A Cochlear Implant (CI) is an electronic device that bypasses damaged cells and converts sound and environmental noises into electrical signals which stimulate the hearing nerve. It is an important scientific and technological achievement. Already acknowledged by the international scientific community it is no longer an experimental method. It has been evaluated and tested by the health authorities in most of the European countries. In 2005 there were more than 20.000 people in Europe with a Cochlear Implant, and almost 10.000 of these* received the CI as children.

Cochlear Implant is designed for persons with a complete or severe-to-profound hearing loss and who do not attain sufficient benefit from traditional hearing aids.

Before proposing a child as candidate for a CI he/she must be evaluated by a multi-professional team. The parents and if appropriate the child should receive full and independent advice before being asked to make any decision. The implant team must take into consideration medical, psychological, pedagogical, social, linguistic and family aspects. If old enough, the child should also be involved in the decision­-making process. In all cases the final decision of whether or not to have an implant must be made by the parents.

Whichever methods of communication are used, the best results from Cochlear Implants, as with traditional hearing aids, are related to an early implantation.

Parents should be informed that the cochlear implant does not restore normal hearing and therefore it is not a miracle cure. A child with a CI remains hearing impaired.

A Cochlear Implant Programme is more than only the surgical procedure. It involves a more complex procedure which should include all the necessary human and technical resources and experience on implants for assuring the following:

• Appropriate choice of the candidates, taking into account physical, neuro- physiological, psychological, audiological and family aspects
• High quality surgery avoiding side-effects
• Choice of the most appropriate device
• Programming by experts specialised in children
• Adequate and sufficient rehabilitation as well as every kind of support
• Close co-ordination among the professionals of the Programme
• Continuous follow-up of the implanted child and his/her family
• Technical maintenance of the device
• General support and advice for the child and the family

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** (SOURCE: EURO-CIU)

For all these reasons, the European Federation of Parents of Hearing Impaired Children (FEPEDA) DEMANDS the following:

• Parents must be clearly and objectively informed of the characteristics of the Cochlear Implant Programme, the prognosticated benefit for their child and the advantages and disadvantages of the implantation for the whole of the child’s life.
• Respect for the decision made by the parents whether to elect cochlear implantation or not. The decision must be made free and without any pressure.
• Health authorities should create, and/or update, the minimum quality standards for Cochlear Implant Programmes. These quality standards must be relative to technical advances and to the required results. Health authorities must assure that Cochlear Implant Programmes follow these quality standards.
• Cochlear Implant Programmes must include highest quality expertise and multi-professional teams. These teams must be specifically trained and sufficiently and adequately provided for meeting the individual needs of each implanted child.
• Post-implant rehabilitation and educational support are essential and they must be provided as long as needed. Special attention should be paid to the linguistic development of the child.
• As with the traditional hearing aids, authorities must assure that the Cochlear Implant Programme is free of charge to the family.
• Once the decision of implantation is taken, the child should be operated without any delay.

Adopted in Madrid, July 2006