Decisions, decisions... One of a parent's most agonizing decisions is whether or not to get a cochlear implant for their deaf child. No sooner does one decide to go ahead with a CI than another confusing choice appears: which brand of implant to choose? It can be overwhelming. The differences between them seem to require a degree in biomedical engineering to understand. To make matters worse, your child's audiologist at the CI center reassures you that all brands work great and that the choice is entirely up to you and should be based on what will "work best for your family." But how is one supposed to know what will "work best for our family?" What if it doesn't work at all? Not working at all seems unlikely to those of us whose children already have cochlear implants, but, this can be a very real concern for someone making what seems like such a weighty decision on behalf of a child, the love of their life.So how does one choose? The audiologist's reassurance is worth noting. All brands do work to a high degree of success, and if they didn't, the implant center could not, in good conscience, offer them! Success depends far more -- even entirely -- on the follow-up care and intervention that a child gets rather than the brand chosen. A child's cochlear implant should be mapped (programmed) regularly. The child should be wearing the implant nearly all waking hours, and parents should be getting regular instruction on how to encourage listening and auditory development in their child. A young brain is an amazing thing, and if all of these criteria are met, the chances of success are very high.
"This is not helping," you say. "I need some guidance here. Help me decide!" OK. First, it's worth figuring out which brands your CI center, and especially audiologist, have experience with. A child, especially a very young one, will not be able to say, at first, what sounds good, clear, etc., so you will be relying on the audiologist's intuition and expertise in making the implant produce the best possible quality of sound for your child. Ask what implants are common among the clinic's patients. Second, look at the devices, both internal and external. Try the sound processors on your child, if he or she will let you, to get an idea of what they might look like. (My son, who has had cochlear implants for 8 years sometimes likes to try the other brands' demo processors on "just for fun" when he's in for a mapping.)
If your child is young, don't worry about whether or not he or she will like the look of the processor when he or she is a teenager. Chances are there will be newer, better-sounding processors with more features available by then -- several times over! Each CI maker seems to release a new sound processor every 4 or 5 years. Also think about which one feels most comfortable and intuitive to you, the parent, since you will be the one manipulating it while your child is young.
If you are still undecided, ask other parents what they like about their choice -- what are their favorite features about their child's CI? Some specific questions include:
* What are my options in how the implant may be worn for a baby or young child?
* How long do batteries usually last?
* What types of batteries do the processors use?
* Is the processor compatible with FM systems and how?
A word of caution here: just like there are "dog people" and "cat people" or "PC people" and "Mac people", there are also "AB people," "Cochlear people," and "Med-El people." There tends to be a great deal of brand loyalty with cochlear implants among adult CI users as well as with parents. And unlike a desktop computer, which can be replaced, once surgery is complete, there is no changing your mind. Naturally, any suggestion by another parent that you could have made a better choice hurts. This is your child, after all, and using the all the information you had and what felt right, you made the best decision you could on behalf of a person who means the world to you. Those of us who are tempted to promote our chosen brand at the expense of another ought to ask ourselves what is our true motivation? Is it out of a sense of insecurity that we want to recruit others to our choice? To reassure ourselves that we made the right one by seeing others make it too? When giving advice, before hitting the "Send" button, put yourself in the shoes of someone who recently made a different choice. Is there anything in what you've written that might offend or hurt such a person, even subtly? If it feels like you might be crossing the line, you probably are. It's also worth keeping in mind that our choice may have been influenced by what was available at the time point that the decision was made. A particular manufacturer may have had the newest device on the market. The options facing parents may be different by now or in another year or two -- things change fast in the CI world, and that's part of the excitement!
In the interest of full disclosure, my son has the Cochlear brand, and I volunteer for the company as a Cochlear Awareness Network Volunteer. I do so primarily because still, not a day goes by that I am not in awe of what cochlear implants have done for my child. I would volunteer for all three brands if I could, though I don't think the other makers would necessarily want me as an advocate because I am not familiar with their products! Last year I was delighted to be part of an foundation that, together with Advanced Bionics, awarded a cochlear implant -- the gift of hearing -- to a young child whose family's insurance would not pay for the surgery.
Perhaps another question to ask parents who have made the choice and whose kids are happily learning to listen, or are accomplished listeners, is how much time do they spend wondering if they made the right choice of brands? Chances are they don't think about it much after it's a done deal, but are absolutely thrilled with what a cochlear implant does for their child.
You can't go wrong!
(For a related story with an implant brand twist, read: The Unexpected - An Adoption Tale)
Lydia is the parent of an almost-12-year-old bilateral CI user who got his first implant at age 4 and second at age 8.
If you would like more guidance on choosing a cochlear implant for your child, join the CI Circle Discussion Group. You can search the archive for past discussions on brand choice or ask anew.