The July/August 2025 issue of the ASHALeader published a review of two new important studies.  Ivette Cejas and Donna Sorkin summarized recently published papers on research encouraged by ACI Alliance to extend and update work led by Dr. John Niparko as part of Childhood Development after Cochlear Implantation supported by NIDCD.  The ASHA Leader reaches over 230,000 print readers and many more via electronic means. See the articles below:

The study supported by ACI Alliance “Cochlear Implantation and Educational and Quality-of-Life Outcomes in Adolescence” by Cejas I et al was published in JAMA Otolaryngology Head Neck Surgery in June 2023. A key study finding was that children with CIs had better academic performance compared with children without CIs with similar levels of hearing loss. The greatest benefit was among children who received implants early (prior to age 18 months) who performed at or above age and gender norms for language and academic achievement. Adolescents with CIs reported better quality of life than children who did not have CIs.

In May 2024 The Laryngoscope published “Costs of Severe to Profound Hearing Loss & Cost Savings of Cochlear Implants” by Cejas I et al. The paper concluded that overall early implantation substantially reduced lifetime costs and that access to hearing health care and technology is critical given the documented benefits for language, education, and quality of life.

SOCIETAL COSTS OF SEVERE TO PROFOUND HEARING LOSS AND COST-UTILITY OF COCHLEAR IMPLANTS

Read more about this in our e-magazine, Calling, November 2023 issue.

The February 2024 issue also has an update on this study:

Findings from this study indicate that children with severe to profound hearing loss who use cochlear implants have better educational outcomes and quality of life, regardless of age at implantation, than non-implanted children. Specifically, children in the CDaCI cohort had better educational outcomes in reading, writing (Woodcock Johnson) and quality of life compared to non-implanted children with severe to profound hearing loss. Children implanted prior to 18 months of age had the highest levels of oral language and academic achievement.

Ivette Cejas PhD / Associate Professor and Director, Family Support Services / University of Miami Department of Otolaryngology / ACI Alliance Conferences Program Committee Member and Co-Chair, Scientific Program for CI2019 Pediatric (Hollywood FL)

Hearing loss is the most common sensory disorder, with severe to profound hearing loss affecting 1 in 1,000 children born in the United States. Untreated hearing loss negatively affects educational outcomes, employment status and earnings, use of healthcare services, and life expectancy. The Project Hope Study (Mohr et al., 2000) is the most comprehensive examination to date estimating the societal costs of hearing loss as an additional $297,000 over an individual’s lifetime. Moreover, for a child with prelingual deafness the estimation exceeds $1 million. This is double the cost associated with strokes, epilepsy, and rheumatoid arthritis. However, the Project Hope study was published in 2000, prior to the wide adoption of cochlear implants as the preferred treatment for bilateral severe to pro- found hearing loss. The benefits of CIs are well-established and research has consistently shown their positive effect on auditory skills and spoken language abilities. CIs have also been shown to be cost-effective, with greater cost-savings being reported for children implanted earlier (Semenov et al., 2014).

I would like to introduce the ACI Alliance community to the investigator team: myself—Ivette Cejas, Alexandra L. Quittner, David Barker, and Esteban Petruzzello. We are a research team made up of psychologists, health economists and statisticians that will work in partnership with the American Cochlear Implant Alliance to build upon the currently available research on the societal costs of hearing loss and cost-utility of pediatric cochlear implants. Despite the known benefits of cochlear implants, variability remains in terms of insurance coverage and reimbursement for cochlear implants.

An economic evaluation of CI will provide an opportunity to measure the cost-effectiveness of early identification and intervention to limit the impact on societal costs. The purpose of a cost-utility analysis is to determine the ratio between the cost of a health-related intervention and the benefits, expressed in quality-adjusted life years (QALYs). QALYs are a treatment effectiveness measure that help quantify health states (such as hearing loss or cochlear implantation) that are considered less preferable to full health and allow comparisons over time.

Over the next year we will be obtaining several datasets that capture the educational and medical costs of severe to profound hearing loss and cochlear implantation. We will also be using data from the Childhood Development after Cochlear Implantation (CDaCI), a unique database that captures a comprehensive developmental picture of deaf children receiving cochlear implants from infancy to adolescence/young adulthood.

Although this is no small task, we are up for the challenge. The importance of evidenced-based data as an educational tool regarding the benefits and costs of cochlear implantation is crucial given the uncertainty of healthcare in the future. We feel strongly that this project will help tackle health disparities in cochlear implants and improve access to hearing health care.

AWARDED GRANT TO EVALUATE COST EFFECTIVENESS OF EARLY IDENTIFICATION AND INTERVENTION:

IMPACT OF PEDIATRIC COCHLEAR IMPLANTATION

August 2020

American Cochlear Implant Alliance (ACI Alliance) was awarded a grant by Oberkotter Foundation to update the seminal Project HOPE study published in 2000 by Mohr et al for the studying of the impact of pediatric cochlear implantation. This work has been a central component of public policy discussions on pediatric deafness for two decades.

The ACI Alliance Research Committee, chaired by Michael Hoa MD, assembled a study research team skilled in the management of complex, longitudinal datasets to find the impact of pediatric cochlear implantation.

Newborn hearing screening and advanced hearing technology provides extraordinary life opportunities for deaf children. ACI Alliance is grateful to Oberkotter Foundation for providing support for this critical study that will provide important research outcomes for everyone involved in supporting families of deaf and hard of hearing children and the impact of pediatric cochlear implantation.

Read our press release here.