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Cochlear Implants Early the Best Method

Cochlear Implants Should be Implanted as Early as Possible

In November 2006 at the Bionic Ear Institute in Melbourne, Australia, a team led by Richard Dowell at the University of Melbourne showed that 11 profoundly deaf children who received cochlear implants before the age of 1 had entirely normal language development at least up to age 4 to 5. Language skills were assessed using a battery of tests, including routine tests of comprehension and expression and observing at what age they started different types of babbling and using key words.

Their language development was also superior to a further 36 children who had been implanted at age 1 or 2, suggesting that the earlier the implant is fitted the better. "The kids still don't have normal hearing, but they have normal language. They can have a conversation, make a joke, lie, tease -- all those normal things that 4- or 5-year-olds do," says team member Shani Dettman.

The team's findings are supported by other studies, including one from Johanna Nicholas, of Washington University in St. Louis, and Ann Geers of the University of Texas-Dallas. It showed a dramatic improvement in the spoken language skills of 76 profoundly deaf children at the age of 3, if they had received their cochlear implant closer to 1 year old rather than 3 years.

The findings are particularly important because spoken language skills seem key to a child's chance of fully integrating into hearing society. A separate study by Thomas Lenarz and Anke Lesinski-Schiedat of the University of Hannover in Germany found that a child who gets a cochlear implant before the age of 2 has a 70 percent chance of attending an ordinary school, compared with a 30 percent chance for a child who receives an implant between the ages of 2 and 4.

Geers agrees deaf culture may be under threat, but says, "there is no hostility here. People are doing this so that deaf people can live in the hearing world, marry who they like and work where they like, and so that hearing parents can have their children as part of their culture. But it must seem like genocide to the deaf."

Until these latest findings, implants had only been shown successful in adults who'd gone deaf later in life, rather than in the estimated 1 in 2,000 people born profoundly deaf each year. The majority of those born deaf had had their implants fitted when they were older than 3, and while many could understand speech, very few developed normal language abilities.

The new results show that very young children can learn the complex rules of language using a cochlear implant, presumably because the infant brain is so adaptable.