Making a decision about cochlear implants
Last reviewed: 25 June 2024
Deciding to get cochlear implants is a life-long commitment. For some families, this can be a difficult decision as there are many things to consider. This page outlines some of the factors you may want to consider when making your decision, but it may not answer all your questions.
Having lots of balanced information and speaking to families with experience of the process may help you make your decision. If you have any questions about the tests, the operation or what it’s like to live with an implant, talk to the professionals working with you and your child.
If at any time, you or your child feel that having an implant isn’t the right choice, you can always say so. The implant team will understand if you need more time to think before making a final decision.
Most cochlear implant users get on well with their implants and continue to use them as adults. However, your child will always have the option not to wear their speech processors.
Jennie is mum to Olive (4) who is profoundly deaf and has 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.”
Jes is mum to Kaya (5) who is profoundly deaf and uses British Sign Language (BSL).
“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.”
Surgery
Getting cochlear implants means your child will need to have 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 your child’s head. The internal receiver is then put in and secured beneath the skin, and the electrode is inserted into the cochlea.
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.
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 speech processor can be changed as technology develops and improves, but this shouldn’t mean further surgery. Currently, the NHS upgrade speech processors every five 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 that you know 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. 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.
- Your child will need to attend audiology appointments throughout their life to have their cochlear implants ‘tuned’ as their hearing levels may change over time.
- 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.
Daisy (12) is profoundly deaf and wears hearing aids.
“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.”
Lewis (13) is profoundly deaf and wears cochlear implants.
“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.”
Where cochlear implants can be worn
The following are some situations where you may need to be careful with your child’s cochlear implants.
Swimming and bathing
Very few speech processors are waterproof. Some are ‘water resistant’, which means they can be worn in the rain, on the beach, or during activities when sweat may be an issue, but they should never be fully submerged in water.
However, waterproof kits are available for most new models of speech processor. The kit will include a waterproof coil and a waterproof cover which fits over the speech processor, allowing your child to continue wearing the processor while swimming. Your cochlear implant centre might give you a waterproof kit when they fit your child’s cochlear implant. If they don’t, you might be able to buy a kit from the company which made the cochlear implant.
Before you buy a waterproof kit, make sure it’s compatible with your child’s cochlear implant and the type of battery they use. For example, the Cochlear Nucleus® 7 Aqua Kit can be worn with the Nucleus® 7 Sound Processor with rechargeable batteries.
Aeroplanes and airport security
There’s no need for your child to remove their speech processors to go through airport security. NHS advice is that metal detectors and security scanners should not damage cochlear implants. However, hearing technology can activate the alarm at security, so it’s a good idea to let airport security know that your child has a cochlear implant.
Some implant centres will give you a Patient Identification Card which you can show to airport security to let them know about your child’s cochlear implants. However, these cards aren’t necessary, and you can just tell airport staff about your child’s implants when you go through security.
For flights, your child will not need to turn off their cochlear implant for take-off or landing. However, if they have wireless technology and Bluetooth functionality, they may need to switch this to flight-safe mode during take-off and landing but can turn it back on during the flight. It’s best to check with the airline staff before flying, but most implant centres will have a letter for patients who are about to travel which explains the importance of keeping the device on during travel.
Sleeping
There’s no reason why a child can’t wear speech processors at night, but most children don’t find them very comfortable to rest on and choose to remove them when they sleep.
Sports
Children with cochlear implants can take part in most activities, although sometimes it’s a good idea to remove the speech processor during the activity to prevent it being damaged, for example, when taking part in football or netball.
To avoid damaging the internal part of the implant, children are advised to wear head protection for some activities or to avoid contact sports where a knock to the head is likely, such as judo, kickboxing and rugby.
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.
Read more about choosing a communication approach for your child.
Getting balanced information
When you start thinking about cochlear implants and finding out more information about them, you’ll come across different views regarding implanting children at a young age.
Some people in the Deaf community don’t feel that deafness needs to be cured and that a deaf child should be old enough to make their own decision before being implanted.
Others see deafness as a condition which can be helped by technological intervention and that a cochlear implant can give a profoundly deaf child their best and only chance of gaining access to spoken language.
If you’re interested in finding out more about this debate, it’s a good idea to talk to deaf people with and without cochlear implants and to families and deaf children themselves about their experiences and feelings.
Your local deaf children’s society is a good place to start. You could also check out the Cochlear Implanted Children's Support Group (CICS website), a voluntary group run by parents offering support to parents of deaf children with cochlear implants and those who are deciding if implantation is right for their child.
Jennie says,
“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.”
Jes says,
“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.”
Useful resources
- The British Cochlear Implant Group (BCIG website) is a professional body that represents all the cochlear implant centres and other specialist medical professionals in the UK.
- Hearing Success (Advanced Bionics website) has online communities where parents of deaf children can ask questions and share information.
- Your Cochlear stories (Cochlear website) has stories of people who have gotten cochlear implants.
- HearPeers forum (MED-EL website) is an online forum for cochlear implant users across the world.
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