Cochlear Implants

Parents of children who are deaf are often presented with the option of obtaining a cochlear implant for their child. Before this choice is made, it is important for parents to gather as much information as possible regarding the technology and to develop realistic expectations associated with its use.

A cochlear implant is an electronic device with both external and internal components. The external component consists of a microphone, sound processor, transmitter, transmitting cable, and battery. The internal components consist of a receiver and an electrode array. These components are embedded into a child’s head behind the ear during surgery. The cochlear implant mechanism operates by receiving sounds through the external components, digitally transforming them into electrical signals, and sending them into the implanted components and to the auditory nerve, which carries them to the brain. Surgery to implant the internal device is usually done on an outpatient basis, requires general anesthesia, and takes about two to three hours. The external components of the implant are fitted four to six weeks after surgery when healing is complete. The speech processor unit of the implant is computer programmed or “mapped” specifically for each individual with an implant. The cochlear implant destroys all residual hearing in the implanted ear.

In comparison to traditional hearing aids, cochlear implants provide improved sound awareness to children with severe to profound hearing loss. As is the case with hearing aids, intensive, appropriate follow up therapy and ongoing monitoring of the device is essential to helping children make sense of the many sounds in their environment that are detected through the implant. While a cochlear implant may provide sound detection at close to normal listening levels, the outcomes and rate of development a child may realize in relation to understanding and using spoken language will vary due to a number of factors. A cochlear implant does not give a child normal hearing and does not guarantee spoken language development similar to that of hearing children.

Parents who decide to have their child implanted may do so because they believe it will help the child in listening and speaking and that these skills will help their child fit in better with their family and with the “hearing world” in general. They also may do so to help the child develop a greater awareness of environmental sounds.

Parents who decide against a cochlear implant for their child may do so because of concern about the medical risks, concern that the child will not be successful with the implant, satisfaction with how the child is progressing with hearing aids, satisfaction with the child’s progress using sign language, and/or satisfaction with the child’s membership in the deaf community.

While in the past, a family’s choosing a cochlear implant for their child suggested that a family did not desire contact with the deaf community, this attitude is fading. Increasing numbers of families choose use of this technology for their child and continue to embrace use of sign language and participation in the deaf community.