Background: Children born with severe to profound sensorineural hearing loss face challenges in a world built around spoken language communications. Hearing loss often has a significant impact on educational progress through the school age years, which later affect their ability for employment. These children and their families have two options: total communications with signing and speech therapy, or cochlear implantation, a surgical procedure where a device is implanted that raises the possibility of hearing restoration. In order for a cochlear implant patient to get the best result from the procedure, it is necessary for the recipient to have extensive testing before surgery, as well as consistent follow-up appointments with both an audiologist and a speech and language pathologist after surgery. Failure to comply with post-operative appointments and therapies can result in the patient eventually becoming a non-user of the implant.

Families coming from challenged social and economic backgrounds have difficulty with managing the appointments and therapies necessary for cochlear implant recipients. When a family fails to support their child in this effort clinicians are faced with a dilemma as to how best to help these families. One option available to medical professionals is to report the family to the Illinois Department of Children and Family services. Clinicians feel very conflicted about doing this for fear of alienating the family. Also, it is unclear if this action helps improve compliance with therapy and outcomes in cochlear implantation. The goal of our research is to review 3 cases where DCFS advocated on behalf of a minor with severe hearing loss

Objectives: The purpose of this study is to review 3 cases of pediatric cochlear implantation where the Illinois Department of Children and Family Services advocated on behalf of the child to determine 1) the effect of DCFS involvement on hearing outcomes, 2) adherence to appointments, and 3) compliance with therapy