Making a decision about cochlear implants

Deciding to get cochlear implants is a big decision as it's a life-long commitment, and there's a lot to consider. This page highlights some of the factors to consider, but it may not answer all your questions.

Getting balanced information and speaking to others with experience of the process may help you make your decision. If you have any questions about the tests, surgery or living with an implant, speak to the professionals working with you.

If, at any point, you change your mind, you can always say so. The implant team will understand if you need more time to decide.

Most cochlear implant users adjust well to their implants and continue to use them as adults. If in the future a young person decides not to continue using their cochlear implant, they can choose to not use their sound processor and explore other communication methods.

A note on terms

Throughout this page, we use the term 'your child'. However, we understand that many deaf young people may be making this decision for themselves. Whenever you see 'your child', please know it also includes any deaf young person considering cochlear implants.

“We did think about it for a long time, because you’re sending your small child for a big operation that’s not medically essential. We went ahead, as we always wanted Olive to have that choice when she’s older.”
Jennie, mum to Olive (4) who is profoundly deaf and has cochlear implants.

“I knew cochlear implants (CIs) were an option, but when I began to research the process, I was put off by the thought of an invasive surgery when my daughter was a healthy, happy baby. Kaya wore hearing aids until she was three. One day she took them out and refused to put them on again. She’s made her communication preferences clear and has flourished using BSL.”
Jes, mum to Kaya (5) who is profoundly deaf and uses British Sign Language (BSL).

Surgery

Getting cochlear implants requires surgery. The surgery for cochlear implants is done under general anaesthetic, which means your child will be given medicines to send them to sleep during the procedure.

The surgery involves making a small cut on the side of the head. The internal receiver is secured beneath the skin, and the electrode array is inserted into the cochlea. There are several types of electrode array to suit different cochleas.

It usually takes one to two hours per ear, and most children can go home the same day. However, some children may need to stay overnight at the hospital.

As with all surgeries that require general anaesthetic, there are some risks. However, these are generally rare. Any risks would be discussed with you as part of the implant assessment process.

Find out more about the surgery process and risks for cochlear implants.

Changes in technology

The internal part of a cochlear implant (which is surgically implanted) is unlikely to need upgrading unless there are problems. Device failure is rare, and most implants work well for many years. Some users have had theirs for over 30 years. If the internal part of the device fails, your child would need a further operation to take out the broken implant and reinsert a new implant.

The external sound processor can be changed as technology develops and improves, but this should not mean further surgery. Currently, the NHS upgrades sound processors every 5 years and when clinically appropriate, for example, where there’s evidence that the upgrade will offer additional benefit over your child’s current device. How often processors are upgraded may change in the future depending on NHS funding.

Long-term care commitment

After the implant is fitted, your child will need long-term support from you, the cochlear implant team and local professionals.

It’s important before making a decision that you know and understand the level of commitment that will be needed, particularly in the early years following implantation.

Your child will need to attend lots of appointments at the implant centre during the first year. This means you may need to take time off work and be away from the rest of your family. You can ask your implant centre for a schedule of expected visits, both before and after the implant operation.

Children will need ongoing audiology appointments to "fine-tune" their implants, as their hearing levels and needs may change over time, and these appointments are crucial for optimal hearing and language development.

When your child is young, you will need to perform daily checks to maintain the external part of your child’s implants. For example, batteries need to be changed or recharged regularly. If your child’s implants use button batteries, you’ll also need to make sure the battery lock is kept on as it’s extremely dangerous if your child swallows a battery.

Learn about maintaining cochlear implants.

Communication options

Deciding whether to get cochlear implants or not may impact the communication approach you use with your child.

If you choose to get cochlear implants for your child, your child is more likely to develop speech alongside, or instead of, sign language.

If you choose not to get cochlear implants for your child, you'll need to consider what communication approach will work best if your child is unable to access speech. For many families, this will mean learning sign language as their child’s main form of communication.

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Benny's cochlear implant story

Getting balanced information

When you start looking into cochlear implants, you’ll come across different opinions, especially about implanting children at a young age.

Some people in the Deaf community believe deafness does not need to be "cured" and that a child should be old enough to make their own decision about an implant. Others view deafness as something that can be helped with technology, and believe a cochlear implant offers a profoundly deaf child the best chance of accessing spoken language.

If you want to learn more about this debate, it’s helpful to speak to deaf people, both with and without cochlear implants, as well as to families and deaf children about their experiences.

Your local deaf children’s society is a good place to start. You can also explore these resources:

Cochlear Implanted Children's Support Group (CICS website): Support to parents of deaf children with cochlear implants or those considering an implant.
Hearing Success (Advanced Bionics website): Online communities where parents of deaf children can ask questions and share experiences.
Your Cochlear stories (Cochlear website): Stories from people who have gotten cochlear implants.
HearPeers forum (MED-EL website): An online forum where cochlear implant users from around the world share advice and experiences.

“Find your gang so your deaf child can have role models and you can get advice from deaf people who have had implants, people who wish they’d had implants or people who have had them and regretted it. Build up a really good picture of all the positives and negatives before you make such a big decision. It needs to be individual and you need to think about whether it’s right for you.”
Jennie

“My advice to another family would be, ‘don’t be afraid to say no’. I feel that many parents are rushed into making the decision before they’re fully informed and before the child can express their own preference.”
Jes

Making decisions together as a family

Deciding on hearing technology can be a deeply personal choice and can sometimes cause tension in families, especially when family members have differing views. To navigate this, it's helpful to explore information together, meeting with professionals and seeking second opinions when necessary.

Where possible, parents should involve their children in the decision-making process, ensuring they have all the facts to form their own opinions.

To resolve disagreements, try to understand each other’s perspectives. Ask questions that explore personal experiences, concerns, and the potential impact on daily life. If necessary, seek support from resources like family counselling, child counselling, or family mediation. You can also contact our Helpline for advice and support.

It's important to respect the rights of children and young people in these decisions. According to the UN Convention on the Rights of the Child, children capable of forming their own views should have a voice in decisions affecting their healthcare. They should be given information in a way they understand, and they have the right to consult with healthcare providers privately, with or without a trusted advocate.

"My parents were asked if they wanted me to have cochlear implants when I was a few months old, but my mum and dad weren’t sure if I’d like having a cochlear implant as I was always pulling my hearing aids off! They decided to let me decide for myself when I got older.
"Getting a cochlear implant is a personal choice and it’s different for everyone. I like the way I hear, and having an operation doesn’t appeal to me at all. I think my parents made the right decision.”
Daisy (12), who is profoundly deaf and wears hearing aids.

“My mum and dad helped me decide whether to get cochlear implants by talking through what life would be like with implants. I decided to get them as they can help me hear more than I could with my hearing aids.”
Lewis (13), who is profoundly deaf and wears cochlear implants.