Transcript Aided Hearing Thresholds: Cochlear implant

Cochlear Implants: what are
they and who are they for?
Suzanne Harrigan
Specialist Speech and Language
Therapist
The Ear Foundation
Before we start…..
• Tell me a little bit about yourselves
• Any questions or issues?
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So what is a cochlear
Implant and what does it
aim to do?
HOW THE IMPLANT
WORKS.
The internal device.
• 22 electrodes.
The external fittings.
• The processor.
• The microphone.
• leads.
• coil.
So what is a cochlear implant
able to offer in terms of
listening levels?
What are we aiming for?
For children with no residual hearing.
• To give the child access to speech
sounds across all the frequencies.
For children who have some access to low
frequency speech sounds.
• Access to high frequency speech
sounds.
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Hearing Thresholds
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Frequency
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kHz
Terms to consider.
• Threshold: The level of the quietest sound
detected.
• Comfort levels: The loudest comfortable sounds.
• Sound level: Recorded in decibels in logarithmic
scale.
• Frequency: The speed in which a sound vibrates.
Hearing Thresholds
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s
dt
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aw ah
f th
ay ee
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Frequency
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kHz
Unaided thresholds.
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Hearing Thresholds
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Frequency
4
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kHz
Aided Thresholds
Hearing Thresholds hearing aids
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Frequency
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Implant
Thresholds
Aided Hearing Thresholds: Cochlear implant
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20
40
60
80
100
120
0.25
0.5
1
2
Frequency
4
8
kHz
Does a cochlear implant
provide normal hearing?
NO!
• They still have a mild to
moderate, and possibly
unilateral loss
• So…. What does it sound like?
Simulation: listening with a cochlear implant
1-channel
2-channel
4-channel
Start with 1-channel and then increase
the number of channels
8-channel
16-channel
Original
This demonstration uses the
noise-band vocoder technique
© The Ear Foundation 2009of Robert Shannon.
TYPES OF
PROCESSOR.
Processors.
COCHLEAR
• Nucleus 5
Medel
ADVANCED
BIONICS
How Processors are worn
• Ear level with body worn battery pack, or
body worn microphone and processor
For younger children, children with disabilities
• Ear level, integrated battery compartment
and microphone and processor
For older children and adults
So what about children
with additional needs
• Cochlear Implants are an option for
children with additional needs
• You may need to think carefully about the
issues
• Pre implant assessment and planning
may take more time
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© The Ear Foundation 2009
Questions…..
• What are the strengths of your child that
make it likely that they can cope with, and
make effective use of an implant?
Is there anything about your child that will
make it difficult for them to cope with and
make good use of the implant?
• Will your be able to cope with the tuning
process?
• Is there anything about the operation or
follow up process that is likely to be
significantly stressful for your child or your
family?
Questions…..
• What are the likely benefits of a cochlear
implantation for your child, and do they outweigh
any difficulties?
• Family issues: What are you and your family’s
expectations of the implant? Are they realistic??
You may have to push!
• “I originally asked about cochlear implants at
school, and it was actually ‘no chance’ and they
said they can’t do that because of his other
needs. I pushed again not long ago and we
actually went through the whole process going
for a cochlear implant, and one of the first things
she said to me is why didn’t you come to see us
years ago he is perfect.”