitive issues, family-related factors, environmental influences, and device-related concerns. The findings highlight the role of individual, familial, and systemic variables that affect long-term CI use in children. These findings highlight the need for early identification of at-risk users and the implementation of tailored, multidisciplinary follow-up strategies to support sustained device use and maximize auditory outcomes.