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Tracey Dorr is a senior executive in an international semi-conductor company and cochlear implant user herself.

Generally, in the U.S. the cochlear implant candidacy guideline for young children is severe to profound bilateral hearing loss. Should we consider cochlear implants case by case for children with bilateral moderately severe hearing loss? Some may benefit going bimodal; wearing a hearing aid in one ear by utilizing residual hearing and a cochlear implant in the other ear to achieve greater sound access.

Children with any form of hearing deficit face additional challenges at school, impeding their learning experiences, difficulties acquiring social skills, and possibly develop poor self-esteem. The exerted listening effort from trying to hear the teachers may limit their ability to process and digest the information presented in classrooms. This may reduce retention of new information taught in classrooms, hence compromising their learning experiences. The accumulation of missed information, year after year from the exerted listening effort and hearing fatigue, may cause hearing deficit individuals to fall further behind at school and create a widening educational gap from their peers. The gap could present a case of missed opportunities on maximizing the potential for moderately severe hearing loss children.

Hearing aids generally serve as an amplifier, often lacking the ability to deliver refined sounds to assist speech discrimination. Whereas cochlear implants, although not perfect, have a greater chance of providing clarity in speech. It may be beneficial for moderately severe hearing loss children to go bimodal.

Possible advantages of early intervention of going bimodal include:

Possible advantages for bimodal children during their schooling years include:

Updating the cochlear implant candidacy criteria for children with moderately severe hearing loss with an option to go bimodal could maximize their potential at school. Bimodal children should experience less listening effort, less hearing fatigue, and a greater chance of retaining new information than moderately severe hearing loss children with bilateral hearing aids. Improving the hearing and learning experiences should mitigate the learning gap in school. In other words, the likelihood of keeping up with their peers at school, acquiring social skills, and healthy self-esteem. Relaxing the cochlear implant candidacy guidelines should apply to moderately severe hearing loss children who’ve been fitted with bilateral hearing aids and consistently miss meeting age-appropriate speech and auditory reception milestones.

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