Download Helping Deaf Children to Hear and Talk

2015 Edition
Helping Deaf
Children to
Hear and Talk
The National Paediatric
Cochlear Implant Programme
1
2015 Edition
Helping
Deaf Children
to Hear and Talk
The National Paediatric Cochlear Implant Programme
Helping Deaf Children To Hear And Talk
The National Paediatric
Cochlear Implant Programme
The National Paediatric Cochlear Implant Programme
Beaumont Hospital/Children’s University Hospital Temple Street
Tel: (01) 809 2191
Tel: (01) 809 2013
Fax no: (01) 809 2753
Text Beaumont
phone: 087 953Hospital/Children’s
5423
e-mail: [email protected]
University Hospital Temple Street
Tel 01 809 2191 - General Enquiries & Spare Parts
Tel 01 809 2013 - Paediatric Appointments
Helping Deaf
Children
Fax 01 809 2753
Text tel 087 953 5423
e-mail [email protected]
To Hear And Talk
Original written by:
Jennifer Robertson, Claire Sheehan & Jaclyn Smith
Revised by: Jennifer Robertson
with
fromTeam
all the Cochlear Implant Team
with contributions
from contributions
all the Cochlear Implant
Revised 2015 by Jennifer Robertson
With thanks to Cochlear Europe Ltd for permission to use images
and to Nottingham Cochlear Implant Programme and the Ear Foundation
With thanks to Cochlear Europe Ltd for permission to use images and
First
Printed 2005 Cochlear Implant Programme and the Ear Foundation
to
Nottingham
Revised May 2012
Due for review 2017
First Printed 2005
Revised May 2015
Due for review 2020
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The National Paediatric Cochlear Implant Programme / Helping Deaf Children to Hear and Talk
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2015 Edition
Contents
The Paediatric Cochlear Implant Programme
The Service
The Technology
What is a Cochlear Implant?
How Does A Cochlear Implant Work?
The Internal Device
The External Components
How Do You Hear With a Cochlear Implant?
Who Is Suitable?
The Cochlear Implant Process
The Assessment Phase
Audiological Evaluation
Speech & Language Assessments
Teacher of the Deaf
Scans
Psychological Assessment
Onward Referrals
Group Information Sessions
Making the Decision
The Final Decision
Surgery
What Does The Operation Involve?
How Long Does The Operation Take?
Are There Any Risks?
Fitting & Tuning of the Speech Processor
What Happens After Initial Tuning?
Outcomes
Frequently Asked Questions
Testimonials
Useful Websites
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The National Paediatric Cochlear Implant Programme / Helping Deaf Children to Hear and Talk
The Paediatric Cochlear Implant
Programme
The National Paediatric Cochlear Implant Programme
was established in 1995 as an extension of the Adult
Programme. It is based in Dublin at Beaumont Hospital
and the Children’s University Hospital, Temple Street,
and is supported by the resources of these major
teaching hospitals. All assessment and rehabilitation
takes place in Beaumont Hospital, and the surgery for
children under 6 years old takes place in Temple Street
Hospital.
There is a multidisciplinary clinical team consisting
of:
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Consultant ENT Surgeons
Teachers of the Deaf
Speech and Language Therapists
Audiological Scientists
Clinical Psychologist
Medical Physicist
Specialist Nurse
Administrators
Cochlear Support Workers
There is also access to:
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››
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››
Interpreters
Radiology Department
Consultant Geneticist
Consultant Ophthalmologist
Consultant Paediatrician
The Paediatric Programme is committed to achieving
a comprehensive family friendly service for the
assessment and management of children with a severe/
profound hearing loss. The National Cochlear Implant
Programme has developed programmes recognised
both nationally and internationally for children and adults
with over 800 people having successfully received
cochlear implants by the end of 2014. Since July 2014
bilateral cochlear implants have been offered to children
suitable for two implants.
The Service
Our service assesses children, including those with
complex needs, for suitability for cochlear implants.
If deemed appropriate we then offer the necessary
medical, surgical and post-operative management and
rehabilitation. Cochlear implantation in young children
requires a unique combination of technology, skills
and long-term child and family support, while the child
learns to use the new auditory sensation provided by
the implant system. Our facilities and staff provide this
comprehensive range of services.
