Cochlear Implant Program | Is My Child a Candidate?

Is my child a candidate?

Determining if a cochlear implant is right for your child is a process that includes appointments and evaluations with various members of our team. If your child is approved for implantation, family members will be asked to attend programming sessions, maintain equipment and support their child and her progress during all waking hours.

To schedule an appointment with a member of our Cochlear Implant Program team, call 781-216-2250.

What range of hearing loss must my child have to benefit from an implant?

A child with profound hearing loss in both ears may receive a cochlear implant at 10-12 months of age. If the hearing loss is severe (70-90 decibels) rather than profound (over 90 decibels), then the child should typically be at least two years old. In this case, hearing aids must be tried long enough to determine whether your child can perceive speech with the aids. If an older child is able to hear well on the telephone using hearing aids, a cochlear implant might not provide more benefit.

Cochlear Implant Program specialists evaluate children with:

  • severe or profound sensorineural hearing loss (loss of function within the inner ear) in both ears
  • sloping hearing loss (high-frequency hearing loss) with limited benefit from hearing aids
  • auditory neuropathy spectrum disorder (auditory dys-synchrony)

At what age should a child receive a cochlear implant?

Children can receive a cochlear implant beginning at 10-12 months of age. For a child hoping to receive a cochlear implant at this age, evaluations should ideally start around 3-4 months of age. This early implantation gives the child the best chance to learn to use sound while language skills are developing.

A child with severe to profound hearing loss who makes maximal use of hearing aids and who already uses spoken language may benefit from a cochlear implant. However, many children who are deaf either from birth or before they speak their first word and who receive a cochlear implant when they are older do not develop the ability to recognize speech with the implant and ultimately may reject its use. For these children, a cochlear implant may not be recommended.

Children who once had normal hearing or partial hearing and then become deaf may be implanted as soon as it is clear that the child’s hearing is not going to recover and that there is little or no benefit from a hearing aid. Older children and teenagers who lose their hearing should participate in the decision whether to have a cochlear implant.

How do I find out if my child is a candidate?

To find out if your child is a candidate for a cochlear implant, call our program coordinator at 781-216-2250. When you call, you will be asked to fill out an intake questionnaire and to provide any relevant audiological, speech/language, educational and medical reports if these evaluations occurred outside Boston Children's Hospital. This information will be reviewed by our team and will help us determine the most appropriate course of appointments to evaluate your child's candidacy for a cochlear implant.

How long does the evaluation process take?

Children frequently require multiple evaluations and meet with a number of specialists during the evaluation process, often requiring several visits. We will keep you informed of your child's potential candidacy along the way. It is our job to determine, from all possible perspectives, whether a cochlear implant is truly the best option for your child.

What appointments and evaluations will my child have?

Over the course of the candidacy process, your child will meet with many members of our cochlear implant team, including:

  • An audiologist: The audiologist provides hearing testing and an information session for the parents, family members and caregivers to learn more about cochlear implants and our program. The audiologist, along with our program coordinator, will be your family's main contact with our program.
  • An otolaryngologist (ear, nose and throat doctor): The otolaryngologist assesses your child from a medical perspective to ensure that a cochlear implant is an appropriate option. This may involve ordering specialized tests, such as a CT scan or MRI, or blood work, to assess your child's anatomy and possibly the cause of the hearing loss. The otolaryngologist will also invite you to meet with the surgeon who would perform the cochlear implant surgery. Together they will share additional information regarding what to expect during and after surgery.
  • A psychologist: The psychologist assesses your child's cognitive function and general development. The psychologist helps ensure there is adequate family support and commitment and that your child has access to an appropriate educational program. For older children, the psychologist can also help prepare the child for what to expect during surgery.
  • A speech-language pathologist (SLP): The SLP assesses your child's speech and language development. This may include sign or spoken language, as our SLPs are fluent in sign language. The SLP will also assess your family's access to aural rehabilitation (listening therapy) services, which are required following implantation. The SLP will also help your family secure services for your child when needed. In addition, they are able to provide direct aural rehabilitation services when therapy cannot be established closer to home.

Other Boston Children’s specialists including developmental pediatrics, occupational therapy, genetics, ophthalmology and neurology, are available as needed for consultation.

What happens after the evaluation process?

After your child has completed all necessary evaluations and examinations, the team discusses their findings with each other, with the family and with your child's primary care pediatrician and school when appropriate. If it is determined that a cochlear implant is an appropriate option for your child, and your family would like to proceed with implantation, our program coordinator will work with your family to set up a surgery date.