Cochlear implants in children: unlimited potential? [Abstract]

Abstract

Multichannel cochlear implants have been in use for adolescents for 8 years and for children for 6 years. Due to the substantial benefits obtained by postlinguistically deafened adults using multichannel implants, there was a degree of optimism about the potential benefits for profoundly hearing impaired children using these devices. It was speculated that children may adapt more quickly and learn to use information from implants more effectively than adults. On the other hand, there were cautionary predictions that there may be a "critical age", particularly for congenitally or early deafened children, that, once passed, would preclude effective use of auditory information from implants. This age was variously predicted to be anywhere from 2 to 12 years, based on neurophysiological, developmental or psychological arguments. With some years of experience with implanted children, it can now be said that neither the optimistic nor the more cautionary "critical age" predictions have been supported. As with many areas of clinical science, the situation appears to be far more complex than first thought. This paper will discuss the results obtained for 100 children using the multichannel cochlear implant in Sydney and Melbourne in terms of predictive factors, and the potential for the future application of multichannel cochlear implants in children.

The results suggest that experience with implant, the number of years of auditory deprivation, the amount of preoperative residual hearing, and the postoperative educational environment may have a significant effect on speech perceptual abilities in implanted children. In addition, approximately 60% of all implanted children show significant open-set speech perception ability with auditory input alone. It is now possible for multichannel cochlear implants to provide auditory skills sufficient for young children to develop functionally normal speech and language through audition, provided consistent, long term habilitation is available.