The selection criteria for a cochlear implant evolve according to technological developments and results observed among cochlear implant users. The following are general criteria that may change over time. It is the selection committee, under the authority of the Centre québécois d’expertise en implant cochléaire, who will make the final decision following assessment of all factors.
State of the Internal Ear (cochlea)
The cochlea must be without obstruction or serious malformation to enable the insertion of electrodes.
Deafness must be permanent; usually its degree must be minimally severe in the best ear. The ability to recognize words and sentences (without lipreading) must be limited with optimal hearing aid fitting.
Age / Communication :
Among Children :
The communication’s criteria are directly related to age and hearing profile presented by each child.
There is no age restriction for children with acquired or progressive deafness (deafness of a lesser degree that has become more severe over time).
There is no age restriction for children with congenital deafness with a certain amount of hearing experience and functional oral language*.
The age limit is 7 years old for children with congenital deafness without hearing experience and/or without functional oral language*.
Among children older than 7 years of age, the communication mode is an important factor, as a child older than 7 who mainly uses sign language and benefits very little from his or her hearing aids, is likely to obtain very limited performance with the implant.
Among adults :
- There is no age limit for adults as long as they have a functional oral language*.
Communication mode is an important factor, as a person who mainly uses sign language and benefits very little from his or her hearing aids, is likely to obtain very limited performance with the implant.
*Functional oral language is assessed during a meeting with the Speech Therapist. The language will be considered functional if the person has the potential to understand and express herself in an oral mode with both familiar and unfamiliar communication partners. The person must be able to follow a conversation (understand the questions and maintain the exchange) only through the oral mode with the support of the lipreading. Intelligibility of speech is one of the important factors taken into consideration. The fact of uttering unintelligible vocalizations on signs or natural gestures is not enough to consider that the oral language is functional.
Psychological State :
Among children and adults :
The potential recipient of a cochlear implant must be in good mental health and not present a serious problem likely to hinder efficient use of the implant. This person must also demonstrate a willingness to participate in each step of the process : surgery, implant programming and intensive functional rehabilitation.
Support from Family and/or Friends :
It is important for the potential recipient and his/her close relatives to have realistic expectations with regard to the cochlear implant. Strong motivation is also necessary. For children, teenagers and elders, family involvement is essential throughout the process.