Cochlear Implant Candidacy

The criteria to determine candidacy for cochlear implants have changed a great deal since the devices were first introduced. Currently, cochlear implants are approved by the Food and Drug Administration (FDA) for children 12 months of age and older.

Criteria for Cochlear Implantation in Children

Hearing Aid Trial

  • In general, it is recommended that a child be appropriately fit with hearing aids and use them for 3-6 months before determining implant candidacy.
  • In cases of meningitis, a shorter hearing aid trial may be recommended or the trial may be waived as bony growth in the cochlea following meningitis may create problems for implantation.
  • In a few cases of meningitis, the physician may proceed with implantation prior to the child reaching 12 months of age. This is to ensure adequate insertion of the electrodes into the cochlea, before the bony growth fills the cochlea.

Degree of Hearing Loss

  • Children between 12 months and 18 months of age: Profound sensorineural hearing loss of 90 decibels or greater in both ears.
  • Children 24 months of age and older: Severe-to-profound sensorineural hearing loss of 70 decibels or greater in both ears.

Lack of Benefit from Appropriately Set Hearing Aids

Examples of this would include:

  • Inconsistent response to his/her name in quiet environment
  • Failure to alert to environmental sounds while wearing amplification

No Medical Contraindications

Contraindications include:

  • Absence of the auditory nerve
  • Medical conditions or developmental delays that would severely limit participation in aural habilitation
  • Active middle ear infections.

Environment: Educational & Home

Children should be in a rehabilitative or educational setting where the development of auditory (listening and speaking) skills is emphasized. Rehabilitative or educational environments that encourage auditory skill development are likely to have a positive effect on the progress in children.

Other important factors include:

  • High motivation on the part of family and/or primary caregivers to promote language and learning
  • Positive family environment
  • Realistic expectations​​