A variety of controversies should be considered by an implant team before recommending cochlear implants in children, adolescents, or even adults who are congenitally deaf. These factors include, but are not limited to, minimum and maximum age for implantation, extent and quality of hearing aid, listening and speaking experience, family financial and emotional support, communication mode in the family and in the educational programs available, role of deaf culture in the family and child's life, the child's own perceptions and ability to participate in the implant decision, advisability of implantation in children with multiple disabilities, extent of outcome data studies, and implications of neural plasticity and cortical reorganization studies.

All these controversies serve to remind the members of the implant team how carefully each family and child must be evaluated and how sensitive the counseling and explanation process must be before the decision to implant is made.


Kretschmer—CHAPTER 81

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