Thursday, May 15, 2014

Is a Cochlear Implant Right for My Child?

The most vital period for hearing development in a child's life occurs in the first two years. Children who receive no auditory stimulation during this critical period will face difficulties learning to speak. The brain's ability to learn to process sound and develop spoken language decreases after this critical period until about age seven, when learning language becomes much more difficult. Children's development of speech and language varies individually. There are, however, milestones for speech and language development that can serve as a guideline for normal development.


Hearing Tests

A variety of different methods are available to test your child's hearing. The audiologist will choose a method that is best suited for your child's age. Usually, hearing tests performed on newborns and babies use objective measuring methods to assess the baby's hearing and do not require the active participation of the baby. All these tests are quick, simple and painless and are performed while the baby is asleep. Parents can stay with the baby while the hearing test is being carried out.
In Otoacoustic Emission (OAE) screening, the function of the hair cells in the cochlea is checked. A tiny earpiece is placed into the baby's ears emitting clicking sounds. When the cochlea receives these sounds, it produces an echo that the screening equipment picks up. A similar screening method, the Auditory Brainstem Response (ABR), measures brain waves in response to auditory stimuli (usually a clicking sound). Older children can participate more actively in audiometry tests. The child indicates when he or she hears a sound (pure-tone audiometry) or understands speech (speech audiometry).

Early Intervention

Newborns are already able to recognize their mother's voice. During the first few months, infants learn to understand a variety of sounds around them. They can very quickly distinguish between human speech and other environmental sounds. The first two years are especially important for language acquisition. Children with hearing loss cannot easily develop these abilities later on.
Early intervention means acting without delay to treat your child's hearing loss. If your child has an irreversible hearing loss that cannot be otherwise remedied, it is vital to get hearing instruments as soon as possible. It is also very important to assess how well the hearing instrument(s) work(s) for the child. If hearing aids are not going to be enough to help the child to develop spoken language, it is crucial to determine this as quickly as possible so that other alternatives can be evaluated while the child is still in the critical language learning phase.
The younger a child's age when receiving a hearing device, the easier it will be for him/her to learn to hear and speak. A baby's brain is better able to process new information than that of older children, and when children are provided with a hearing device at a very young age, they often develop spoken language quickly and can "catch up" with other children born with normal hearing.

Is My Child a Candidate for a CI?

If you and your audiologist or speech-language professional consider a cochlear implant to be the best solution for your child, the next step is to contact an ENT clinic with a cochlear implant program. A list of cochlear implant centers is available from MED-EL. Your local team of CI specialists will work with you to determine whether your child is a candidate for cochlear implantation.

Basic candidacy criteria for implantation include:

  • Your child has a profound sensorineural hearing loss in both ears.
  • Your child receives little or no benefit from hearing aids.
  • There are no medical reasons your child cannot undergo surgery.
  • Your child has access to appropriate education and rehabilitation follow-up.
  • You and your child are highly motivated to participate in required rehabilitation programs.
Please note: not every child with a profound hearing loss is a candidate for cochlear implantation. Here are some reasons why:
  • If your child can receive a significant benefit from hearing aids, they are likely the better solution.
  • If your child's hearing loss comes from somewhere other than the inner ear, a cochlear malformation, or the absence of the hearing nerve, an alternative solution might be more effective.
  • To gain the greatest hearing benefit from a CI, it is important for children to have full support from their family and to participate in rehabilitation programs. If a family cannot commit to participation in a rehabilitation program, other options besides a CI may need to be considered.

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