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The Technology
Cochlear implantation is now established as a routine
clinical procedure to provide useful hearing sensation to
those with a severe / profound hearing loss. For young,
profoundly deaf children, cochlear implants provide the
opportunity to learn to communicate effectively using
spoken language. The National Paediatric Cochlear
Implant Programme regularly reviews the technology
used, ensuring the latest developments are available.
Since July 2014 bilateral implantation is being offered
where appropriate, as per international best practice.
What is a Cochlear Implant?
A cochlear implant is a highly sophisticated electronic
device that provides a hearing sensation for people
with a severe / profound hearing loss. It replaces
the function of the damaged inner ear (cochlea) by
electrically stimulating the hearing nerve (also known
as the auditory or VIIIth nerve) to produce a sensation
of sound. It can improve communication abilities and
give awareness of everyday sounds. Worldwide over
324 000 severe-to-profoundly deaf people of all ages,
had become cochlear implant recipients by 2012.
Throughout this period improvements to cochlear
implantation technology have provided benefit to every
age group of recipients
How Does A Cochlear Implant Work?
A cochlear implant sends an electrical message through
a wire called an electrode directly to the hearing nerve,
bypassing the damaged or absent hair cells in the
cochlea. This means, provided the hearing nerve is
still working, profoundly deaf people can hear sound.
With developments in technology and with expanding
cochlear implant candidacy criteria, many people can
now benefit significantly, and their quality of life can be
improved with cochlear implants.
The cochlear implant consists of both internally
implanted and externally worn components.
The Internal Device
The internal device consists of a receiver and electrode
array. Figure 1 shows the Nucleus system. The
electrode array consists of 22 active platinum electrode
bands. It is inserted into the cochlea by the surgeon,
and the 22 electrodes can stimulate multiple sites within
the cochlea to give a hearing sensation for all speech
sounds. The electrodes of the cochlear implant are
connected to a small control circuit called the receiverstimulator. There is a magnet to enable the external
transmitter coil to be held in place (see below). All of this
is placed under the scalp during surgery.
The Internal Device
2015 Edition
The internal device consists of a receiver and electrode array. Figure 1 shows
the Nucleus system. The electrode array consists of 22 active platinum
electrode bands. It is inserted into the cochlea by the surgeon, and the 22
electrodes can stimulate multiple sites within the cochlea to give a hearing
sensation for all speech sounds. The electrodes of the cochlear implant are
connected to a small control circuit called the receiver-stimulator. There is a
magnet to enable the external transmitter coil to be held in place (see below).
All of this is placed under the scalp during surgery.
Receiver - Stimulator
Plate
Electrode
Antenna
How Do You Hear With a Cochlear
Implant?
The ear level microphone (1) picks up sound, which
is then sent to the speech processor. The speech
processor converts the sound information into an
electrical signal. This information is then sent to the
How Do You Hear With a Cochlear Implant?
Reference
transmitting coil (2), and crosses the skin to the internal
electrode
22 Electrode
The ear
level microphone
picks
up sound,
then sent
to the speech
receiver
stimulator(1)via
radio
signal.which
This issignal
is then
Array
processor.
The
speech
processor
converts
the
sound
information
into an
decoded to determine which electrodes should be
electrical signal. This information is then sent to the transmitting coil (2), and
stimulated and at what level. The appropriate electrodes
crosses the skin to the internal receiver stimulator via radio signal. This signal
in the
cochlea
(3) are stimulated
and should
they send
electricaland at
Figure 1: The Nucleus cochlear implant and electrode array (not to
is then
decoded
to determine
which electrodes
be stimulated
Figure
1: The Nucleus cochlear implant and electrode array (not to scale)
scale)
the auditory
nervein(4).
auditory
what impulses
level. The to
appropriate
electrodes
the The
cochlea
(3) are stimulated and
they nerve
send electrical
impulses
to the
auditory
(4).they
The are
auditory nerve
sends the
signals
to the
brainnerve
where
sends the signals to the brain where they are interpreted as sound. This
The External
Components
interpreted as sound. This whole process happens at
The External
Components
whole process happens at the same speed as normal hearing.
the same speed as normal hearing.
The
External
Components
The
of of
thethe
equipment
consists
of a battery
(or rechargeable cell)
Theexternal
externalpart
part
equipment
consists
of a battery
driven
speech processor.
