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SYSTEMATIC REVIEW article
Front. Audiol. Otol.
Sec. Clinical Research in Auditory Implants and Hearing Aids
Volume 3 - 2025 | doi: 10.3389/fauot.2025.1583242
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Introduction: Bilateral cochlear implantation is the typical intervention for children with severe-toprofound sensorineural hearing loss, but speech perception and hearing outcomes remain variable. This scoping review explores which contextual factors relate to speech perception and hearing outcomes following pediatric bilateral cochlear implantation based on themes aligned with Bronfenbrenner's bioecological systems theory: 1) individual; 2) microsystem; 3) mesosytem; 4) exosystem; 5) macrosystem; and 6) chronosystem.Method: PRISMA-ScR guidelines were followed to systematically search nine electronic databases with a keyword strategy. Eligible studies were published in English and included an analysis of contextual factors in relation to a behavioral speech perception or hearing outcome measure. Study quality was assessed using Quality Assessment with Diverse Studies (QuADS) criteria and the role of contextual factors in outcomes was explored with a narrative synthesis approach.Results: Twenty-three research articles met the criteria for inclusion. Contextual factors identified ranged from the proximal to distal context. Contextual factors such as non-verbal cognitive ability, social skills, cochlear implant usage, positive parent-child interactions, educational placement, auditory or oral therapy, ethnicity and prematurity were related to cochlear implant outcomes.Discussion: Relationships between contextual factors and outcomes were not consistent across developmental time or studies. Study quality and methodological limitations are discussed. Research on outcomes related to bilateral cochlear implantation should actively integrate and examine contextual factors in prospective, longitudinal designs. This approach will facilitate the development of interventions to target specific levels of the bioecological system, thereby improving outcomes for the pediatric bilateral cochlear implant recipient.
Keywords: cochlear implant, contextual factors, outcomes, Speech Perception, ecological systems, development
Received: 25 Feb 2025; Accepted: 27 Mar 2025.
Copyright: © 2025 CORBETT and van Zalk. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
FLEUR CORBETT, Dyson School of Design Engineering, Imperial College London, London, SW7 2AZ, England, United Kingdom
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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