About Cochlear Implants

Q: What is a cochlear implant?
A: A cochlear implant is an electronic medical device designed to restore the ability to perceive sounds and understand speech by individuals with moderate to profound hearing loss. Children and adults who are not sufficiently helped by hearing aids may benefit from cochlear implants. Unlike a hearing aid, which delivers amplified sound acoustically, a cochlear implant bypasses damaged hair cells in the cochlea and stimulates the remaining nerve fibers directly through the application of electrical current.  
A cochlear implant consists of external and internal (surgically implanted) components.

The external components include:

  • A microphone that picks up sounds from the environment;
  • A speech processor (a computer) that analyzes and digitizes sound signals and sends them to a transmitter;
  • A transmitter worn on the head that sends the signal to the surgically implanted internal receiver/stimulator.

The internal components include:

  • A receiver/stimulator just under the skin which receives signals from the processor and converts them into electric impulses;
  • An electrode array that receives the signal from the transmitter and stimulates the auditory nerve. The transmitted information is then sent to the brain, which “learns” to interpret the signal as meaningful information.
Q: Why not use hearing aids?
A: Hearing aids help the majority of individuals with hearing loss by amplifying sound. But even the most advanced hearing aids may not overcome the hearing difficulties associated with severe to profound hearing impairment. A cochlear implant bypasses the damaged areas of the cochlea and may provide improved hearing abilities for speech understanding and the perception of music and environmental sounds.
Q: Who is a candidate to receive a cochlear implant?
A: A determination of candidacy is made by an audiologist and ear-nose-throat (ENT) surgeon with special training in cochlear implants. As of 2012, an adult with moderate to profound hearing loss may have up to 50% sentence discimination (i.e. words in sentences) in the ear to be implanted -- wearing hearing aids -- and be an appropriate candidate. In general, if someone wearing appropriately fit hearing aids cannot understand speech without seeing the speaker’s face, they  should be evaluated for a cochlear implant. For children, an assessment of any child with a severe to profound hearing loss should be made as early as possible as outcomes with a cochlear implant are significantly better in children who receive an implant at the earliest possible age. For a listing of cochlear implant  centers where an evaluation can be performed, please visit the websites of the three companies that manufacture and distribute cochlear implant devices in the U.S. See a list of our partners on this website.
Q: What is involved in the process of cochlear implantation?
A: See the Continuum of Cochlear Implant Care
Q: What are the barriers to cochlear implantation?
A: Barriers to cochlear implantation can be traced to low awareness among both the general public and the medical community. Further, there are no universally sanctioned medical/clinical guidelines for best practices in cochlear implantation and audiology after care—the data-based, best practices which lead to consistent clinical outcomes. Low reimbursement through public and private payers along with recent reductions in Medicaid payment has only increased the financial burden.
Q:  Can cochlear implants provide recipients with an appreciation for music?
A: For many, music is a universal language that unites people when words cannot. But for those who use cochlear implants – technology that allows deaf and hard of hearing people to comprehend speech – hearing music remains extremely challenging. To read more, see this ARTICLE

