366 - FDA Expands Pediatric Cochlear Implant Candidacy: What’s Changed?

Pediatric cochlear implant candidacy has expanded significantly in recent years, creating opportunities for earlier intervention and opening the door to implantation for children who may not have been considered candidates in the past.Dr. Bob Traynor is joined by Dr. Samantha Scharf, Research Assistant Professor in the Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina at Chapel Hill, to discuss recent changes to FDA indications for pediatric cochlear implants and what they mean for audiologists, cochlear implant teams, and families.Scharf explains how pediatric candidacy has evolved, including the reduction of the minimum implantation age to 7 months for certain children with bilateral profound sensorineural hearing loss and the expansion of audiometric criteria to include children with more residual hearing. They discuss the research supporting earlier implantation and why providing consistent access to sound during critical periods of auditory and language development can have an important impact on long-term listening and spoken-language outcomes.The conversation also examines cochlear implantation for children with single-sided deafness, the evidence supporting implantation in younger children, and ongoing research evaluating whether candidacy for single-sided deafness could eventually extend below the current minimum age of 5 years.For clinicians, Scharf emphasizes the importance of beginning the referral process early rather than waiting until a child reaches the minimum implantation age. She also discusses the Pediatric CI 3-60 Guidelines, which recommends referral for a cochlear implant candidacy evaluation when a child meets any one of three measures in the ear being considered: an unaided four-frequency pure-tone average (4FPTA) of 60 dB HL or greater, an aided Speech Intelligibility Index (SII) of 0.60 or less, or a word recognition score (WRS) of 60% or less when available. These measures are intended to help identify children who warrant a comprehensive CI evaluation—not to determine candidacy on their own.Scharf also offers guidance for families navigating a new diagnosis of profound hearing loss and discusses why timely evaluation and intervention can be particularly important when listening and spoken language are among a family's goals.

• Read the referenced article, “New Cochlear Implant Candidacy Criteria for Children,” in The Hearing Journal

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