DOI: 10.1097/01.HJ.0000446440.44172.67
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Issn Print: 0745-7472
Publication Date: 2014/04/01
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Excerpt
Implantation by 12 months of age is now the standard of care for children born with profound sensorineural hearing loss. Professionals who work with these children have become more comfortable moving infants through the candidacy process.
On the other hand, decisions about when to transition older children with more residual hearing from amplification to cochlear implantation are challenging, but they are greatly important for ensuring auditory access.
In a common scenario for pediatric hearing healthcare, a child is diagnosed with moderate to severe hearing loss via auditory brainstem response and is fit with hearing aids during infancy. At that time, the child is not considered to be a candidate for cochlear implantation because hearing aids provide adequate audibility for speech.
Perhaps the child has a gradual progression of hearing loss, or behavioral audiometric assessment reveals poorer thresholds than initially evident from the auditory brainstem response test.
The child may start to experience delays in the development of auditory skills or of speech and language. Compared with other children who use amplification, the child may be developing more slowly.
When we examined these issues in our own clinic to determine the best time to send a child for cochlear implant evaluation, we discovered that, unlike the rapidly expanding literature on early cochlear implantation, research on assessing cochlear implant candidacy in older children who are not advancing despite amplification is much more limited.
