With cochlear implants, earlier use leads to better speech

et published -- suggest that by age 4 and a half, children who had cochlear implants very early often have normal speech and can potentially enter kindergarten with their hearing peers.

"Kids with residual hearing can get some help from hearing aids, but cochlear implants give a tremendous hearing advantage over hearing aids -- the implants provide more sound information," Nicholas says. "For example, high-frequency sounds are magnified more with cochlear implants, so kids can hear 's' sounds and 'ed' endings better. So they tend to catch on to plurals and verb tenses faster."

While studies like this and others favor early implantation, the decision for or against cochlear implantation is frequently put off, Nicholas indicates. Hearing parents often find they need time to learn about deafness and potential treatments. Implantation also may be delayed to make certain an infant's deafness has not been misdiagnosed.

Even when deafness is confirmed, the idea of head surgery for their baby makes many parents hesitate. And they may be daunted by the fact that a cochlear implant is forever -- the device destroys any residual hearing so that hearing aids are no longer an option.

"Studies like ours are meant to help answer parents' questions about cochlear implants," Nicholas says. "Our overall goal is to focus on the best age for implantation. If the window of time for the best outcome is small, we want parents to know that. With the results we've seen so far, we believe that it is best to implant when the child is younger than 24 months if parents want a deaf child to use spoken language at the same level as their hearing peers."

Nicholas is also on the faculty of the Program in Audiology and Communication Sciences (PACS) at Washington University School of Medicine. The PACS program is part of a consortium of programs formerly operated by Central Institute for the Deaf and now collectively known as CID at Washington University School of Medici

Contact: Gwen Ericson
Washington University School of Medicine

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