Cochlear implants
In 1987 the first child in the UK received a cochlear implant. Cochlear implantation is a well-established and safe procedure. In 2007, 430 children were implanted in the UK (1).
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A cochlear implant does not restore normal hearing levels. However, for those children with severe to profound deafness who receive limited benefit from conventional hearing aids, a cochlear implant can bring significant benefits by providing access to sound enabling them to acquire and understand spoken language and speak intelligibly (1).
In January 2009 the National Institute for Health and Clinical Excellence (NICE) published ‘Cochlear implants for children and adults with severe to profound deafness’ (2) which includes recommendations on candidature criteria for unilateral and bilateral implantation.
NDCS welcomed this guidance which should ensure that funding is routinely available for the procedure across England and Wales. NHS Quality Improvement Scotland provides evidence-based advice to NHS Scotland and advises that the recommendations are also valid for Scotland.
Our policy
Updated 24 February 2009
NDCS is committed to a holistic approach to supporting deaf children where their education, health, social and personal needs are met in a co-ordinated way.
NDCS believes that cochlear implants are one part of this approach and not an alternative to it.
NDCS will support families in making informed choices for their child by:
- providing clear, unbiased, factual information for families
- encouraging honest and open discussion of the key issues (see accompanying information) of which parents need to be aware and that professionals need to address
- working with other organisations to promote research in cochlear implantation and ensure that the results are accessible to families
- providing opportunities for parents to contact other parents, deaf adults and professionals.
Through our QS documents and working with professionals in the field of cochlear implantation, NDCS advocates on behalf of families so that cochlear implant teams working with children:
- provide information about implants which is clear, jargon-free and accessible
- ensure a multidisciplinary approach
- provide parents and children with effective counselling and support, whether or not the child receives an implant
- ensure parents and children are given appropriate time and space, particularly after confirmation of deafness, to consider all the information and the implications of implantation
- ensure that parents are not put under pressure, prior to or following an implant, to change communication methods that work for them and their child
- give parents realistic information about the potential outcomes for their child
- ensure that parents considering an implant understand that their child will continue to be a deaf child
- ensure parents are provided with the safety guidelines appropriate to cochlear implantation and of particular relevance to children
- encourage families considering an implant for their child to meet other deaf children, with and without an implant, and provide the opportunity to meet deaf adults
- ensure the child is, wherever possible, fully involved in the decision-making process and procedure
- ensure that children with an implant receive the highest possible standards of lifelong care, with smooth transition to the adult cochlear implant service.
NDCS will work locally with PCTs and commissioners to ensure that the recommendations of the NICE guidance are upheld and to ensure that adequate referral pathways are commissioned for families opting for cochlear implant assessment, procedure and follow-on care.
NDCS acknowledges that some parents will choose not to have a cochlear implant for their child.
Equally, a cochlear implant may not be suitable for some profoundly deaf children (e.g. those born without an auditory nerve or with severe cochlea deformity).
A cochlear implant assessment should be offered to parents as one of the options to consider for their child, alongside other non-medical alternatives.
NDCS believes that these children and families should have equal access to service provision and should not be denied appropriate support on the basis of the type of technology (hearing aids, cochlear implant, none) they use.
References
(1) Cochlear Implants: 2008, The Ear Foundation www.earfoundation.org.uk
(2) Cochlear implants for children and adults with severe to profound deafness, (2009), NICE
(3) http://www.nhshealthquality.org/nhsqis/5250.html
(4) Quality Standards: Cochlear Implants for Children and Young People (2005), Joint Revision by The National Deaf Children’s Society & British Cochlear Implant Group
(5) Cochlear implant services; Commissioning guidelines (2007), RNID, NDCS, Ear Foundation, CICS, NCIUA, Commissioners, DH
The Ear Foundation is a UK charity that supports and provides activities fordeaf children and young people with cochlear implants, their families and
supporting professionals. Website: www.earfoundation.org.uk.
The British Cochlear Implant Group represents professionals from all the
cochlear implant teams in the UK. The BCIG is committed to the
enhancement and promotion of the best possible quality of service provision for children, young people and adults who receive cochlear implants in UK. Website: www.bcig.org.
Accompanying information
Download the NDCS Policy on Cochlear Implants in full for accompanying information.
