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Cochlear Implant Evaluation Services
Hearing aids can only do so much. For millions of people with severe-to-profound hearing loss, cranking up the volume stopped working a long time ago—conversations blur, phone calls turn into guesswork, and the world gradually goes quieter no matter how powerful the device. Cochlear implant technology opens a different door: instead of amplifying a broken signal, it bypasses the damage entirely and talks straight to the auditory nerve.
At Audiology Island, Dr. Stella Fulman and Dr. Zhanneta Shapiro walk you through every stage of that process—candidacy testing, surgical coordination, device fitting, speech mapping, and the long-term rehabilitation that actually makes it all stick. Whether you’re exploring options for yourself, a parent, or a child, our evaluation gives you real clinical answers, not vague reassurances.
What Are Cochlear Implants?
Think of a hearing aid as a loudspeaker. It takes whatever sound arrives and cranks up the volume. Helpful—until the inner ear’s sensory hair cells are too damaged to decode that louder signal. A cochlear implant takes a fundamentally different approach: it skips the broken parts. An external processor worn behind the ear picks up sound, translates it into coded electrical pulses, and beams those pulses to a tiny electrode array threaded into the cochlea during surgery. The auditory nerve fires in response, and the brain interprets the result as sound.
Why does this matter so much clinically? Because for someone whose inner ear has essentially quit transducing, turning up the volume is like shouting into a disconnected phone. Two decades of peer-reviewed data show that implant recipients frequently reach open-set sentence recognition above 80 percent in controlled lab settings. Impressive, yes—but those figures need an asterisk. How long a person went without hearing, what age they were implanted, how healthy the auditory nerve is, and frankly, how hard they work in rehab afterward all shape the final outcome. No two patients land in the same place.
The core idea: Hearing aids turn up the volume. Cochlear implants rewire the delivery route—sending sound straight to the nerve when the ear’s own hardware can’t keep up.
Who Can Benefit from a Cochlear Implant?
The short answer? Far more people than most realize. When the FDA greenlit multi-channel implants for adults back in the mid-1980s, candidacy was narrow—essentially limited to profoundly deaf individuals getting zero help from hearing aids. Fast-forward four decades and the criteria look nothing like that. Children as young as nine months with bilateral profound sensorineural hearing loss now qualify, along with adults whose sentence-recognition scores sit at 50 percent or below even with well-fitted amplification.
An audiogram, though, only captures part of what’s going on. Emerging research—Lin et al.’s 2023 JAMA study among the most cited—draws a troubling line between untreated severe hearing loss and faster cognitive decline, shrinking social circles, and a creeping vulnerability to depression, especially in older adults. Kids face a different but equally urgent pressure: spoken language develops on a biological clock, and that window starts narrowing sharply around age three. So candidacy isn’t really just about thresholds and word scores. It’s about what happens to the rest of someone’s life if hearing stays broken.
Still, not every person with major hearing loss should rush toward surgery. Nerve health, cochlear anatomy, realistic expectations, willingness to commit to rehabilitation—all of these weigh heavily. A sixty-year-old retiree and a two-year-old toddler sit in the same waiting room for very different reasons, and our evaluation teases those reasons apart.
What Does the Candidacy Evaluation Entail?
It’s not a single appointment. At Audiology Island the assessment stretches across multiple visits, and that’s deliberate—we need both hard data and the kind of nuanced clinical picture that doesn’t reveal itself in one sitting.
First come comprehensive hearing tests: pure-tone audiometry, speech-in-quiet, speech-in-noise, immittance measures. Before we draw any conclusions about implant candidacy, though, we make sure existing hearing aids are actually doing their job. You’d be surprised how often someone walks in convinced amplification “doesn’t work” when really the devices were programmed months ago and never fine-tuned. We optimize those settings, run a proper trial, then re-test speech perception with validated materials—CNC monosyllabic words, AzBio sentences—in both aided and unaided conditions.
Imaging follows. High-resolution CT or MRI of the temporal bones lets the surgical team verify cochlear patency and flag anything unusual in the anatomy before anyone picks up a scalpel. A thorough medical-history screen runs in parallel, catching conditions that could raise operative risk or complicate recovery.
