Myth #6
Apr 22, 2008 @ 01:07 PM
Myth
#6: We don't really know who will succeed with
cochlear implants; it's a crapshoot.
We do know who will usually succeed and we know what contributes to success. While there is some variability, and certain anatomical considerations which patients and doctors would need to discuss, the following are lists of what makes for successful implantation follow-up. I'm not talking candidacy, though the majority of profoundly deaf and some severely deaf individuals could be candidates. I'll save candidacy for another time, because there are plenty of myths about that, as well. Keep in mind I'm talking about typically developing children; those with other disabilities might have different measures for success and different paths to get there based on their developmental disabilities.
Success depends on:
1) Age of implantation for children. While there is no one specific age which is THE age, earlier is better. See studies on our Research page, plus more on Pubmed.
2) Less length of time without sound; for kids or adults who have lost their hearing due to meningitis or other causes, more time means more gradual decline for their hearing nerve. Some adults who never heard and never used hearing aids have enjoyed cochlear implants, but they will have poorer results with understanding speech, etc. (Again, candidacy discussions should be with your doctor).
3) Oral education following implantation. This includes bathing in auditory information both at home and at school (or child care). "Hedging your bets" reduces the use of auditory information. Granted, no one is suggesting that an older child suddenly be ripped away from a prior manual language, but the youngest implantees will have very little if any at the time of their surgery. In fact, some surgeons will refuse to implant if they do not believe that the family or patient is committed to using their audition. Why implant if you don't want to use the auditory information? That's what oral ed. is all about. Using the audition and creating your own. Exactly what oral method and how to evaluate progress is up to the parent and the people they rely on for evaluation.
4) Consistent care of the device: mapping are important! As a child or adult gets further out from their actual surgery date, the time between mappings will likely increase, but in the first few months, the parent or patient should be very aware of the ability to hear in the various frequencies. Parents may do the ling sounds, have children repeat various sounds or words while avoiding lipreading, etc. If you think they are missing something, inform the audiologist so that she can adjust the levels. Maintenance is also very important; if a child's device isn't functioning they won't hear. Parents can do the same thing described above. When Oliver wakes from a nap or puts on his CI in the morning, I might say "mommy" with my hand over my mouth, as he loves to repeat that word. Or I might say "baby," "candy" or "Nick." I always pick things he likes to talk about, but I mix it up. I can detect a broken cable in 5 minutes or less, and then check it on Elliot's processor!
5) Consistent wearing of the device. This seems like a no-brainer, but the key to auditory development is stimulating those nerves. Every minute without the device separates your child from kids who are hearing and developing. You can't get used to something if you don't wear it. If it's uncomfortable beyond the period of "getting used to wearing it," you need an appointment with your audiologist or doctor; cochlear implants should not hurt! They don't make loud static, they don't have feedback, and they don't "scare" a person who is used to hearing. IF there is a broken part there may be a momentary discomfort which parents can be on the lookout for and can fix with their "box of tools." Older kids will just tell you. Elliot once or twice a year will tell me "my cable is broken" or "I can't hear." He lives every waking moment as a hearing kid, so he can easily tell the difference and let us know. When he was a toddler we watched behavior and tested on a daily basis.
There are stories out there about CI "failures." Usually the real story would reveal a lack in one or many of the above criteria. And what really is success? I believe that cochlear implant success is being able to use it to receive and utilize auditory information in order to communicate and live safely. It isn't necessarily "perfect speech" for every child. No doubt most parents want their children to be understood by strangers and friends alike. For us, the devices have astounded us and the boys' speech is great. But even if they had pitch or tone qualities which were different, the top of my list would be easy communication. Second to that is being able to hear emergency vehicles, fire alarms, tornado warnings, microwave beeps, water boiling over, and the tap running (and stuff like that).
We do know who will usually succeed and we know what contributes to success. While there is some variability, and certain anatomical considerations which patients and doctors would need to discuss, the following are lists of what makes for successful implantation follow-up. I'm not talking candidacy, though the majority of profoundly deaf and some severely deaf individuals could be candidates. I'll save candidacy for another time, because there are plenty of myths about that, as well. Keep in mind I'm talking about typically developing children; those with other disabilities might have different measures for success and different paths to get there based on their developmental disabilities.
Success depends on:
1) Age of implantation for children. While there is no one specific age which is THE age, earlier is better. See studies on our Research page, plus more on Pubmed.
2) Less length of time without sound; for kids or adults who have lost their hearing due to meningitis or other causes, more time means more gradual decline for their hearing nerve. Some adults who never heard and never used hearing aids have enjoyed cochlear implants, but they will have poorer results with understanding speech, etc. (Again, candidacy discussions should be with your doctor).
3) Oral education following implantation. This includes bathing in auditory information both at home and at school (or child care). "Hedging your bets" reduces the use of auditory information. Granted, no one is suggesting that an older child suddenly be ripped away from a prior manual language, but the youngest implantees will have very little if any at the time of their surgery. In fact, some surgeons will refuse to implant if they do not believe that the family or patient is committed to using their audition. Why implant if you don't want to use the auditory information? That's what oral ed. is all about. Using the audition and creating your own. Exactly what oral method and how to evaluate progress is up to the parent and the people they rely on for evaluation.
4) Consistent care of the device: mapping are important! As a child or adult gets further out from their actual surgery date, the time between mappings will likely increase, but in the first few months, the parent or patient should be very aware of the ability to hear in the various frequencies. Parents may do the ling sounds, have children repeat various sounds or words while avoiding lipreading, etc. If you think they are missing something, inform the audiologist so that she can adjust the levels. Maintenance is also very important; if a child's device isn't functioning they won't hear. Parents can do the same thing described above. When Oliver wakes from a nap or puts on his CI in the morning, I might say "mommy" with my hand over my mouth, as he loves to repeat that word. Or I might say "baby," "candy" or "Nick." I always pick things he likes to talk about, but I mix it up. I can detect a broken cable in 5 minutes or less, and then check it on Elliot's processor!
5) Consistent wearing of the device. This seems like a no-brainer, but the key to auditory development is stimulating those nerves. Every minute without the device separates your child from kids who are hearing and developing. You can't get used to something if you don't wear it. If it's uncomfortable beyond the period of "getting used to wearing it," you need an appointment with your audiologist or doctor; cochlear implants should not hurt! They don't make loud static, they don't have feedback, and they don't "scare" a person who is used to hearing. IF there is a broken part there may be a momentary discomfort which parents can be on the lookout for and can fix with their "box of tools." Older kids will just tell you. Elliot once or twice a year will tell me "my cable is broken" or "I can't hear." He lives every waking moment as a hearing kid, so he can easily tell the difference and let us know. When he was a toddler we watched behavior and tested on a daily basis.
There are stories out there about CI "failures." Usually the real story would reveal a lack in one or many of the above criteria. And what really is success? I believe that cochlear implant success is being able to use it to receive and utilize auditory information in order to communicate and live safely. It isn't necessarily "perfect speech" for every child. No doubt most parents want their children to be understood by strangers and friends alike. For us, the devices have astounded us and the boys' speech is great. But even if they had pitch or tone qualities which were different, the top of my list would be easy communication. Second to that is being able to hear emergency vehicles, fire alarms, tornado warnings, microwave beeps, water boiling over, and the tap running (and stuff like that).