Natalie’s first CI, a Nucleus 22 device, was switched on just after her third birthday. She is now (in 2008) 15 years old. Natalie and her family have chosen not to have a second CI for her.

As a family we have discussed bilateral implants, and Natalie is adamant that she doesn’t want her other ear implanted and, to be honest, we are very happy with this decision. Her one implant has far surpassed all our expectations and we aren’t sure how much extra she would get from another one. We know all the reasons for having two ears – but none are really an issue to us or Natalie.

She doesn’t find locating sound easy, but she can do it and if she doesn’t immediately know where a sound is coming from, she looks round and sees it – this is not a problem to her at all. We are so used to her having only one ear – that we automatically speak in that direction – although this isn’t necessary anymore – we can have conversations with her when she’s in a different room with the TV on! She is bilingual – she signed from an early age and has continued to sign as she learnt to speak, therefore when the batteries go flat or on the rare occasion the processor has broke we sign. Both Natalie and us never cease to be amazed at how much she gets from her first CI. When she was implanted we were told she might get an awareness of environmental sound; now she can use a phone - and not just with familiar people! She is extremely happy with only one and is doing very well with speech and listening and at school.

Quite a few parents have commented to me that they feel like a failure because they have not been able to secure funding for a bilateral implant for their child; that one implant is no good. They feel that their child will not reach his or her full potential. Whilst there is undoubtedly evidence that two ears are better than one we feel compelled to say that one is also great. It saddens me to think that some parents think that one is not good enough and they become so distraught when they cannot get the second one.

Or perhaps we just think differently from the families who are going through the process now? When she was implanted there was no thought at all of having both ears done; she has done so well, that we can’t actually see a problem with only having one ear done and no point in doing the second one for what little extra she would get. Prior to her first one, she couldn’t hear a thing even with the best hearing aids, but with her implant she can even hear the gas hissing when you switch the fire on! There is no way she will gain that much from having her second ear done. We didn’t feel that she would gain enough to warrant going through it all again, and in Natti’s words: “What do I want two for? Another operation, extra tunings, two leads, two coils, six batteries, two processors to look after and sort out, no thanks I’ll stick with just one!”

We knew Natalie was a good user, but we were very interested in exactly what she could hear. At the yearly tuning sessions in Nottingham she always does well in all the listening tests and quite enjoys them, so we thought it might be interesting to go to take part in Professor Summerfield’s research. There were a variety of tests – some simple listening tests similar to those at tuning and then lots of others testing sound location skills. She did really well and thoroughly enjoyed it. We were very pleased with the results which not only showed how well she could actually hear, but we also felt they backed up our reasons for not having a bilateral implant.

There were too many tests to go into full detail, but the following are points taken from the conclusion to the report. I hope it may give some peace of mind to those families who are not able to secure funding for a bilateral:

• We conclude from tests 1 and 2 that Natalie is able to use her implant to localise sounds which are separated by 120° or 60°. Test 4 showed she is not able to track moving sound.
• We conclude from tests 5 and 6 that she is able to identify words spoken quietly in a quiet environment, and that she is able to identify words in noise.
• We conclude from Test 7 that she can detect sufficient evidence of the acoustic fine structure of sound at low frequencies to be able to separate concurrent sounds with different pitches.
• We conclude from Test 8 that Natalie shows a good ability to report spoken words presented in quiet.

We were extremely pleased with the results – which showed what we already knew – that Natalie gets an immense amount of information through her single implant. It also showed us that although she might possibly get more if she had two implants, this would only be a marginal improvement, and in some areas she is doing better with one than other children with two.

Every child is different and we all want the best for our children. If you can’t get a bilateral implant for your child it is not the end of the world. You only have to look at Natalie and many others like her who were implanted at around three years old and with old models. There are many teenagers around today who have only one, do exceptionally well with only one, and who feel that the slight improvement offered by a bilateral is not enough to warrant having their other ear implanted. At the end of the day, if your child only has one implant and you can’t get a bilateral, you have not failed your child and your child is not doomed to failure. They can, and do, do very well with one.