Achieving Early Implantation: Australian Delivery of Comprehensive Cochlear Implant Care

Over the past 40 years, paediatric cochlear implantation has evolved from being a highly controversial intervention offered only to older children with total hearing loss, to be the standard of care for many children with severe profound sensorineural hearing loss (SNHL). During this time, the clinical indications for cochlear implantation have expanded as the body of evidence has grown to support cochlear implantation in the first year of life. Achieving the goal of early implantation requires sufficient funding and a well-articulated referral pathway from hearing screening, through diagnostic audiology, to early amplification and ultimately to cochlear implant (CI) intervention. This chapter will outline how such goals are achieved in Australia, where infants consistently receive CIs between 6 and 12 months of age. An overview of the Australian health system and how it enables early diagnosis, audiological management, cochlear implantation and habilitation of children who are deaf and hard of hearing (DHH) will be provided. Achieving early implantation in Australia has not been without its challenges. This chapter will also highlight past barriers and future opportunities to further facilitate early cochlear implantation for infants.