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Updated: Mar 21, 2026
Author Spotlight: Advancements in Impedance Monitoring for Cochlear Implant Surgery
Published on: August 4, 2023
Barriers to early cochlear implantation
Shani Dettman1,2,3, Dawn Choo1,2,3, Richard Dowell1,2,3
1a The University of Melbourne, Department of Audiology and Speech Pathology , Parkville, Victoria , Australia ;
Insights
Newborn hearing screening has reduced the age of cochlear implant (CI) and hearing aid (HA) fitting for children. Factors like socio-economic status and diagnosis influence CI timing.
Area of Science:
- Audiology
- Paediatric Medicine
- Medical Technology
Background:
- Early intervention is crucial for children with hearing loss.
- Cochlear implants (CIs) and hearing aids (HAs) are key devices for auditory rehabilitation.
- Newborn hearing screening (NHS) aims to identify hearing impairment early.
Purpose of the Study:
- To identify variables associated with paediatric access to cochlear implants (CIs).
- To examine trends in age at CI surgery and HA fitting.
- To explore demographic factors influencing early CI implantation.
Main Methods:
- Analysis of trends in age at HA fitting and CI surgery over time, correlated with NHS implementation.
- Exploration of demographic factors for children implanted under 3 years.
- Examination of pre-implant steps for infants receiving CIs under 12 months.
Main Results:
- Age at HA fitting and CI surgery decreased over time, linked to NHS implementation.
- Earlier HA fitting, higher socio-economic status, and specific diagnoses (e.g., Connexin 26) were associated with earlier CI in children under 3.
- Progressive hearing loss correlated with later CI, and significant delays were noted in diagnosis and pre-implant imaging.
Conclusions:
- NHS implementation is associated with reduced age at device intervention for paediatric hearing loss.
- Timely access to CIs depends on a combination of screening, socio-economic factors, and diagnostic pathways.
Objective:
Identify variables associated with paediatric access to cochlear implants (CIs).
Design:
Part 1. Trends over time for age at CI surgery (N = 802) and age at hearing aid (HA) fitting (n = 487) were examined with regard to periods before, during, and after newborn hearing screening (NHS). Part 2. Demographic factors were explored for 417 children implanted under 3 years of age. Part 3. Pre-implant steps for the first 20 children to receive CIs under 12 months were examined.
Results:
Part 1. Age at HA fitting and CI surgery reduced over time, and were associated with NHS implementation. Part 2. For children implanted under 3 years, earlier age at HA fitting and higher family socio-economic status were associated with earlier CI. Progressive hearing loss was associated with later CIs. Children with a Connexin 26 diagnosis received CIs earlier than children with a premature / low birth weight history. Part 3. The longest pre-CI steps were Step 1: Birth to diagnosis/identification of hearing loss (mean 16.43 weeks), and Step 11: MRI scans to implant surgery (mean 15.05 weeks) for the first 20 infants with CIs under 12 months.
Conclusion:
NHS implementation was associated with reductions in age at device intervention in this cohort.
