Age and degree of hearing loss

Research shows that the decision can be more clear-cut if a child is diagnosed as totally deaf from birth.[1] If a child has an implant fitted as a baby, they can learn to hear and speak as well as any other child and in a natural way. Research shows that implantation before the age of two improves their chances of attending mainstream school and fulfilling their potential as far as education and career opportunities are concerned.[2]

They also won’t have the same awareness and emotions about having an operation that an older child would have.

However, you may not find the decision as easy if your child has developed a hearing problem after several years or if they have a degree of residual hearing and are already part of the ‘deaf culture’, using sign language and lip reading.

There’s very little research on the views of young people who have been implanted, but a small study by the Ear Foundation and National Deaf Children’s Association on teenagers with implants gave positive feedback.[3]

  • All except two of the 29 teenagers interviewed said they wore their implants all day every day.
  • They positively felt that they belonged to both the deaf and hearing worlds.
  • None of the young people who had had their implant fitted when they were young criticised their parents for making that decision or for making the decision without involving them. On the contrary, they were grateful to them for the choice they had made.

Timing

While having a hearing implant is a decision that must be carefully considered, evidence shows that results are better, the shorter the period of hearing loss. In other words, take time to thoroughly investigate and consider the options, but don’t leave it too long before making the final decision.

Babies and children

In the early years of a child’s life, the brain is at its most adaptable, ready to receive sound and develop language. Research suggests that the first year of life is the ideal time for an implantation. In fact, most children who are fitted with cochlear implants at an early age don’t display any significant differences in their hearing and speaking abilities from children without hearing problems [4] . Not only is the brain’s capacity to learn to hear at its peak, but speech and language development can also follow a fairly natural pattern.

Every time a baby hears a sound, the brain’s auditory pathway is stimulated, but after several years of silence, this part of the brain is partially allotted to other functions. This doesn’t mean a child won’t be able to hear and speak with the help of a cochlear implant, but it may limit the results.

Adults

The good news is, there’s no upper age limit for hearing implants and, while younger adults perform better when it comes to understanding speech after implantation [5], both groups report similar improvements in quality of life [6].

However, studies show that the duration of deafness is important when predicting success in adults. The longer someone has been severely or profoundly hearing-impaired, the longer it will take for them to learn to recognise and understand speech after surgery. So if you’re considering an implantation, it’s best not to leave it too long after your hearing deteriorates enough for you to qualify. Using hearing aids can help keep the hearing part of your brain stimulated and ready to interpret sound.

Many independent studies show that hearing implants help older people understand speech better, and in turn have a better quality of life and higher self-esteem [7].

Reference:

[1] Hyde, M. et al, 2010. Coming to a Decision About Cochlear Implantation: Parents Making Choices for their Deaf Children Journal of Deaf Studies and Deaf Education  15 (2): 162-178. doi: 10.1093/deafed/enq004

[2] Stacey PC, Fortnum HM, Barton GR, Summerfield AQ. 2006. Hearing-impaired children in the United Kingdom, I: Auditory performance, communication skills, educational achievements, quality of life, and cochlear implantation. Ear Hear 27(2):161-86.

[3] Cochlear implants: young people’s views (2007) the National Deaf Children’s Association http://www.ndcs.org.uk/

[4] Geers AE, Nicholas JG Enduring Advantages of Early Cochlear Implantation for Spoken Language Development; J Speech Lang hear Res 2013 Apr;56(2):643-55.

[5] Roberts, DS; Lin, HW; Herrmann, BS; Lee, DJ Differential cochlear implant outcomes in older adults (2013) Laryngoscope, 123(8), 2013 Aug, p. 1952-1956

[6] Sanchez-Cuadrado, I., et al; (2013). Is there an age limit for cochlear implantation? Annals of Otology, Rhinology & Laryngology, 122(4):222-228

[7] Lachowska et al. Outcomes of CI Users Implanted over 60 Years Old. Audiology & Neurotology 2011;17:17-18