Socioeconomic and Demographic Trends of Sign Language Speaking Cochlear Implantees: A National Database Analysis

Sunday, October 12, 2025

10:06 AM - 10:12 AM EDT

Location: 244

Disclosure(s):

Elizabeth Lee, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Christopher Z. Wen, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Charlyn N. Gomez, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Adam C. Kaufman, MD PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Cochlear implants (CI) remain controversial within the Deaf community, as critics argue CI usage implies deafness as a disease and erodes Deaf culture. A salient predictor of Deaf identity is speaking American Sign Language (ASL), and this study examines whether the socioeconomic and demographic characteristics of ASL-speaking cochlear implantees differ from those of the broader CI population.

Methods: This cross-sectional study analyzed patients receiving CI between January 2014 and June 2024 using the Epic Cosmos database. χ2, Fisher’s exact, and two sample t-tests compared differences between ASL speakers and non-speakers in age, sex, race/ethnicity, insurance, explantation, socioeconomic status (SES)/social vulnerability index (SVI), and urban/non-urban categories.

Results: Of 35,034 cochlear implantees identified, 1,033 (3.04%) indicated ASL as their preferred language. Pediatric ASL speakers were significantly older than pediatric non-speakers (6.49 vs. 5.30 years, P<.001), while adult ASL speakers were younger (41.70 vs. 64.55 years, P<.001). ASL-speaking CI patients were more likely to be female (P <.001, OR=1.36, CI 1.20-1.55), Hispanic (P <.001, OR=2.57, CI 2.16-3.05), and urban (P <.001, OR=1.57, CI 1.30-1.89). Additionally, there is a significant association between type of insurance coverage, SES, SVI, and ASL (P <.001). ASL speakers were more likely to be in the most vulnerable SES group (P <.001, OR=1.65, CI 1.43-1.89) and more likely to undergo explantation (P <.001, OR=2.65, CI 1.96-3.53) compared to non-ASL speakers.

Conclusions: Deaf cochlear implantees display socioeconomic and demographic differences compared to the general CI recipient population. Deaf identity may intersect with health considerations, like CI explantation, highlighting the need for culturally informed approaches to patient care.

Presenting Author(s)

Elizabeth Lee, BS

Medical Student
University of Maryland School of Medicine
Baltimore, MD, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Christopher Z. Wen, MD

Resident, PGY-4
University of Maryland School of Medicine
Baltimore, MD, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Charlyn N. Gomez, BS

Medical Student
University of Maryland School of Medicine
Silver Spring, MD, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Marcelina Puc, BA, MS

Graduate Student
Drexel College of Medicine
Philadelphia, Pennsylvania, United States

Disclosure information not submitted.
DP

Danielle Powell, AuD PhD

Assistant Professor
University of Maryland
College Park, Maryland, United States

Disclosure information not submitted.
DE

David J. Eisenman, Professor

Vice-Chairman Dept. of Otorhinolaryngology- Head & Neck Surgery
University of Maryland School of Medicine
Baltimore, MD, United States

Disclosure information not submitted.

Senior Author(s)

Adam C. Kaufman, MD PhD

Assistant Professor
The University of Maryland
Baltimore, MD, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.