Hearing loss dramatically impacts a child’s cognitive, linguistic, and social development, making the pursuit of relationships and gainful employment more difficult. Cochlear implant devices convert acoustic signals to electric signals that are then delivered to the cochlear nerve endings through a set of electrodes, enabling the brain to discriminate sounds and frequencies.
According to Brian Reilly, MD, Co-director of the Hearing Restoration Program at Children’s National Health System, three out of 1,000 children in the Washington, DC, metropolitan area have hearing loss that could benefit from cochlear implantation.
Early intervention is key for cochlear implantation because a child’s neuroplasticity peaks within the first two years of life. Over time, the brain’s ability to adapt to and make sense of new stimuli declines. Without sensorineural stimulation, the auditory cortex begins to shut down and can no longer process sounds into meaningful data.
At the Hearing Restoration Program, formerly known as the Cochlear Implant Program, infants who are identified with hearing loss first undergo a trial to assess the effectiveness of hearing aids. Infants who do not show improvement with hearing aids are evaluated by the Cochlear Implant Committee. This group of audiologists, speech therapists, and otolaryngologists determine each infant’s candidacy for cochlear implantation. Ideal candidates are usually children who:
- Are between 6 months and 2 years old
- Are diagnosed with severe to profound (total) hearing loss
- Have bilateral (in both ears) hearing loss
- Have no other known neurological deficits
- Have normal cochlear anatomy, including a normal caliber cochlear nerve
The program at Children’s National has performed cochlear implantations for 15 years. Drs. Diego Preciado and Brian Reilly perform approximately 50 pediatric implantations annually—more than any other pediatric cochlear implant program in the area. The procedure involves making a small incision behind the ear and drilling away a portion of the temporal bone. The device is placed underneath the scalp, and an electrode is threaded into the cochlea through a permanent hole called a cochleostomy. The device is activated following surgical recovery, typically within a few weeks.
Once the device is turned on, patients undergo auditory habilitation with specially trained speech-language therapists. Some patients require a combination of sign language and verbal speech to effectively communicate, while others develop fully normal speech skills.
The Hearing Restoration Program evaluates children at any age and hearing level.