{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T21:43:01Z","timestamp":1781905381308,"version":"3.54.5"},"reference-count":45,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T00:00:00Z","timestamp":1674086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>We examined how sociodemographic and audiologic factors affect receptive and expressive language outcomes in children with cochlear implantation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A hearing loss (HL) clinic at a tertiary center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sociodemographic variables, HL\u00a0characteristics, age at implantation, and receptive language scores (Preschool Language Scale and the Clinical Evaluation of Language Fundamentals) were collected from patients with congenital HL who received their first implant by 4 years old after January 1, 2007. <jats:italic>t<\/jats:italic>\u00a0Tests, linear regression, Mann\u2010Whitney, Cohen's <jats:italic>d<\/jats:italic>, and mediation analysis were used for descriptive statistics and hypothesis testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 79 patients, 42 (53%) were females, 44 (56%) under\u2010represented minorities, and 56 (71%) had public insurance. At least 1 year after implantation, the median receptive language score was 69 (range 50\u2010117). Females (<jats:italic>p<\/jats:italic>\u2009=\u2009.005), having private insurance (<jats:italic>p<\/jats:italic>\u2009=\u2009.00001), having a Cochlear Implant Profile score below 4 (<jats:italic>p<\/jats:italic>\u2009=\u2009.0001), and receiving their implant at or before 12 months of age (<jats:italic>p<\/jats:italic>\u2009=\u2009.0009) were significantly associated with improved receptive language outcomes. Insurance type had a significant effect on receptive language outcomes, independent from age at first implantation (total effect: coef\u2009=\u2009\u221213.00, <jats:italic>p<\/jats:italic>\u2009=\u2009.02; direct effect: coef\u2009=\u2009\u221212.26, <jats:italic>p<\/jats:italic>\u2009=\u2009.03; indirect effect: coef\u2009=\u2009\u22120.75, <jats:italic>p<\/jats:italic>\u2009=\u2009.47). Sociodemographic variables had large effect sizes, with the Cochlear Implant Profile score having the largest effect size (<jats:italic>d<\/jats:italic>\u2009=\u20091.3).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Sociodemographic factors have a large impact on receptive language outcomes. Public insurance is associated with worse receptive language, not mediated by later age at implantation, suggesting that other factors primarily impact language outcomes in publicly insured children with cochlear implants.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.178","type":"journal-article","created":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T05:04:06Z","timestamp":1674104646000},"page":"1185-1196","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Impact of Sociodemographic Disparities on Language Outcomes After Cochlear Implantation in a Diverse Pediatric Cohort"],"prefix":"10.1002","volume":"168","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9562-5999","authenticated-orcid":false,"given":"Elizabeth N.","family":"Liao","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of California San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveen","family":"Yaramala","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of California San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Coulthurst","sequence":"additional","affiliation":[{"name":"Department of Audiology, San Francisco Benioff Children's Hospital University of California Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kris","family":"Merrill","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of California San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Audiology University of California San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt","family":"Kramer","sequence":"additional","affiliation":[{"name":"Department of Audiology University of California San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan K.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of California San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.12.022"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.17647"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003446-200508001-00005"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200408000-00027"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.130.5.570"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1044\/1058-0360(2008\/013)"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.451"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2005.06.013"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001976"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11689-011-9098-z"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/14992027.2017.1370139"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/14992027.2018.1458703"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-2333"},{"key":"e_1_2_9_15_1","unstructured":"CDC.\u00a0Data obtained from CDC hearing screening and follow\u2010up survey.\u00a0Accessed June 28 2022.www.cdc.gov\/ncbddd\/hearingloss\/ehdi-data.html"},{"key":"e_1_2_9_16_1","unstructured":"American Academy of Otolaryngology\u2010Head and Neck Surgery (AAO\u2010HNS).\u00a0Position statement: pediatric cochlear implantation candidacy. 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