Cochlear implants in early childhood may be recommended at this age which is critical for speech and language development. Implantation cannot yet be accepted in this group because of diagnostic difficulties, special rehabilitation problems and the frequency of middle ear infections with the possible risk of bacterial invasion of the cochlea. As children grow older, insufficient motivation may reduce the effects of rehabilitation procedures. A good cooperation with educators must be guaranteed. A further problem of cochlea implantation in children is posed by pre-operative counselling complicated by ethical and legal considerations. Cochlear implantation in children requires improved diagnostic tools to establish the etiology, objective testing of residual hearing and quantifications of nerve survival in addition to special rehabilitation programs.