About the ACI Alliance

Q: There are a number of nonprofits in the hearing loss health arena. Why establish another one?
A: In 2010, a group of surgeons, audiologists, speech-language pathologists, and other professionals including representatives of cochlear implant manufacturers met to discuss why of the estimated population of candidates who could benefit from a cochlear implant, only a small percentage has received one. The group determined that while there are nonprofit societies and membership associations that represent the needs of the diverse populations of those with hearing loss, there was no independent organization with a dedicated, accountable and organized approach addressing access to cochlear implantation on behalf of patients. Hence the “American Cochlear Implant Alliance Foundation “ACI Alliance” was born.
Q: What is the mission of American Cochlear Implant Alliance?
A: The mission of American Cochlear Implant Alliance is to advance access to the gift of hearing provided by cochlear implantation through research, advocacy and awareness. It is committed to eliminating barriers to cochlear implantation by sponsoring research, driving heightened awareness and advocating for improved access to cochlear implants for patients of all ages across the U S.
Q: How does the American Cochlear Implant Alliance plan to eliminate the barriers to cochlear implantation?
A: In order to eliminate barriers to cochlear implantation the American Cochlear Implant Alliance has four aims: Conduct cochlear implant awareness campaigns among the general public, patients and medical community; develop and/or sponsor clinical trials and research documenting cochlear implant benefits and demonstrating links to overall health and wellness; educate health care plan executives and government officials about cochlear implant technology, its economic and social benefits, and the relative value associated with coverage; and organize collaborative efforts to foster new research and encourage best clinical practices for standardized cochlear implant outcomes.
Q: When did the American Cochlear Implant Alliance become a Not-For-Profit organization?
A: Effective October, 2011, the American Cochlear Implant Alliance Foundation (EIN 45-3568770), “ACI Alliance”, was formed as a Delaware Not-for-Profit Corporation and received its 501(c)(3) tax-exempt status from the IRS. The American Cochlear Implant Alliance has also been qualified to do business in the State of Illinois and is in the process of registering as a Charitable Organization throughout the US.
Q: What distinguishes the research the American Cochlear Implant Alliance plans to conduct as compared to other research based hearing loss nonprofit organizations?
A: The American Cochlear Implant Alliance is focused on developing and/or sponsoring clinical trials and research which document the benefits of cochlear implants and demonstrate links to overall health and wellness as well as organizing collaborative efforts to foster new research and encourage best clinical practices for cochlear implant standardized outcomes. The Alliance hopes to affect reimbursement coverage and patient outcome standards by utilizing health outcomes data (e.g., quality of life measures) and increasing the focus on both economic and social benefits of cochlear implants in the US.
Q: What does the American Cochlear Implant Alliance plan to do to become financially sustainable?
A: The American Cochlear Implant Alliance Board of Directors is committed to building a sustainable, efficient and effective mission driven organization. Key strategic initiatives include building a strong fundraising arm with diversified revenue streams through memberships, individual contributions, foundation grants and corporate sponsorships while meeting or exceeding industry standards for organizational efficiency.
Q: How can someone support the mission of American Cochlear Implant Alliance?
A: There will be numerous opportunities to support American Cochlear Implant Alliance’s mission whether it’s through contributing as a volunteer or financially. Visit our Get Involved section.

About ACIA and the Hearing Loss Community

Q: How does the American Cochlear Implant Alliance respond to concerns in the hearing loss community about the use of cochlear implants?
A: The American Cochlear Implant Alliance respects individual choices. As an organization committed to public hearing health it’s important that people are aware of what’s available and armed with knowledge to make the choice that’s right for them and their family. That is what the Alliance strives to do by driving heightened awareness and advocating to improve access for patients of all ages across the US.

About the ACIA’s Board of Directors

Q: How does the Chairman of the Board and other Officers get elected?
A: As part of its charge through the American Cochlear Implant Alliance governing by-laws, the Nominating Committee puts forth the Chairman of the Board slate for election to a one year term. The committee, which consists of board and non-board members, reviews the Chairman Position Description identifying candidates from among the current board of directors whose experience and expertise aligns with the strategic goals of the organization. All deliberations are made in closed door sessions and nominees are contacted by a member of the nominating committee. The Chairman of the Board is elected concurrently with individuals to the Board of Directors. Officers of the board are recommended by the Nominating Committee to the Chairman of the Board who per the Alliance by-laws has the authority to name individuals to these positions. Officers are elected for a one year term by the current Board of Directors in place. Both the Chairman of the Board and Officers of the Board are eligible to serve two consecutive one year terms.
Q: Will there be opportunity for volunteers to join the American Cochlear Implant Alliance Board of Directors?
A: As the American Cochlear Implant Alliance grows the number of opportunities for committee volunteers will increase and over time it is hoped these volunteers will become part of a robust pipeline for future leadership. The slate of directors proposed for election will be published on the Alliance website as will future volunteer opportunities as it is fully developed.
Q: How long does a Board Member serve on the American Cochlear Implant Alliance Board of Directors?
A: American Cochlear Implant Alliance Directors are elected for a two year term and may be re-elected for three consecutive two year terms on the Board of Directors. No member of the board may serve more than six consecutive years. At the recommendation of the Nominating Committee the Board of Directors may also determine to elect a Director for a term of one or two years in order to maintain staggered terms on the Board

Q: How does an individual become a member of the ACI Alliance Board of Directors

A: The American Cochlear Implant Alliance governing by-laws include a Nominating Committee which provides leadership, oversight and management of the nomination process, election and annual review of the Alliance Board of Directors and its officers. The committee consists of both board and non-board members and is charged with identifying and annually reviewing the appropriate skills and characteristics across consumer and professional disciplines, which are required of Board members to ensure the Alliance achieves its mission. These factors include, but are not limited to experience, geographic location, diversity and skills in areas that are expected to contribute to overall board effectiveness and achievement. The Nominating Committee seeks nominations among both board and non-board members and recommends nominees for election based on the number of open positions for that term period. All deliberations are made in closed door sessions and nominees are contacted by a member of the nominating committee.