Cochlear implants in young children

The first pediatric cochlear implant program was established at the House Ear Institute in 1980. Incredible as it may seem from the current perspective, the primary issue in that era was whether to consider implanting children at all. In 1980, the first child (a 9-year-old boy) was implanted, and by 1982, 12 children with age ranges from 3.5 to 17 years had been implanted in their program [1]. The House/3M single-channel device was used exclusively, and initial reports noted results similar to those in prelingually deafened adults. Initial concerns regarding device infection from childhood otitis media and electrode problems caused by head growth were quickly shown to be essentially irrelevant. The House/3M device obtained Food and Drug Administration (FDA) approval for implantation in adults in 1984 and in children in 1986. In June 1990, the Nucleus-22 channel implant received FDA approval for implantation in children aged 2 years and older. Shortly thereafter, momentum gained rapidly, and by the mid-1990s, more children were being implanted than adults. Until the last few years, cochlear implantation, particularly in children, was strongly opposed by the "deaf" community. Initial objections were based on erroneous assumptions that children did not benefit from the procedure-and that efforts toward oral rather than manual education would result in children who would not be able to communicate with either the hearing or the nonhearing world. Subsequent objections were more focused on the negative effects cochlear implantation would have on the deaf community. Successfully implanted deaf children would no longer enter the deaf community, which would seriously limit the future of the deaf culture. These objections took on an emotional and political bent and were highly publicized throughout the 1990s. More recently, with the clear evidence of the dramatic benefit cochlear implants provide to children, such arguments have not been taken seriously.