Northeast Florida Medicine
Vol. 66, No. 1 2015
13
Otolaryngology
observation. Pre-school and school-age children are given
an auditory perception assessment, a language assessment
and an articulation assessment, if appropriate. Children
who experience the notable difficulties with the auditory
perception portion of the evaluation are most often the
better candidates for a cochlear implant. Additionally, if a
child demonstrates little to no improvements or a decline
in improvements over a given period of time, he or she may
also qualify for a cochlear implant.
The audiological, or hearing, evaluation may include one
or more testing sessions where a child’s hearing is tested by
a cochlear implant audiologist to see if the hearing loss falls
within candidacy criteria, if their hearing aids fit properly
and if they are providing optimal benefit. If a child has
speech and language, speech perception testing will be
completed to assess their understanding abilities. Testing
includes word and sentence tests of varying difficulties based
on the child’s current capabilities or language age. A child’s
score on the tests will allow the team to evaluate if they fall
into candidacy criteria. If the child is too young or has not
acquired spoken language, this testing cannot be completed.
Parent questionnaires are often administered to evaluate a
child’s hearing capabilities, hearing aid use and development.
The candidacy criteria for children typically include:
• Bilateral severe-profound sensorineural hearing loss
• Ages 12 months to 18 years
• Demonstration of marginal to no significant benefit
from hearing aids following appropriate use, therapy
and intervention (use of hearing aids during all
waking hours)
• Commitment to oral communication
• Evidence of strong family support and motivation
• Appropriate expectations of family for the outcomes
for each individual child
• Receptive and supportive educational system if
appropriate
• Physically capable of undergoing the surgical
procedure and no contraindications to surgery
Conclusion
This multidisciplinary approach to the cochlear implant
evaluation process allows for a comprehensive picture of
the child’s hearing, listening skills, hearing aid benefit and
medical issues. The cochlear implant team meets to discuss
each candidate to formally make a decision if a cochlear
implant is appropriate for a child. A formal counseling session
with the family informs them of the team’s decision, reviews
the remainder of the CI process and the devices, as well as
a discussion of post-operative appointments and therapies
to ensure maximum benefit from the cochlear implant.
v
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