The processor
connected to
a transmitting coil by a
(or
rechargeable
cell) driven
speechisprocessor.
The
The
External Components
2
The
externalinpart
of the equipment
consists
battery (or
rechargeable
cell)
cable. There is
a magnet
the middle
of the coil that
holdsof
thea external
device
processor isdriven
connected
to
a transmitting
coil by isa connected
cable.
speech
processor.
The
processor
to
a
transmitting
coil by a
onto the
implant
that is underneath
skin(oratrechargeable
the back of
the ear. Over the
The external
part
of the equipment
consists of athe
battery
cell)
There
isprocessor.
a have
magnet
inseveral
theis middle
of in
the
that
holds
the
driven
speech
The
processor
connected
tothe
acoil
transmitting
coil
bycoil
a that both
cable.
There
aisdifferent
magnet
middle
of
the
holdsbody
the external device
years
there
been
models
of
speech
processor,
cable.
Thereand
is a device
magnet
inonto
the
middle
ofbelow
the
that
holds
the
device
external
the implant
that
is2)underneath
the
onto
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thatcoilis
underneath
the Nucleus
skin
at Series
the back
of the ear. Over the
worn
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Pictured
(figure
are external
the
6 speech
onto the implant that is underneath the skin at the back of the ear. Over the
1 body3
skin at the– back
of
the
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Over
theand
years
there
have and
years
there
have
been
several
different
models
of speech
processor,
both
processors
the BTE
(behind
ear)
the
body worn,
the Nucleus
6
4
years there have been several different models of speech processor, both body
worn
and
ear
level.
Pictured
below
(figure
2)
are
the
Nucleus
Series
6
speech
processor
being
worn
(figure
3).
Young
children,
and
occasionally
some
adults,
different
speech
processor,
worn been
and earseveral
level. Pictured
belowmodels
(figure 2)ofare
the Nucleus
Series 6 speech
are
with
thethebody
worn
configuration
initially.
The
external
speech
processors
–ear)
the
BTE
(behind
the
ear)
and
the
worn,
and the Nucleus 6
processors
–body
the BTE
(behind
and
the
body worn,
and
the(figure
Nucleus
bothprovided
worn
and
ear
level.
Pictured
below
2)6 body
processor
being worn
(figure
3). being
Young
children,
and
occasionally
some
adults, and occasionally some adults,
processors
are
fitted
about
one
month
after
surgery.
processor
worn
(figure
3).
Young
children,
are the Nucleus
Series
6 speech processors
– thespeech
BTE
are provided with the
worn configuration
initially.worn
The external
arebody
provided
with the body
configuration
initially. The external speech
(behind
the about
ear) and
the body
worn, and the Nucleus
processors
are fitted
one month
after surgery.
processors are fitted about one month after surgery.
6 processor being worn (figure 3). Young children,
and occasionally
some
adults,BTE
are speech
provided
with the (left) and body
Figure
2: The Nucleus
6 Series
processor
Figure
2: The
Nucleus
6 Series BTE
speech processor
(left) and
body
worn
speech
processor
(right)
body
worn
configuration
initially.
The external
speech
Figure 4: Transmission of sound using the cochlear implant
wornprocessors
speech processor
(right)
are fitted
about
one month
afterBTE
surgery.
Figure
2: The
Nucleus
6 Series
speech processor (left) and body
Magnet
worn speech processor (right)
Who
Is Suitable?
Figure
4: Transmission
of sound using the cochlear implant
We consider children for implantation if the following
are met:
Whocriteria
Is Suitable?
We consider
children
for implantation
the following criteria
are met:
›› Bilateral
severe
/ profoundif sensori-neural
hearing
loss.
Bilateral severe / profound sensori-neural hearing loss.
Aged
under
years
if spoken
language
has not
• ›› Aged
under
fivefive
years
if spoken
language
has not developed.
developed.
Ideally,
children born profoundly deaf who have not acquired spoken
language should receive their cochlear implant before the age of five.
