cochlear implant candidacy children

Changing Cochlear Implant Criteria

For some reason, the cochlear implant guidelines for young children has always been behind the times. For a long time children with a profound hearing loss could be implanted at 1 year but a child with a severe hearing loss could not be implanted before age 2.

Don’t children who are 18 months old need to hear? Audiologists and ENT’s have always proposed earlier implantation to the FDA, but change takes time.


Early Intervention Matters


We know that babies have very plastic brains so we really want to have them implanted as early as possible. Waiting 6 or 9 or 12 months can make a big difference.

Current criteria recommends that the adults  can be implanted with moderate to profound sensorineural hearing loss. Children 2-17 years can be implanted with a severe to profound hearing loss and children 9-24 months can be implanted with a profound hearing loss.

Australia and several European countries implant children earlier than we do in the US. We need to work to change criteria so that as soon as we know that a child has a severe to profound hearing loss they can be implanted.

We need to change the criteria so that degree of hearing loss is not different for people of different ages. The cochlear implant companies and large cochlear implant centers need to do the necessary research and the FDA needs to be convinced that criteria needs to change. And, finally, insurance companies have to allow surgeries earlier.

Let’s get a move on everyone…



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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