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Position Statement: Cochlear Implant Candidacy for Children with Bilateral Sensorineural Hearing Loss

Position Statement: Cochlear Implant Candidacy for Children with Bilateral Sensorineural Hearing Loss

Children with bilateral sensorineural hearing loss should be fitted with hearing aids by an experienced audiologist. When using amplification, children should be monitored closely to ensure expected progress according to age appropriate developmental milestones, especially in speech and language.  The position of the American Academy of Otolaryngology, Head and Neck Surgery is that cochlear implantation should be considered for children with bilateral sensorineural hearing loss who are not making expected progress despite appropriately fit amplification.

Adopted 07/2021

References / Recommended Resources

  1. Carlson, Matthew L.*†; Sladen, Douglas P.*; Haynes, David S.; Driscoll, Colin L.*; DeJong, Melissa D.*; Erickson, Hannah C.*; Sunderhaus, Linsey W.; Hedley-Williams , Andrea; Rosenzweig, Elizabeth A.; Davis, Timothy J.; Gifford, René H.†‡ Evidence for the Expansion of Pediatric Cochlear Implant Candidacy.  Otology & Neurotology 36 (1): 43-50.
  2. Blamey PJ1, Sarant JZ, Paatsch LE, Barry JG, Bow CP, Wales RJ, Wright M, Psarros C, Rattigan K, Tooher R. Relationships among speech perception, production, language, hearing loss, and age in children with impaired hearing. J Speech Lang Hear Res; 44(2):264-285.
  3. Lin FR, Wang NY, Fink NE, et al. Assessing the use of speech and language measures in relation to parental perceptions of development after early cochlear implantation. Otol Neurotol. 2008;29(2):208–213.
  4. Yoshinaga-Itano, C. (2003). From Screening to Early Identification and Intervention: Discovering Predictors to Successful Outcomes for Children With Significant Hearing Loss, The Journal of Deaf Studies and Deaf Education 8:1, 11–30.
  5. Ching, T.Y., Dillon, H., Button, L, et al.,. Age at intervention for permanent hearing loss and 5-year language outcomes. Pediatrics;140: 2017.
  6. Leigh, J., Dettman, S., Dowell R., et al., Communication development in children who receive a cochlear implant by 12 months of age. Otol Neurotol;34: 443–50.
  7. Joint Committee on Infant Hearing. (2019). Year 2019 Position Statement.  Principles and guidelines for early hearing detection and intervention programs.  The Journal of the Early Hearing Detection and Intervention, 4(2), 1-44.
  8. Leigh JR, Dettman SJ, Dowell RC. Evidence-based guidelines for recommending cochlear implantation for young children: Audiological criteria and optimizing age at implantation. Int J Audiol. 2016;55 Suppl 2:S9-S18. doi:10.3109/14992027.2016.1157268. Epub 2016 May 4. PubMed PMID: 27142630.
  9. Lovett RE1, Vickers DA, Summerfield AQ. Bilateral cochlear implantation for hearing-impaired children: criterion of candidacy derived from an observational study. Ear Hear. 2015 Jan;36(1):14-23.
  10. de Kleijn JL, van Kalmthout LWM, van der Vossen MJB, Vonck BMD, Topsakal V, Bruijnzeel H. Identification of Pure-Tone Audiologic Thresholds for Pediatric Cochlear Implant Candidacy: A Systematic Review. JAMA Otolaryngol Head Neck Surg. 2018;144(7):630–638. doi:10.1001/jamaoto.2018.0652
  11. American Academy of Pediatrics Committee on Practice and Ambulatory Medicine and American Academy of Pediatrics Bright Futures Periodicity Schedule Workgroup (2017). 2017 Recommendations for Preventive Pediatric Health Care.  Pediatrics, 139(4), e20170254.

Organization and Association Resources (Hearing Loss Focus)


Alexander Graham Bell Association for the Deaf and Hard of Hearing & the AG Bell Academy for Listening and Spoken Language:

American Academy of Audiology (AAA):

American Speech-Language-Hearing Association (ASHA):

American Society for Deaf Children (ASDC):  [email protected]

Beginnings for Parents of Children Who Are Deaf or Hard of Hearing, Inc.:

Boys Town National Research Hospital:

Centers for Disease Control and Prevention (CDC):

Early Hearing Detection & Intervention — Pediatric Audiology:

Hands & Voices:

Hearing First, LLC:

John Tracy Clinic:

National Association for the Deaf (NAD):

National Center for Hearing Assessment & Management (NCHAM):

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