When is the best time to provide a cochlear implant (CI) to a young child with congenital deafness?
It is well known that there are critical periods for neurobiological development in the brain. A sensitive period for the development of the central auditory system is a time when the central auditory pathways have the greatest plasticity (or responsiveness), and are primed for stimulation-driven development. It is reasonable to believe that cochlear implantation occurring within this sensitive period would achieve the most positive results. One objective measure of the development of auditory cortical pathways is the latency (timing) of cortical auditory-evoked potentials (CAEPs). In particular, the latency of the first positive peak (P1) of the CAEP in children is considered an indicator, or biomarker, of the mature development in the auditory cortical areas. The P1 peak latency varies as a function of age—and is considered an index of cortical auditory maturation. Evidence from intracranial recordings in humans, as well as from animal models, suggests that several generators of the
