Annie has a bilateral hearing loss which we just learned is progressive, and has decreased from mild-moderate to moderately severe to profound in the past 6 months. We are researching cochlear implants and I am searching for the answer to "When do we decide that implants are the right choice, and commit to move forward?" Can you speak to this? Thanks!

Dear Ms. Mom,
You certainly seem to be keeping current with Annie's audiological needs. You wrote that her hearing loss has progressed from mild-moderate to profound over the last six months. I'm sure the audiologist has been adjusting your little girl's hearing aids and talking with you about a cochlear implant. As a result, the big question you now face is when to make the decision and committ to move forward.
Children learn most language skills between two and three years of age. This is a crucial time to be hearing if spoken language is the communication mode which you have chosen for Annie. So if you want your child to be oral, the time to commit is now. And since she did have hearing when she was younger, her brain may remember sounds and she may adapt to the implant more easily.
If Annie is using sign language and you are happy with this option, the committment to an implant isn't as crucial. The longer you wait, the more she will use the implant to know that sound exists, but not for an understanding of sounds. I hope this makes sense.
So, to answer your question in a nutshell: This is the time to make a decision, and it must be based on your choice about Annie's communication mode. You know yourselves and your child best, so whatever decision you make will be the right one. And please write again if you have more questions or concerns.
Sincerely
Kathleen Sutherland