Topic Card 5: The How and When of Cochlear Implants


Related Terms:

Cochlear Implant; Speech Processor; Electrode Array; MAP


What is early intervention?

What is a cochlear implant?

How does a cochlear implant differ from a hearing aid?

Is there only one type of cochlear implant?

Who can get a cochlear implant

If a cochlear implant is recommended for my child, would he/she get one cochlear implant or two (bilateral) cochlear implants?

How much does a cochlear implant cost?

What is involved in surgery and follow-up?

What kind of training or therapy is needed?

How do I get more information about cochlear implants?

  • What is a cochlear implant?

A cochlear implant is an electronic device designed to convey auditory information including speech by directly stimulating nerve endings in the inner ear (cochlea). The cochlear implant system consists of an internal device that is surgically implanted into the inner ear and an external component, consisting of a head set and speech processor, which is custom programmed to provide sound to a child. For some children a hearing aid does not provide enough information for sound to be meaningful for them. A cochlear implant may provide sound information for these children.


  • How does a cochlear implant differ from a hearing aid?

Hearing aids amplify sound while cochlear implants change sound to electrical impulses. In a hearing aid, sound arrives at a microphone. The hearing aid amplifies the sound, making it louder. The amplified sound is sent as sound waves to the inner ear. In the inner ear (cochlea) the sound waves stimulate existing hair cells through the motion of the inner ear fluid. The hair cells are connected to the hearing nerve that sends the sound message to the brain.

In a cochlear implant, sound enters the microphone and is sent to a speech processor. The speech processor is a small computer that changes sound waves into special coded signals that are sent as electrical impulses to the device that has been surgically implanted in the inner ear. Within the cochlea, the implant’s electrode array does the work of the missing or damaged inner ear hair cells. The electrode array receives the sound message and sends it to the hearing nerve and the brain.

  • Is there only one type of cochlear implant?

All cochlear implants work in the same basic way. There are currently several companies who make implants and these implants have some differences. If your child gets a cochlear implant, you and your physician will make the final decision as to which implant is best for your child.

  • Who can get a cochlear implant?

To determine if your child may benefit from a cochlear implant, an extensive evaluation is completed by a team that includes audiologists, speech pathologists, physicians, and educational specialists. The Food and Drug Administration (FDA), the federal agency responsible for regulations in this area, has established basic eligibility guidelines. To be eligible for an implant a child must: 1) have a severe to profound sensorineural hearing loss in both ears; 2) be at least 12 months of age (age criteria has been lowered in recent years and may change again); 3) show a lack of progress in the development of simple auditory skills when using hearing aids; 4) be enrolled in an educational program that supports listening and speaking for communication (even if sign language is also used); 5) have no other medical issues that may complicate the surgery or rehabilitation.

  • If a cochlear implant is recommended for my child, would he/she get one cochlear implant or two (bilateral) cochlear implants?

Many children receive only one implant and do very well. Research shows that sound localization and listening in noise may be improved with the use of a second implant. There are many factors including audiological, medical, and monetary/insurance that are considered in this decision. If your child is recommended for an implant, your cochlear implant center and physician will help answer this question.

  • How much does a cochlear implant cost?

The complete cochlear implant, including surgery and the device, costs considerably more (as much as 10 times more) than the most expensive digital hearing aid. Medicaid and many U.S. healthcare providers cover some of the cost of the implant, the surgical procedure, and associated care. Ongoing costs may include repair/replacement of external implant components such as cords, batteries, and coils as well as the costs for special training and therapy.

  • What is involved in surgery and follow-up?

The cochlear implant surgery is an outpatient procedure performed by an ear, nose and throat (ENT) physician. It takes approximately three hours to implant the cochlear implant’s internal components. Four to six weeks after the surgery, the child returns to the implant center for the initial fitting of the outside components of the cochlear implant. The audiologist uses a computer to program the cochlear implant settings that allow the child to hear sounds. The individual listening program designed for each child is known as a MAP. During numerous follow-up sessions, the audiologist will readjust and fine-tune the MAP.

  • What kind of training or therapy is needed?

Children who receive cochlear implants need special training to learn to make sense of the new sound sensations provided by the implant. Training involves helping the child to recognize and understand the meaning of the new sound sensations. Family members make a big commitment; they have an important role in encouraging and reinforcing their child’s attempts at listening and speaking. The key to successful usage of the cochlear implant is coordination between parents, teachers, speech pathologists, and audiologists to provide consistent auditory training, both at home and at school.

  • How do I get more information about cochlear implants?

Your audiologist, parent advisor or other early intervention specialist will be a good source of additional information on cochlear implants. These professionals can also give you the name of a cochlear implant center, specialist, and/or support group in your area.