How Well Do Parents and Professionals Know Their Child’s Cochlear Implant?

Once a child has received cochlear implants (CI), the responsibility of managing and maintaining the implant is upon parents and caregivers. These adults should have received detailed information on use, maintenance, and troubleshooting of their child’s CIs at the activation and subsequent appointments. It is well known, however, that the information parents receive is often not well retained for use at home.

When a child reaches school age, some of the responsibility for maintaining and troubleshooting their CI may shift to school personnel, such as speech-language pathologists (SLP), classroom teachers and teachers of the deaf (TOD), and other school personnel. While these professionals may have received instructions on troubleshooting and maintaining a student’s CI, when an audiologist is not available, this becomes challenging, as most educational programs for SLPs and TODs do not include coursework on CI troubleshooting.  

There are several tools currently available to assess the knowledge and skills of adult CI recipients regarding the management and maintenance of their devices. The Cochlear Implant Skills Review (CISR; Vasil et al., 2021) requires CI recipients to demonstrate knowledge and skills regarding sound processor manipulation and maintenance, as well as skills related to new features such as smartphone connectivity, streaming, and use of the manufacturer’s app.

Recently, Thornton et al. (2026), adapted the CISR to assess skill and knowledge of adults who care for a child’s CI to determine its inter- and intra-rater reliability and establish construct validity. There were 48 participants, divided into four groups of 12: (a) parents/caregivers of new CI recipients (<1 year of use), (b) parents/caregivers of experienced CI recipients (> 1 year of use), (c) TODs, and (d) SLPs. There were 3 independent raters.

The authors concluded that the newly developed Ped-CISR is a valuable clinical tool for assessing the skills and knowledge of adults responsible for their child, client, or student’s CI. The Ped-CISR demonstrated strong inter- and intra-rater reliability, and the current study provides initial evidence of its construct validity. They recommend more research to establish its construct validity and add additional questions about pairing and manufacturer apps to the Ped-CISR. 

 References

 Vasil, K., Lewis, J., Ray, C., Baxter, J., Bernstein, C., …. Moberly, A. C. (2021). Assessment of reliability and validity of the Cochlear Implant Skills Review: A new measure to evaluate cochlear implant users’ device skills and knowledge. American Journal of Audiology, 30(1), 105–127.

‌Thornton, K. E. T., Bosworth, C., Smith, A. M., Lopez, M. A., Buxton, C., …..Bernstein, C. M. (2026). Evaluating the cochlear implant competence of caregivers, educators, and speech-language service providers with the Pediatric Cochlear Implant Skills Review. American Journal of Audiology, 1–27.