{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T12:57:40Z","timestamp":1778158660879,"version":"3.51.4"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010198","name":"Ministerio de Asuntos Econ\u00f3micos y Transformaci\u00f3n Digital, Gobierno de Espa\u00f1a","doi-asserted-by":"publisher","award":["757-89-l120"],"award-info":[{"award-number":["757-89-l120"]}],"id":[{"id":"10.13039\/501100010198","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Deafness from birth represents a critical challenge for children\u2019s communication, with substantial public health considerations. One intervention has been cochlear implants (CI) for children with severe to profound deafness. Since 2008, Chile has implemented regulations to provide a CI at an early age. However, wide variability exists in factors and expected outcomes without previous national studies. This study aimed to characterise deaf children with CI in Chile and evaluate the impact of CI on speech perception and production, social inclusion, and parental satisfaction.<\/jats:p>\n<jats:p>We conducted a prospective study using hospital clinical records and an online questionnaire with 107 deaf children under 15 who had received CIs from 2017 to 2019. We characterised factors and outcomes and investigated the relationship between demographic, audiological, and social determinants of health and outcomes, including communication at home, CAPII, SIR, Geers and Moog Scale, Social Inclusion, and Parental Satisfaction.<\/jats:p>\n<jats:p>Our study showed a national profile of deaf children with CI, representing 70% of those implanted from 2017 to 2019. CI beneficiaries lived in more developed boroughs (.54) compared to the national average (.37). Communication and speech perception outcomes varied and were concerning, yet more positive outcomes were presented for social inclusion and parental satisfaction. We found an association between the measured outcomes and children\u2019s age, a socio-economic factor, CI use and CI training. This novel national study supports integrating public services close to each beneficiary\u2019s borough to improve outcomes with the device. CI use and parental training might be crucial measures during rehabilitation treatment.<\/jats:p>","DOI":"10.1371\/journal.pone.0317238","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T18:26:28Z","timestamp":1741199188000},"page":"e0317238","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Deaf children with cochlear implants in Chile: A national analysis of health determinants and outcomes in the Latin American context"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0796-0202","authenticated-orcid":true,"given":"Mario","family":"Bustos-Rubilar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fiona","family":"Kyle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merle","family":"Mahon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"issue":"4","key":"pone.0317238.ref001","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.bjorl.2014.05.011","article-title":"Profile of patients assessed for cochlear implants","volume":"80","author":"MH de Barbosa MH","year":"2014","journal-title":"Braz J Otorhinolaryngol"},{"issue":"10111","key":"pone.0317238.ref002","doi-asserted-by":"crossref","first-page":"2414","DOI":"10.1016\/S0140-6736(17)33097-0","article-title":"Hearing loss: time for sound action","volume":"390","author":"Lancet The","year":"2017","journal-title":"Lancet"},{"key":"pone.0317238.ref003","unstructured":"World Health Organization. World report on hearing. 2021."},{"key":"pone.0317238.ref004","unstructured":"World Health Organization. Global costs of unaddressed hearing loss and cost-effectiveness of interventions: a WHO report. 2017;87:149\u2013200."