Otherwise
it becomes
for thehave
childnot
to make sense
Ideally,
children
bornincreasingly
profoundlydifficult
deaf who
of the new auditory sensation, and to learn to listen and talk. If the
Figure 2: The Nucleus 6 Series BTE speech processor (left) and body
acquired
spoken language should receive their cochlear
child has already acquired spoken language, age is not a
worn speech processor (right)
implant
factor. before the age of five. Otherwise it becomes
increasingly difficult for the child to make sense of the
• new
Limited
auditory
speech discrimination
ability
Figure 3: The speech processor being
auditory
sensation,
and to learn
to listen and talk. If
worn The external parts of the implants can
the child has already acquired spoken language, age is
be removed at any time, for example, when
not
a factor.being
sleeping. When
Figurethey3: are
Theremoved,
speech no
processor
hearing sensation
wornoccurs.
The external parts of the implants can
be removed at any time, for
example,
when speech discrimination ability
›› Limited
auditory
Figure
The removed,
speech processor
being
sleeping. When
they3: are
›› Have parentsnowho understand
the long-term
worn
The external parts of the implants can
hearing sensation
occurs.
commitment
involved
in
cochlear
implantation and will
Figure 3: The speech processor
be removed at any time, for example, when
being worn The external parts
ensure
attendance
at the Cochlear
Implant Centre for
sleeping. When
they
are removed,
no
of the implants can be removed
ongoing
management.
hearing
sensation
occurs.
at any time, for example,
when sleeping. When they are
removed, no hearing sensation
occurs.
›› Have local professionals who support the process
of cochlear implantation and will provide consistent
oral/aural input whatever the educational or
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The National Paediatric Cochlear Implant Programme / Helping Deaf Children to Hear and Talk
communication setting.
›› Appropriate inner ear and hearing nerve anatomy as
shown on MRI scan
Paediatric Cochlear Implant Programme
Assessment Schedule
Children with additional disabilities or complex needs
are also considered for cochlear implantation.
Referral
Initial Medical Consultation
Initial contact to:
Audiological Scientist ENT Consultant
What Factors Influence Progress with a Cochlear
Implant?
The multi-channel cochlear implant provides the
severely or profoundly deaf child with access to auditory
speech information. Following implantation the child
has to (re) learn to “listen” and use the information
provided by the implant/s. Some children learn to make
better use of this auditory information than others.
Good listening skills are the essential building blocks for
developing spoken language.
There are several factors that can affect how a child
develops listening and talking, including:
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Age at implantation
Age at onset of hearing loss
Length of profound deafness prior to implantation
Degree of residual hearing and hearing aid use prior
to cochlear implant
Presence of additional needs
Presence of processing difficulties or additional
language difficulties
Number of active electrodes
Cause of deafness
Experience using an implant
Communication mode
Educational setting
Consistency of (re) habilitation and support from
family, peers and professionals
Auditory memory
Attention skills
Learning ability
Consistency of processor use post implant
Child’s own motivation and personality
As each child is an individual, we aim to ensure that the
expectations of the child’s family and friends are realistic
and achievable.
The Cochlear Implant Process
The decision to implant the deaf child begins a lifetime’s support, through childhood, adolescence and
into adulthood. If the decision is made to go ahead with
cochlear implants, the time from initial consultation to
implant surgery varies depending on assessment needs
and waiting lists, but is usually about 9 months.
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Assessment Phase
Evaluation of hearing
Initial Communication / Educational Assessment
Information counselling
MRI scan
Further individual assessments or visits to home or
school may take place as needed
Reports to Parents & Local Professionals
Medical Review Consultation
Results of MRI scan
Discussion and shared decision
Information/consent form
Final Medical Review Consultation
Sign consent form
Date for surgery
Surgery
Admitted day before or day of surgery
Discharged approx 1-2 days after surgery
Switch On
(approx. one month after surgery)
Learning to use the speech processor
Habilitation and regular assessments
to monitor progress
Life-long support & maintenance
2015 Edition
The Assessment Phase
Speech & Language Assessments
Audiological Evaluation
During the assessment phase the child will also attend
for appointments with a speech and language therapist
on the team to assess their communication, listening
skills and pre-verbal development. If the decision is made
to go ahead with cochlear implantation, this will include
an assessment, the results of which will be used as a
baseline from which to monitor progress over the coming
years.
The assessment phase is very important and will be
carried out in conjunction with the family and local
professionals. After referral, the parents and child
attend a medical appointment during which they meet
the ENT medical team, and are told about the various
assessments that are part of the process.
The next phase will involve an audiological evaluation
of the child’s hearing to confirm the type and degree of
hearing loss and to establish the auditory benefit the child
is gaining from their hearing aids.
