Cochlear Implants in Infants and Young Children | FAQs

Q. What is a cochlear implant?

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 is a device for people whose hearing technology needs may be beyond hearing aids. Read more here.

Q. What are the steps to get a cochlear implant?

Cochlear implantation involves a team of people with a range of training and skills. Teams include specially trained ear, nose and throat (ENT) physicians, audiologists, and speech language pathologists. Other members of the team might include a social worker, a teacher of children with hearing loss, and a psychiatrist or psychologist. As a specialized procedure, cochlear implant (CI) surgery is not performed in all ENT clinics. Cochlear implants are a specialized intervention undertaken by individuals who have chosen to specialize in this device. Unlike other interventions, a cochlear implant is a lifelong process that requires care over a person's lifetime. Read more details on the steps here.

Q. What are the youngest age infants can receive a cochlear implant?

Universal newborn hearing screening has made it possible to begin the process of fitting young children with hearing technology at the earliest possible age thus minimizing language delays. For children born with severe to profound hearing loss who are candidates for cochlear implants, research has shown that one of the most important determinants of outcome is age of the child at the time of the surgery. Children who receive a cochlear implant at 9 months of age, have a better opportunity for reaching typical language development milestones by the time they enter school. A medical professional can provide families with additional information on cochlear implant resources, candidacy evaluation, referrals to CI professionals and/or a CI center, and possible connections with other families who have gone through the process.

Additionally, this webinar reviews past and present cochlear implant candidacy criteria for pediatrics and adults, and discusses ways to identify potential cochlear implant patients. It discusses evidence-based research and provides audiological case studies to aid the clinician in counseling the patient and their family on the need to pursue a cochlear implant evaluation. https://www.acialliance.org/page/ClinicalGuidance

Q. How do I know if my child would benefit from a cochlear implant?

Parental decision-making on whether and when to pursue a cochlear implant for their child can be overwhelming. Often parents have no experience with hearing loss as over 90 percent of babies are born to two typically hearing parents. Making an informed choice includes a review and discussion of comprehensive information that may be entirely unfamiliar to them and this is likely to be going on during a highly emotional time. Resources that may help with the decision-making might include: a CI surgeon (also called an ear, nose, and throat doctor); audiologists; information from the Internet and printed literature; and shared personal information from parents of children who have already received a cochlear implant. Adult recipients may also be helpful in explaining the experience of hearing with cochlear implants.

Q. What is best practice for determining CI candidacy for bilateral deafness?

With greater recognition of the importance of bilateral hearing in children for language development and overall academic success, single-sided deafness is now an accepted candidacy indication for cochlear implantation. This paper reviews both the current evidence and guidance for referral to a cochlear implant team: a 3-frequency pure-tone average of 60 dB HL or poorer or an aided speech intelligibility index poorer than 0.65 in the ear to be implanted. This paper also details evaluation and management of children with single-sided deafness who receive cochlear implants, including suggestions for spatial hearing assessment and subjective questionnaires. Read paper here.

Q. What is best practice for determining CI candidacy for children with single-sided deafness?

Current criteria for cochlear implantation in children has shifted from the historical requirement of bilateral profound sensorineural hearing loss to a more flexible and broader interdisciplinary approach. This manuscript combines global research evidence with clinical expertise across multiple areas to promote a 50/70+ guideline for pediatric cochlear implant referrals: 50% word recognition, audiometric thresholds of at least 70 dB HL, and poor functional performance (e.g., less than month-over-month progress for speech, language, or hearing; poor well-being or quality of life). Read paper here.

Q. What are the key factors that affect how well a child will perform with a cochlear implant?

Watch a video on Facilitating Listening and Spoken Language in Children With Cochlear Implants (5 mins)

Q. What is the recovery process like?

Children, unlike adults, will usually stay in the hospital one night before going home to recover. Once home, most children can go back to school or day care after 1 week, but they should not take part in sports or other strenuous activities for about 3 to 4 weeks. 1-4 weeks after surgery, the child will return to the clinic to have the device activated for the first time.

Q. What type of therapy will a child need after cochlear implant surgery?

Please refer to our paper on rehabilitation for children: https://www.acialliance.org/page/ACITherapyStatement

Q. What are some children outcomes after the surgery that I can read?

To read more on children cochlear implant outcomes, you can visit our stories page, where other parents have documented their journey's. You can also read our parent advocate stories page and watch a some short webinars on outcomes and related stories. 

Q. How do I find a clinic near me?

Use our find a clinic map to help find the closest implant center near you.

Find a Clinic

Searchable online tool to find a clinic near you

Check out our other resources

Parent Stories: https://www.acialliance.org/page/storiesaboutchildren

Parent Advocacy: https://www.acialliance.org/page/ParentAdvocacy

Parent Choice: https://www.acialliance.org/page/ParentChoice