Determinants and outcomes in children with cochlear implants in Chile: A longitudinal study in the Latin American context

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Abstract
Deafness from birth presents a major challenge to communication development and carries significant public health implications. Cochlear implants (CI) are a key intervention for those with severe to profound deafness. In Chile and across Latin America, policies exist to support early CI access. However, delays in implementation and limited monitoring reduce their effectiveness. As a result, variability persists in spoken language outcomes for deaf children using CI. This study followed 49 Chilean children who received a CI between 2017 and 2019, using hospital records and two parental surveys over a 12-month period. Language outcomes and progress were investigated using validated tools (CAP-II, SIR, CDI Vocabulary), alongside five selected key factors: additional disabilities, age at implantation, daily CI use, socioeconomic factors, parental training and confidence. Findings indicated a modest yet uneven improvement in speech perception and language abilities over the study period. Fewer than one-third of children used only spoken language at home. Auditory performance and speech intelligibility improved slightly, while receptive vocabulary scores plateaued, and vocabulary production increased modestly after one year of CI use. Daily CI use and parental training were the strongest predictors of language outcomes . Despite current/recent policy advances, CI outcomes continue to be limited by delayed access, fragmented services, and socioeconomic inequality. These results underline the need for tailored strategies to strengthen early intervention and language support in Chile and across Latin America.

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