cochlear implant baby hearing loss

Age At Cochlear Implantation: Predicting Learning and Cognitive Abilities

There has been a lot of research which has demonstrated that with cochlear implantation, as with many other things, earlier is better. This is based on research on critical periods for brain development.

Delay in auditory access results in auditory deprivation which decreases cortical plasticity over time. This effects both cognitive and linguistic development. And delays in linguistic development refers to delays in literacy.


Factors influencing performance


Receiving an implant early is certainly a critical factor but it is not the only critical factor. However there are other factors. The fact that a child has an implant doesn’t mean that the child is using the implant. Research is clear that children who wear technology at least 10 hours/day will have better performance than children who do not use the technology at least 10 hours/day.

Another factor that is critical is if and how parents are talking to their children. Having technology on is necessary but will only be useful if someone is talking to the child. Parents need to be new casters – talking constantly, and describing what is happening.

“Look, I have your cup. What is in your cup? Is there milk? Is there juice? I think it is juice. I am going to look and see. It is juice… Do you want some?”  

By talking in complicated sentences we are providing children with excellent language exposure which will help build the brain. In addition, parents need to learn how to pause, and wait for children to respond – babble (when they are young) and to respond when they are older.




The research is difficult to review, because subjects receive CI’s at different ages, use devices for a different number of hours a day, and have different therapy. But the data is clear. Younger is better. Children who receive CI’s early do better. Children who use hearing aids early also do better if they wear technology early.

Start early, fit technology early, wear technology full time (at least 10 hours/day), talk talk talk to children. Give them the opportunity to babble or talk back to you.

Have high expectations. They can be met!!!

About Jane Madell

Jane Madell has a consulting practice in pediatric audiology. She is an audiologist, speech-language pathologist, and LSLS auditory verbal therapist, with a BA from Emerson College and an MA and PhD from the University of Wisconsin. Her 45+ years experience ranges from Deaf Nursery programs to positions at the League for the Hard of Hearing (Director), Long Island College Hospital, Downstate Medical Center, Beth Israel Medical Center/New York Eye and Ear Infirmary as director of the Hearing and Learning Center and Cochlear Implant Center. Jane has taught at the University of Tennessee, Columbia University, Downstate Medical School, and Albert Einstein Medical School, published 7 books, and written numerous books chapters and journal articles, and is a well known international lecturer.

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