And then there’s the piece most clinics underestimate: counseling. A cochlear implant doesn’t sound like natural hearing—especially not at first. The signal is thinner, more electronic, sometimes unsettling. Dr. Fulman and Dr. Shapiro carve out real time for expectation-setting and family conversations, because the data are clear on this: patients who walk into surgery understanding what “different” sounds like do measurably better than those who expect instant normalcy. Informed consent here isn’t paperwork. It’s a clinical variable.
Manufacturers That We Work With
We don’t believe in one-brand-fits-all. Device choice should hinge on your anatomy, your listening goals, your daily routine—not on which sales rep visited the clinic last. Our partnerships with the leading implant makers mean patients see genuine options, explained honestly.
Advanced Bionics
Their HiRes Ultra 3D platform delivers 120 spectral bands and a current-steering system that creates finer pitch resolution than most competitors—a real advantage for music lovers and anyone who spends time in noisy rooms. The external processors carry an aquatic rating, too, which matters more than people expect once they start living with the device day to day.
Cochlear Americas
The oldest name in the field, and there’s a reason they’re still here. The Nucleus line—including the N8 processor series—pairs SmartSound iQ scene-classification with one of the deepest reliability data sets any manufacturer publishes. Their system reads the acoustic environment and shifts processing strategy automatically, so the user isn’t fiddling with settings at a dinner table.
Why Choose Audiology Island for Cochlear Implant Evaluation Services
Lots of audiology offices run cochlear implant evaluations. Here’s where ours differs: we treat the evaluation itself as treatment—not a gate you either pass or fail. Dr. Stella Fulman, Au.D. and Dr. Zhanneta Shapiro, Au.D. hand every patient a written breakdown of their results, walk them through what the numbers actually mean (and where the numbers stay silent), and build a recommendation around audiometric data, daily communication realities, cognitive picture, and emotional readiness all at once.
Both hold specialized cochlear-implant programming credentials and keep active training ties with manufacturer engineering teams. We also feed our patients’ post-activation speech-perception gains into multi-site tracking programs that compare outcomes against national benchmarks. Self-reported satisfaction tells you something; measured performance tells you more. When a patient’s trajectory dips below where it should be, we dig in and recalibrate. That willingness to iterate—not any single gadget—is what actually restores hearing in a lasting way.
Cochlear Implant Evaluation Services at Audiology Island
Candidacy Evaluation
Several sessions, not one. We run aided and unaided audiometry, speech-perception testing (CNC monosyllabic words, AzBio sentences at +5 dB SNR), hearing-aid verification, and coordinate imaging review with your surgical team. Pre-surgical counseling is baked in, not bolted on. At the end you get a detailed candidacy report—shared with your referring physician, the surgeon, and you.
2Cochlear Implant Fittings and Speech Mappings
Activation day usually falls two to four weeks after surgery, once tissue has healed enough. During that first session—and the mapping visits that follow—we check electrode impedances, dial in threshold and comfort levels across the entire array, and fine-tune which frequencies land on which electrodes. Most people come back for several adjustments in year one alone; we pace that schedule around both measured data and how things sound to you.
3Maintenance and Adjustments
Processors need upkeep: firmware patches, microphone checks, fresh cables, coil magnets, batteries. Routine stuff, but easy to neglect. Beyond hardware, we schedule annual or twice-yearly mapping tune-ups because the auditory nerve’s response profile shifts over time, and any residual acoustic hearing you retain may change too.
4Aural Rehabilitation
Surgery is the halfway point. Not the finish. Our rehab program layers structured listening drills, real-world communication strategies, and—in pediatric audiology—auditory-verbal therapy into a schedule that matches each person’s pace. The evidence here is stark: recipients who go through a systematic rehab course score meaningfully higher on speech-perception tests at the twelve-month mark than those who just let incidental listening do the work. Adults can choose one-on-one sessions or group classes tackling phone calls, noisy restaurants, work meetings, and streaming media.
Our Doctors of Audiology
Dr. Stella Fulman
Dr. Fulman completed her Doctor of Audiology degree at Northwestern University, followed by specialized fellowship training in vestibular assessment and rehabilitation. Her 22 years of clinical practice spans pediatric through geriatric populations, with particular expertise in complex diagnostic cases and tinnitus management.