},{"key":"pone.0317238.ref005","first-page":"655","author":"OMS","year":"2018"},{"issue":"1","key":"pone.0317238.ref006","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1080\/00016489.2022.2162959","article-title":"Hearing loss in school-aged children","volume":"143","author":"MC Torrente","year":"2023","journal-title":"Acta Otolaryngol"},{"key":"pone.0317238.ref007","first-page":"1","author":"HEd Knoors","year":"2018"},{"issue":"4","key":"pone.0317238.ref008","doi-asserted-by":"crossref","first-page":"212","DOI":"10.3109\/00206090009073081","article-title":"Hearing impairment in latin America: An inventory of limited options and resources","volume":"39","author":"JJ Madriz","year":"2000","journal-title":"Int J Audiol"},{"issue":"1\u20132","key":"pone.0317238.ref009","first-page":"79","article-title":"Deafness as disability: Countering aspects of the medical view","volume":"9","author":"BA Ha\u2019am","year":"2017","journal-title":"Public Reason"},{"issue":"4","key":"pone.0317238.ref010","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1353\/sls.2013.0012","article-title":"Deaf ethnicity, deafhood, and their relationship","volume":"13","author":"P Ladd","year":"2013","journal-title":"Sign Lang Stud"},{"issue":"10","key":"pone.0317238.ref011","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1097\/MAO.0000000000001976","article-title":"Language Outcomes Improved Through Early Hearing Detection and Earlier Cochlear Implantation","volume":"39","author":"C Yoshinaga-Itano","year":"2018","journal-title":"Otol Neurotol"},{"issue":"6","key":"pone.0317238.ref012","doi-asserted-by":"crossref","DOI":"10.3390\/jcm11061548","article-title":"Multidimensional family-centred early intervention in children with hearing loss: A conceptual model","volume":"11","author":"D Holzinger","year":"2022","journal-title":"J Clin Med"},{"key":"pone.0317238.ref013","unstructured":"NHS England. NHS England. 2023 [cited 2024 Aug 28]. p. 1\u201330 Cochlear implantation services (adults and children). Available from: https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2013\/05\/D09sa-cochlear-implantation-services.pdf"},{"key":"pone.0317238.ref014","unstructured":"CSG M\u00e9xico. Guia Rapida: Hipoacusia neurosensorial bilateral e implante coclear. 2010."},{"key":"pone.0317238.ref015","first-page":"7428","year":"2016"},{"key":"pone.0317238.ref016","unstructured":"Plan nacional de salud auditiva y cuidado del o\u00eddo para Chile. 2022;1\u201368."},{"issue":"5","key":"pone.0317238.ref017","doi-asserted-by":"crossref","first-page":"1\u201326","DOI":"10.1371\/journal.pone.0232421","article-title":"Cochlear implantation outcomes in adults: A scoping review","volume":"15","author":"I Boisvert","year":"2020","journal-title":"PLoS One"},{"issue":"1","key":"pone.0317238.ref018","first-page":"139","article-title":"Barriers to rehabilitation care in pediatric cochlear implant recipients","volume":"176","author":"B Noblitt","year":"2018","journal-title":"Physiology & Behavior"},{"issue":"6","key":"pone.0317238.ref019","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1080\/14670100.2017.1375238","article-title":"Evaluation of pediatric cochlear implant care throughout Europe: Is European pediatric cochlear implant care performed according to guidelines?","volume":"18","author":"H Bruijnzeel","year":"2017","journal-title":"Cochlear Implants Int"},{"key":"pone.0317238.ref020","doi-asserted-by":"crossref","first-page":"109635","DOI":"10.1016\/j.ijporl.2019.109635","article-title":"Parent-perceived challenges related to the pediatric cochlear implantation process and support services received in South Africa","volume":"126","author":"A Bhamjee","year":"2019","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"2","key":"pone.0317238.ref021","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1017\/S0305000915000033","article-title":"A parent-directed language intervention for children of low socioeconomic status: a randomized controlled pilot study","volume":"43","author":"DL Suskind","year":"2016","journal-title":"J Child Lang"},{"key":"pone.0317238.ref022","unstructured":"Mar\u00eda Elisa Giraudo, Carlos Mario Boccio, Federico Di Lella, Mar\u00eda Chalabe LM. Evaluaci\u00f3n pre implante coclear en pacientes pedi\u00e1tricos. 2019;(5):61\u201373."},{"issue":"1","key":"pone.0317238.ref023","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5354\/0719-4692.2022.64710","article-title":"Chilean Spanish transcultural adaptation of CAP-II and SIR scales in an online format for parents of children with hearing aids or cochlear implants","volume":"21","author":"M Bustos-Rubilar","year":"2022","journal-title":"Rev Chil Fonoaudiol"},{"key":"pone.0317238.ref024","article-title":"\u00cdndice de Desarrollo Comunal. 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