Pediatric Cochlear Implantations

Pediatric Cochlear Implant Information Packet       

Candidate's Meeting Information 

Younger Children and Cochlear Implantation

Younger children may be good cochlear implant candidates if any one of the following is true: 

• No response or highly elevated response on ABR testing
   
• Severe to profound sensorineural hearing loss in both ears
   
• Diagnosis of Auditory Neuropathy/Auditory Dys-Synchrony in both ears and not progressing with use of hearing aids
   
• Difficulty getting aided responses at 25-30 dB HL at all frequencies for each ear

Older Children and Cochlear Implantation

Older children may be good cochlear implant candidates if:

• The child has a severe to profound sensorineural hearing loss in both ears, has difficulty getting aided responses at 25-30 dB HL at all frequencies for each ear, and has plateaued on development of listening skills with high power hearing aids.
   
• Diagnosis of Auditory Neuropathy/Auditory Dys-Synchrony in both ears and not progressing with use of hearing aids.
   
• The child's hearing loss is progressively getting worse (is in the severe or severe-to-profound range in both ears) and the child is beginning to have difficulty understanding others when listening alone (not lip reading).

Factors that Affect Performance

Considerable time is spent with each family discussing the potential benefit if the child were to receive a cochlear implant. Factors that may affect performance with a cochlear implant include:

• Length and Degree of Deafness
  • Children born with hearing loss (even if it is profound) who are implanted at a very young age (as an infant or toddler) will learn to understand speech with the cochlear implant more quickly and more easily than those who are implanted when they are older.
     
  • Children, even those who are older, who receive some benefit from hearing aids and continue to use them fairly well may transition to the cochlear implant more quickly and more completely than children who are older and are unable to understand any speech with their hearing aids.
     
  • Children with progressive hearing loss who are implanted as soon as they are no longer able to rely on hearing aids for understanding speech will transition to the cochlear implant more quickly than those who have been struggling for longer periods of time. Typically most children with progressive hearing loss eventually make good use of the cochlear implant for speech understanding.
     
• Physiologic Issues:  Status of the cochlea, the presence of cochlear ossification, and the presence of healthy auditory neural tissue all can affect a child's ability to understand speech with a cochlear implant. These issues are discussed with each potential candidate's family.
   
• Motivation and Commitment:  Successful benefit from a cochlear implant requires
  • Consistent use of the device,
     
  • Proper care of the equipment,
     
  • Regular follow-up appointments at the implant center,
     
  • Therapy to aid in the use of implanted hearing for speech and language development,
     
  • Support of family and care-givers, and
     
  • Support of early intervention providers or educators in maintaining and facilitating the use of a cochlear implant.