The candidate is evaluated on an out-patient basis over a one-to-two day period at UCSF. Patients are selected for implantation based on medical and audiological histories and test results, findings and recommendations of the psychological interview, educational placement, family support and therapy services available for the pediatric candidate.

Due to the number of procedures, the evaluation generally takes more than one day to complete. In addition to the formal test measures, considerable time is spent discussing the components of the device and their function, the surgical process as well as the benefits and limitations of a cochlear implant. The evaluation process differs slightly between adults and children.

Components of the evaluation:

1. Medical Evaluation.
Conducted by the implant surgeon who will take a medical history, examine the ears and explain the surgical process. All implant surgeons are in the Department of Otolaryngology at UCSF.

2. CT Scan.
Completed in the Department of Radiology. This scan produces a two-dimensional x-ray of the inner ear. This is important because it allows the surgeon to evaluate the ear's internal structure, recommend which ear to implant and may provide information as to the cause of deafness.

3. Audiological Evaluation.
Consists of: a hearing test to confirm type and degree of hearing loss, a hearing aid evaluation to assess benefit provided by hearing aids, and aided speech recognition testing to determine whether a hearing aid might provide greater benefit than that anticipated with the implant.

4. Psychological Screening.
This screening is conducted by clinical psychologists at the UC Center on Deafness to assess the candidate's feelings about hearing loss, the cochlear implant, reasons for seeking the implant and to evaluate expectations about the cochlear implant.

5. Cochlear Implant Counseling/Orientation Session.
The purpose is to review and discuss the components of the device, the possible benefits and limitations of implantation and recommend in favor of or against implantation based upon the results of the entire evaluation.

6. School visit (for children).
The purpose of the school visit is to establish an on-going relationship with the child's school, teacher and therapist(s) prior to implant surgery; to provide in-service training to the professionals working with the child in order to ensure mutual support and shared goals.