Auditory Brainstem Response (ABR) testing will be
arranged for children who are too young or unable to
participate in co-operative behavioural hearing tests.
ABR testing is an objective hearing test performed either
under sleep (with very young babies) or under a general
anaesthetic. For more information please read the ABR
leaflet. Several appointments for hearing assessments
may be required to ensure that the hearing test results
are consistent and accurate.
It is ideal for children to attend the CI Programme with
hearing aids as a hearing aid trial is critical before a final
decision can be made about cochlear implantation.
Hearing aids are fitted and maintained through local
audiology services. It is important that the best hearing
aids and earmould combinations are provided to
determine the benefit obtained from high powered digital
hearing aids.
Assessment of what sounds the child hears with hearing
aids may indicate that despite being a good hearing aid
user, the child is not hearing enough speech information
for good spoken language development. In this case
cochlear implantation will be considered. On the other
hand, assessment may indicate that the child has good
access to speech and is making good progress with
acquiring spoken language, therefore, cochlear implant/s
may not be suitable for them currently. However such
children will continue to be carefully monitored for any
changes or deterioration in hearing levels.
If a child has a hearing loss due to meningitis, the
assessment procedure will be expedited as in some
cases the inner ear can become blocked by the formation
of bone (ossification), which could make it very difficult
or impossible for the surgeon to place the implant
electrodes accurately in the cochleas. Therefore, the
decision to proceed with implants may be made more
quickly, in which case this would be discussed with the
family in detail by the implant team.
Teacher of the Deaf
A teacher of the deaf from the team will liaise with the
child’s local visiting teacher of the deaf, may visit the child
at home and, if appropriate, at school to assess their
functioning in their local setting.
Scans
A Magnetic Resonance Imaging (MRI) scan is carried out
under sedation or general anaesthetic unless the child is
older, as it is essential to lie completely still. An MRI is a
sophisticated scan, which is used to assess the structure
of the inner ears, the auditory nerves and the brain. An
appointment will be made a few weeks later with the
medical team, who will explain the results of the scan. If
the child is suitable for cochlear implantation, the surgeon
will also explain the risks of the operation and any further
assessments that may be necessary.
Psychological Assessment
The clinical psychologist with the Cochlear Implant
Programme may also meet with the family and the
child. Often it is important to find out about children’s
understanding or cognitive abilities, their behaviour and
their social development and play skills. This information
is sometimes important in deciding whether to proceed
with a cochlear implant and can help in making a decision
about the child’s schooling. The psychologist can assess
these areas using formal tests but can also meet with
parents or children if they are worried or upset about any
other issues. The psychological assessment process can
often take up to two or three appointments to complete
but this will be discussed at the time.
Onward Referrals
As a significant proportion of hearing loss has a genetic
basis, or is associated with other medical issues, children
are referred to a paediatrician for further assessment as
required. Often parents would like to find out why their
child is deaf. In a number of cases, the paediatrician or
the geneticist is able to pin point the cause of the hearing
loss and may be able to advise parents of any risk that
future children, or their children’s children, may inherit the
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The National Paediatric Cochlear Implant Programme / Helping Deaf Children to Hear and Talk
deafness. Not all genes or other factors causing a hearing
loss are known. Some parents decide that they do not
wish to know if a gene has caused the hearing loss.
Any referral for genetic testing is based upon parental
request. Hearing loss can occasionally be associated with
syndromes and other medical issues, consequently, the
child may be referred to other medical specialists e.g. to
assess their vision etc.
Group Information Sessions
Parents will be given the opportunity to attend
information and support meetings within the
department. This will include information on cochlear
implants, development of spoken language, realistic
expectations etc. There will also be an opportunity to
meet parents of children with cochlear implants and
the children themselves. This helps to develop a better
understanding of the whole process and the level of
commitment required to maximise the benefits from the
cochlear implant.
How Long Does The Operation Take?
The operation takes approximately 4 hours if two
cochlear implants are being inserted, and less for only
one implant. After surgery children remain in hospital for
at least 24 hours, but in most cases are up and out of
bed the following day ready for discharge! The child will
have a large bandage on their head for 24 hours, but
after that no further dressing is required.
Making the Decision
Are There Any Risks?