Dr. Zhanneta Shapiro
Dr. Shapiro earned her AuD from the University of Florida, subsequently completing advanced training in hearing aid technology and real-ear verification techniques. Over 20 years, she’s fitted thousands of patients with amplification, developing refined strategies for addressing difficult-to-fit configurations and the adjustment process.
Our Office Locations and Hours
Main Office
11 Ralph Place, Suite 304,
Staten Island, NY 10304
Phone: (888) 995-5655
Office Hours
Mon & Thur
8:30AM – 7:00PM
Tue, Wed & Fr
8:30AM – 5:00PM
Sat-Sun
Clossed
Additional Locations:
Request Your Appointment
Once you’ve decided to take the journey of getting better hearing, our audiologists will help you determine if you’re a cochlear implant candidate by doing a thorough cochlear implant evaluation. The cochlear implant system you decide to go with is an important, lifelong decision that will affect every step of your journey to hearing. Call us today to schedule a consultation with our doctors of audiology who will help you make the right choice.
Patient Testimonials
Patient Information
What is a cochlear implant evaluation?
It’s a structured series of hearing tests and consultations designed to figure out whether a cochlear implant makes sense for someone with severe-to-profound sensorineural hearing loss. At Audiology Island, Dr. Stella Fulman and Dr. Zhanneta Shapiro run aided and unaided speech-perception testing (CNC words, AzBio sentences), verify hearing-aid performance, and provide detailed pre-surgical counseling—all before anyone makes a candidacy call.
Who is a candidate for a cochlear implant?
Generally, adults scoring 50 percent or lower on sentence-recognition tests with optimized hearing aids, and children as young as nine months with bilateral profound hearing loss. But Dr. Fulman and Dr. Shapiro look beyond the audiogram—nerve health, cochlear anatomy, lifestyle demands, and realistic expectations all shape the final recommendation.
Is the cochlear implant evaluation painful?
Not at all. The cochlear implant candidacy evaluation is completely non-invasive—hearing tests, speech-perception checks, and a counseling conversation. If imaging is needed (high-resolution CT or MRI of the temporal bones), those are standard diagnostic scans with zero discomfort.
How long does a cochlear implant evaluation take?
Budget four to six weeks total, spread across two or three visits. The first audiological evaluation at Audiology Island runs about 90 minutes. After a hearing-aid optimization period, Dr. Fulman or Dr. Shapiro wraps up with final aided speech-perception testing and sends a written candidacy recommendation to your surgical team.
Does insurance cover cochlear implant evaluation and surgery?
Usually, yes. Most major carriers, Medicare, and Medicaid cover cochlear implant evaluations and the surgery itself once medical necessity is documented. Our patient-care coordinators handle benefit verification and prior authorization before testing starts, so you know what you’ll owe upfront.
Can children get cochlear implants?
Absolutely. The FDA has cleared cochlear implantation for infants as young as nine months who have bilateral profound sensorineural hearing loss. Dr. Fulman and Dr. Shapiro assess pediatric candidates with age-appropriate speech-perception protocols at Audiology Island—because getting a child implanted during the critical language window can reshape their entire communication trajectory.
What happens after cochlear implant activation?
Activation usually happens two to four weeks post-surgery. Then come several speech mapping sessions—frequent at first (every few weeks), tapering to semi-annual check-ins as the brain adapts. We pair every activation with an aural rehabilitation plan, because the implant delivers the signal but the brain has to learn what to do with it.
What is the difference between a hearing aid and a cochlear implant?
A hearing aid turns up volume—great when inner-ear hair cells still partially work. A cochlear implant goes around them, converting sound into electrical signals fired straight at the auditory nerve. Think of it as amplification vs. rerouting. Dr. Fulman and Dr. Shapiro at Audiology Island help patients figure out which approach fits their hearing loss and communication needs.
Other Services
Diagnostic Hearing Evaluation
Earwax
Removal
Balance/Fall Risk Assessment
Tinnitus Evaluations and Treatment
Hearing Care
for Children
Custom Hearing
Protection
Aural
Rehabilitation
TeleCare Service
(TeleAudiology)
Auditory Processing Disorder
Hearing Aid
Repairs
