Hearing, Speech and Language Outcomes in Children with Cochlear Implants: a Comparison between ADIP Scheme and Self-Financed Scheme
Abstract
Purpose: Cochlear implants (CIs) are of immense benefit to children with severe to profound hearing impairment. While cochlear implants under the ADIP scheme cost a lot to the public exchequer, parents spend considerable amounts on CI surgery under the self-financed scheme. This study aimed to find and compare outcomes of cochlear implants in children who availed of the ADIP scheme and those who were implanted under a self-financed scheme. The secondary aim was to elicit the views of parents on the challenges their wards faced under the ADIP scheme for cochlear implants.
Method: The study focused on twelve children who received cochlear implants under the ADIP scheme and twelve children who received implants under a self-financed scheme at a tertiary care health centre. The baseline for measurement of various outcomes was a minimum of six months post implantation. Cochlear implant outcomes were compared using MAIS/IT-MAIS, SIR, CAP, and ISD tests. Interviews were also conducted with the parents of children who received cochlear implants under the ADIP scheme, for information regarding the challenges they faced.
Results: There was a significant difference (p<.05) between the two groups in the scores of CAP and reception, speech, and cognition subsections of the ISD scale. The scores of the ADIP group were significantly lower in these domains. The possible reasons might be a lack of funds, not visiting the therapy centre regularly, loss of wages during a visit to the therapy centre, lack of family support, and insufficient time to repeat therapy activities at home. There was no significant difference in age, CI age, and CI usage duration between the two groups.
Conclusion and Implications: Compared to children implanted under the self-financed scheme, children implanted under the ADIP scheme are significantly lacking in a few domains of communication skills. The efficacy of the ADIP scheme for cochlear implantation can be evaluated and policy change can be advocated based on this study. The study has outlined some modifications to this welfare scheme in order to fill the observed lacunae and widen the scope of its reach.
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