Transcript What To Do When You Find Out That You Have a Child with

• Michael Scott, Au.D., CCC-A
Cochlear Implant Program Coordinator, CCHMC
President, NOCCCI
All questions will be honored
and answered at the end of today’s
proceedings. Please write your question/s
on a provided note card.
What is a Cochlear Implant?
Having a Great School Year…
Goals:
1. Review hearing loss
2. Provide a basic
understanding of how a
cochlear implant works
3. Compare hearing aids
& Cochlear implants
4. List the current
candidacy criteria
Why are we all here today?
• Because hearing loss has the potential to
negatively impact ANY of our students at
ANY time.
• A quick review to explain how…
Access to Sound
without access to the entire “speech banana”, a child
would be miss out on vital parts of speech…
For example:
• To the right, is a
hearing loss that may
be considered for a
cochlear implant:
For example:
• The blue region is the
range of sounds
heard by this child
• That means that they
do not hear: /f/, /s/,
/h/, /th/, among others
Why an implant?
Cochlear implants provide children with severe
to profound hearing losses with access to
sound.
Don’t hearing aids do this?
Hearing aids vs. Implants
- hearing aids have their limitations
-even with the best hearing aid, a child
may not hear high pitches
Access to Sound
-A cochlear implant can provide access to the entire
speech banana without the limitations of hearing aid
output levels and without feedback.
- An implant is much more
complicated than a hearing aid.
How a Cochlear Implant
differs from a Hearing Aid
• Hearing aids amplify the signal, which passes through the
auditory system and utilizes surviving hair cells to carry the
signal to the auditory nerve.
• No matter how loud a signal the hearing aid produces,
some profoundly hearing-impaired ear cannot process the
information due to the damaged hair cells.
• With a cochlear implant, the electrode array bypasses
damaged hair cells in the cochlea to directly stimulate the
surviving auditory nerve fibers.
Access to Sound
Rather than just making sounds louder, cochlear
implants send sound directly to the child’s hearing
nerve, electrically.
Hearing Aids vs. Implants
Hearing aid
–
–
–
–
–
Microphone
Battery
Circuitry
Speaker
Earmold
– Sounds made
louder
Cochlear Implant
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–
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–
Microphone
Battery
Circuitry
Transmitting Coil
– Sounds delivered
electrically
Access to Sound
Rather than just making sounds louder, cochlear
implants send sound directly to the child’s hearing
nerve, electrically.
Processor Anatomy
1. Circuitry
2. Power source
3. Program/volume/
sensitivity controls
4. Microphone
5. Cable
6. Transmitting coil with
magnet
Processor Anatomy
1. Circuitry
2. Power source
3. Program/volume/
sensitivity controls
4. Microphone
5. Cable
6. Transmitting coil with
magnet
Processor Anatomy
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1. earhook
2. microphone
3. circuitry
4. program selector
button
5. display
6. battery
compartment
7. cable
8. coil with magnet
•
Photo courteous of Cochlear Americas
•
•
Implant
1. Magnet
2. Receiving Coil
3. Circuitry
4. Electrode array
Implant
• Silicone/ceramic casing
• Electronics
• Electrode array
• Ground electrode
• Magnet
• NO POWER SOURCE
•
Photos courtesy of Advanced Bionics
Access to
Sound
Therefore, without
the speech
processor (outside
part)….
Demo
• http://www.youtube.com/watch?v=S
mNpP2fr57A&feature=player_embe
dded
2. After the sound is
changed to electrical
energy, it is transmitted
across the skin via the
transmitting coil
Demo
•
1. sound is picked up
by the processor
3. the surgically
implanted receiver
accepts the signal and
transmits it down the
electrical array
4. The electrical array
stimulates the hearing
nerve, which sends the
signal directly to the
brain
http://www.nidcd.nih.gov/health/hearing/ear_coch_img.htm
Manufacturers
WHO CAN GET A COCHLEAR IMPLANT?
FDA Criteria
• Severe/Profound sensorineural hearing loss in both ears
• 12 months to 17 years of age (in the case of meningitis
with ossification, implantation can be done earlier)
• Receive little to no benefit from appropriately fit hearing
aids
• No medical/surgical contraindications
• Motivated and supportive caretakers, as well as
appropriate expectations (parents and child, when
appropriate)
• Failure to reach developmentally appropriate auditory
milestones
• Less than or equal to 20% correct on a open-set word
recognition test OR less than or equal to 30% on an
open-set sentence test (HINT for Children).
Pediatric Candidacy:
Take-home message
• 12 months or older
• Severe to Profound sensorineural hearing loss
in both ears
• Delayed auditory skill development
• No medical contraindications
The Cochlear Implant Team
• Coordinator/ Cochlear
Implant Audiologist
• Administrative
Assistant
• Aural Rehabilitation
Audiologist
• Speech/Language
Pathologist
• Surgeon
• Social Worker
• Developmental
Pediatrician
• Representative from
school
• Candidate & family
Cochlear Implant Evaluation Protocol
• Audiologic evaluations showing no benefit
from consistent hearing aid usage over at
least a 3-6 month period
• Cochlear Implant Consultation
• Aural Rehabilitation evaluation (independent
of or in conjunction with Speech Pathology)
• Speech/language evaluation (independent of
or in conjunction with Aural Rehabilitation)
Cochlear Implant Evaluation Protocol
• Evaluation of family support systems
and counseling regarding the
psychosocial impact of obtaining a
cochlear implant
• Pre-surgical counseling and
evaluation
• Coordination and consultation with
child’s school placement
Resources
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Cochlear Implant Awareness Foundation: http://www.ciafonline.org/index.html
American Speech and Hearing Association: http://www.asha.org/default.htm
Natural Communication, Inc.: http://www.nciohio.com/
Auditory Options Project: http://www.auditoryoptions.org/
Listen-Up: http://listen-up.org/
Let Them Hear Foundation: www.letthemhear.org
NOCCCI: http://groups.yahoo.com/group/NOCCCI
AG Bell Association: www.agbell.org
Manufacturers:
• Advanced Bionics: www.bionicear.com
• Cochlear Americas: www.cochlearamericas.com
• MedEl: www.MedEl.com