Cochlear Implants: FAQs

Are all deaf children cochlear implant candidates?

Not necessarily.  If you are interested in a cochlear implant for your child, we suggest contacting your local implant centers and ask about their particular candidacy criteria, and give them information about your child’s hearing loss, age, communication skills and educational placement. 

 

Which is the best implant?

We work with children using all three manufacturers’ devices, and we find generally the same range of performance across all three manufacturers.  We recommend you take the advice of your surgeon if he or she has a preference for your child.  If there is no preference, you may choose the one you feel most comfortable with, after you study the options. We are happy to help you by providing information and demonstrations of these options.

 

Will my child’s hearing be normal after implantation?

No. Cochlear implants do provide access to sounds across the speech frequency range at levels that allow them to hear most of the components of speech at normal conversational levels. This is only when he or she is wearing the external equipment, though--a cochlear implant does not cure hearing loss. 

 

Will my child be able to talk with a cochlear implant?

It isn’t possible to predict how any child will be able to use what he hears with a cochlear implant. With appropriate therapy and follow-up at home, most children who receive cochlear implants do develop the ability to listen and talk, though some will continue to use Sign Language as well.

 

Will my child be able to attend a general education classroom with a cochlear implant?

Again, it isn’t possible to predict.  But with appropriate therapy and follow-up at home, many children do attend general education classrooms.  Additional services may be required to help them achieve their best.

 

Will my child get one or two implants?

This will depend on your child’s hearing loss, whether your child is medically a candidate for two implants, whether she can benefit from a hearing aid in one ear, and whether you as parents are interested in one or two.

 

If one, which ear will be implanted?

If one ear is the better choice medically, the surgeon will advise you.  If either ear is a  good choice medically, the recommendation may be the ear with the better hearing history--that is, of two ears with very poor hearing, one may have had slightly better benefit from a hearing aid.  Or, if one ear can still benefit significantly from a hearing aid,  the recommendation will be to implant the poorer ear.

 

Should we wait until our child can decide for herself if she wants a cochlear implant?

We know from an abundance of research that when there is little to no benefit from hearing aids, the earlier we can perform cochlear implantation, the better the outcome is likely to be.  Your child may be a good candidate for a cochlear implant when she is a baby or toddler, but if you wait until she is school aged or older the outcome may be much poorer.  If you are in favor of cochlear implantation and your child is deemed a good candidate, we recommend you proceed right away.

 

Should we wait until better/smaller/less visible technology comes along?

For the same reasons we don’t recommend waiting until your young child can decide for himself if he is deemed a candidate right now,  we recommend that if you are in favor of cochlear implantation you proceed right away with the available technology.  Early implantation is known to be one of the most important factors in success, much more important that the particular device itself.  The manufacturers know that your child will have his device for many years and they all make it a priority to create new external equipment that can be used with older internal devices.  So for at least some years, new external equipment will likely be available for your child.

 

With the emphasis on very early implantation, are older children ever candidates for cochlear implantation?

Absolutely! Older children who do not already communicate through listening and speaking will be less likely to learn to understand spoken language or learn to communicate primarily through listening and speaking. But children who have received at least some benefit from hearing aids --just not enough, especially as the demands on their listening abilities becomes greater in school-- and communicate primarily by listening and speaking already can be very good candidates indeed. Older children with sudden-onset hearing loss or progressive hearing loss who communicate through oral language already can be excellent candidates as well.

 

Do some children successfully use a hearing aid on one ear and a cochlear implant in the other?

Yes.  The more residual hearing a child has in the unimplanted ear, the more likely they will benefit from a combination of both devices.  The implant and the hearing aid may each provide different benefits in terms of the quality of sound. The hearing aid may need to be programmed slightly differently to make the most of these benefits.

 

How often will my child need therapy?

As with the type of therapy, the amount of therapy will vary depending on the children’s age, the presence or degree of language delays, and the philosophy of therapy that the family has chosen.  For children newly implanted, most typically a comprehensive approach to intervention is important. Children need to have many opportunities throughout the day to develop listening and communication skills.  For children who are slightly older at the time of implantation and who have substantial language delays, they may benefit from having more structured and frequent therapy. On the other hand, for children implanted at very young ages (e.g., under 18 months of age), once weekly therapy may be adequate provided that there is strong family involvement and home carry over of skills throughout the rest of the week. Your child’s therapist or implant center will help guide you and discuss with you what may be most appropriate for your child.