Which children should be considered candidates for cochlear implantation?

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04 February 2013

Presenter(s): Dr Rosie Lovett
Time: 13.00 - 14.00
Location: NHBRU, Meeting Room 1


It can be difficult to judge whether a young child with hearing impairment will receive more benefit from cochlear implants or acoustic hearing aids. In England and Wales, only children with profound, or borderline severe-to-profound, hearing impairment are eligible for cochlear implantation. In order to assess whether this policy is optimal, I am conducting a longitudinal study to compare outcomes for children with cochlear implants and children with acoustic hearing aids.

Seventy-one children are taking part in the study. Twenty-seven children use bilateral cochlear implants and have severe or profound hearing impairment.  Forty-four children use bilateral acoustic hearing aids and have hearing impairment ranging from mild to profound. Outcome measures include tests of the ability to understand speech in quiet and in noise, tests of the ability to localise sources of sound, and assessments of spoken language skill. Children are assessed when they join the study (aged 3 to 6 years) and again a year later.

I will present the results of the first assessments and interim results from the second assessments. The data have been analysed using a method developed by Boothroyd (1993). For each outcome measure, a regression function was used to characterise the relationship between unaided hearing level and performance for children with acoustic hearing aids. The distribution of scores for implanted children was used to calculate, for a newly-diagnosed child with a known hearing level, the odds of better performance with implants than with hearing aids. A criterion of candidacy for cochlear implantation can be defined as the most advantageous hearing level for which the odds of better performance with implants exceed an acceptable ratio, such as 4 to 1. I will discuss our findings in the context of healthcare policy in the UK and abroad.

Boothroyd, A. (1993). Profound Deafness. In R. Tyler (Ed.), Cochlear implants: audiological foundations (pp. 1-33): Singular Publishing Group.