American Cochlear Implant Alliance Task Force Guidelines for Determining Cochlear Implant Candidacy in Children

Area of Science:

• Audiology
• Otolaryngology
• Pediatric Medicine

Background:

• Current guidelines for pediatric cochlear implantation (CI) in the US are based on available evidence.
• Candidacy determination traditionally relies on audiologic and medical criteria.
• Factors beyond standard criteria influence CI candidacy and outcomes.

Purpose of the Study:

• To summarize evidence for current pediatric CI clinical protocols.
• To provide updated candidacy recommendations for pediatric CI in the US.
• To advocate for a flexible, child-centered approach to CI evaluation.

Main Methods:

• Review of available evidence on pediatric cochlear implantation.
• Analysis of Food and Drug Administration (FDA) criteria.
• Consideration of factors like skill progression, quality of life, ear-specific performance, residual hearing, and early intervention.

Main Results:

• Candidacy should be flexible, considering a child's progress and quality of life with hearing aids.
• Ear-specific factors (performance, residual hearing) are crucial for surgical technique and device selection.
• Early intervention is vital to mitigate long-term communication and quality of life deficits.

Conclusions:

• Evidence-based guidelines support a comprehensive approach to pediatric CI candidacy.
• A team-based approach focusing on the whole child and family system is recommended.
• Flexibility in candidacy determination optimizes outcomes for children with hearing loss.