Skip Navigation
Search Menu
Otolaryngology-Head and Neck Surgery

In This Section      
Print This Page

Pediatric Cochlear Implants

Learning to use a cochlear implant to great effect is seen most dramatically in young children, but many of the same principles of learning apply to adults. Indeed, experience with hundreds of children and adults has enabled The Listening Center to apply insights gained in one group to the other, allowing both to take the experience of listening with a cochlear implant to its fullest potential.

The Listening Center is committed to the following principles:

Early intervention yields the best results

Studies show that early implantation is important for producing optimal results in children with deafness. For example, sensitive hearing is achieved early in the vast majority of these children. However, it is the degree to which restored hearing turns into language that best defines success with a cochlear implant. Speech and language skills develop more readily when a child hears spoken language early in life. From birth through early childhood stages, children's neural pathways develop in a manner that is shaped by their sensory experience. The shorter the period of deprivation of sound, the better the results from cochlear implantation.

Rehabilitation maximizes the potential of children who receive cochlear implants

Sensitive hearing is necessary but not sufficient for understanding spoken language and producing speech that is easily understood by others. While the cochlear implant provides access to sound, understanding takes more than just hearing. Rehabilitation provides a structured approach to learning to identify and associate meaning with unfamiliar sounds, thereby allowing spoken language skills to develop. Read more about the importance of pediatric rehabilitation from the American Cochlear Implant Alliance.

Families and professionals need to act as a team soon after a diagnosis of deafness in a child

Children with cochlear implants are more likely to gain sophisticated communication skills when families and professionals collaborate. The Listening Center works in partnership with parents, teachers, therapists, and physicians to ensure continuity of the training offered at the Center into the daily life of the child with a cochlear implant.

Cochlear Implant Resources

Four of Tracy and Josh Hugel's five children had cochlear implant surgery at Johns Hopkins. Read about their experience at The Listening Center.

Get answers to the most frequently asked questions about cochlear implantation, device activation, and auditory rehabilitation from our team of experts.

Find helpful tips for being a caregiver to a child with a cochlear implant.

Meet our team of cochlear implant and rehabilitation experts.

Functioning After Pediatric Cochlear Implantation

The FAPCI instrument is a psychometrically-validated survey that is used to evaluate the real-world verbal communicative performance of children aged 5 years or younger using cochlear implants. This instrument was designed to fill a gap in our current approach to the assessment of cochlear-implanted children, and FAPCI scores reflect a child's ability to communicate in real-world settings (e.g. at home or when interacting with family members).

The 23-item FAPCI instrument is completed by the child's parent or primary caregiver and has been designed to be a completely self-administered instrument for English-speakers with a 8th grade reading level. There is no need for a test administrator to be present to provide directions or answer questions.

The FAPCI instrument is currently being used in several ongoing industry and NIH-funded studies of pediatric cochlear implantation and has also been translated into German and Korean. Ongoing research efforts are assessing the variables that impact FAPCI scores (real-world communication) in contrast to clinical measures of speech perception.

At the clinical level, the FAPCI instrument is being used to track an individual child's progress after cochlear implantation. Recently, preliminary "growth" curves of FAPCI scores in normal hearing children have been developed to aid in FAPCI score interpretation.

Download the FAPCI instrument and related materials and read about research conducted about the FAPCI Instrument.

The FAPCI instrument is copyrighted by the Johns Hopkins University but is freely available for routine clinical use. Researchers interested in using the instrument in funded studies, however, are asked to pay a modest licensure fee ($200/site) to help defray the costs of continued instrument research and development.

For more information, questions or comments about FAPCI, please email