A cochlear implant is a small, complex electronic device that can help provide a sense of sound to a person who is profoundly deaf or severely hard-of-hearing. The implant has an external portion that sits behind the ear and a second piece that is surgically implanted under the skin.
The implant does not restore normal hearing, but it does increase the ability to hear sounds. The device is significantly more effective than a hearing aid in boosting a deaf child’s ability to use and understand speech. Hearing aids increase the loudness of sounds so that they may be heard by damaged ears while cochlear implants send signals directly to the brain, which then recognizes the signals as sounds.
Technological Advances
Cochlear implants were first approved in the early 1990s for adults over age 18. In 2002, the Food and Drug Administration (FDA) approved the use of the device for children as young as 12 months. Advances in the development of cochlear implants have opened up new opportunities for thousands of deaf children.
Research shows that the earlier the device is implanted, the better the outcome for spoken language development. Parents considering this option for their child must weigh the benefits and risks to determine if the device will potentially improve their child’s quality of life.
The implant is surgically placed under the skin behind the ear, and an electrode is inserted into the inner ear. External components include a magnet, which is aligned with the internal magnet, a microphone, and a speech processor.
The surgery takes about three hours and costs from $40,000 to $60,000, which is covered by most insurance companies, including Medicaid, according to the National Association of the Deaf.
FDA criteria for children who are candidates for cochlear implants include:
- Age one year or older
- Bilateral profound hearing loss
- Documentation of no significant benefit from hearing aids
- Evidence of strong family support
- No medical contraindications to surgery
- Receptive and supportive educational system
Benefits and Risks
Physicians cannot guarantee that a child who receives an implant will develop spoken language or will communicate more effectively than a deaf child who is exposed to early language without a cochlear implant. The benefits of the device depend on several factors, including the parents’ and child’s willingness and ability to schedule weekly appointments, consistency of use, and ability to afford additional costs, such as batteries and maintenance. These costs can add up to as much as $1,000 per year.
Parents must be willing to invest some time and money for their children to receive optimal benefits from the device. The social and psychological implications of the surgery must be considered as well. The cochlear implant is somewhat controversial, particularly in the deaf community.
Many people who are deaf do not consider their lack of hearing ability a medical condition to be cured. Instead, they feel that the deaf community is a social network with its own language, culture, and identity.
In addition, parents must determine if their child is old enough to decide to have the surgery and use the device. Some teenagers stop using their cochlear implant, complaining that it sets them apart from their deaf peers, or interferes with their identity as a deaf person. Others stop wearing the cochlear implant because they feel it is ineffective.
Making an Informed Decision
The cochlear implant is a marvel of new technology, yet parents must be fully informed to decide if the device is right for their child, and recognize that they have many options to consider.
Social workers can provide counseling for families who are making this decision, as well as resources and information about implants. These professionals are uniquely qualified to help parents consider the long-term implications of wearing the device, such as future educational options, which may be determined by how well the implant works.
Even when a child seems to be an ideal candidate for a cochlear implant, social workers can help parents sort through the important facts and ethical implications and review all options before electing surgery.