There will be ongoing discussions about making the
decision regarding implantation e.g. whether everyone
concerned feels that it is the right route forward for the
child.
There are some risks involved with the cochlear implant
operation but no more than the risks involved with any
major ear surgery. The risks associated with cochlear
implant surgery include:
If the child is old enough, he/she will be encouraged
to participate fully in the decision. Families should
make sure they know how their child feels about
having cochlear implants, as his/her feelings are very
important.
›› Risks associated with the use of general anaesthetic,
as for any surgery
›› Risk of inflammation or infection
›› Disturbance or damage to the facial nerve leading to
a facial paralysis
›› Stiffness or numbness around the ear
›› Disturbance of taste or balance
›› Possibly changes in head noises (tinnitus).
›› Possible inability to fully place the electrode within the
cochlea.
The Final Decision
Following completion of all the assessments the team
will meet with the family and discuss the suitability of
cochlear implants for the child.
Remember, any final decision to proceed with cochlear
implants lies with the family!
A final visit to the implant centre is arranged in order to
confirm the decision, and to discuss any final issues
before final consent is given and a date for surgery is
arranged.
Surgery
What Does The Operation Involve?
Patients are admitted to the hospital either a day before
or on the morning of their implant operation. During the
operation, the surgeon implants the internal parts of the
cochlear implant/s underneath the skin. A small area of
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hair is shaved, but this hair will grow back quickly after
the operation. There will be a small scar that is generally
covered by hair. The body of the implant sits just behind
the ear and the delicate electrode array is inserted into
the chamber of the inner ear (cochlea). The audiological
scientist will perform intra-operative checks of electrode
function, called NRT (Neural Response Telemetry). This
ensures that the electrodes are working properly, and
also gives the scientist some important information
to use at the initial tuning and fitting of the speech
processor.
Vaccinations against meningitis are advised prior to
surgery as there have been some reports that patients
with cochlear implants, and / or inner ear malformations
may have a slightly higher risk of meningitis. The
vaccinations significantly reduce any such risk.
The cochlear implant surgeon will discuss the risks in
more detail before the operation.
While it is important to be aware that these
complications can occur, in practice there have been
very few significant negative side effects worldwide for
people receiving cochlear implants.
2015 Edition
Fitting & Tuning of the Speech Processor
Approximately one month after surgery the child will
attend the Cochlear Implant Programme to have the
external speech processors fitted and “switched on”.
The external speech processors are placed on the
child. Some children need to be coaxed to accept what
is a new and unfamiliar device. If hearing aids have
not been worn consistently it may take some time to
persuade the child to wear the speech processors.
When the system is in place, the audiological scientist
connects each speech processor to a computer and
performs the electrode checks again (Telemetry) to
ensure that the internal component is still working
correctly.
An initial programme or MAP will then be made,
primarily based upon the NRT measurements obtained
during surgery. Programmes are made to use the
NRT measurements cautiously as a “guide” for the
initial programmes. Older children will participate in
further co-operative testing that gives us feedback on
their individual programme needs. When the speech
processors are switched on, usual reactions from
children include:
1.No reaction
2.Stilling, looking bemused
3.Searching
4.Getting upset
5.Turning / running to parent(s) for reassurance
There are no typical reactions as each child is different.
Although we do not wish to surprise or frighten children
with the new sensations, any adverse reaction should
be looked at as a positive reflection – that the child
responded to the strange sensation. Alternatively, some
children just do not react behaviourally, despite neural
telemetry having indicated that the nerve is responding
to sound. Once the cochlear implants are switched on
the child needs time to adapt to the new sound quality.
If the brain has not heard sound before the sounds
will be very strange at first. The MAPs in the speech
processors will need to be fine-tuned over the coming
months.
The biggest changes in sound quality will generally
happen in the first few months, and frequent tuning
sessions will be required initially.
What Happens After Initial Tuning?
Following the initial tuning the child will attend for further
tuning sessions until the audiological scientists are
satisfied that the MAPs give the child good access to
the full range of speech sounds. This is when the real
work (and hopefully fun!) begins.
There will be regular appointments with the speech
and language therapist over the next few months to
work with the child to facilitate listening and spoken
language development. More importantly the speech
and language therapist will work with the family to help
the family learn how best to do this at home and in
everyday life – families are the most important people
on the rehabilitation team!
After the first year, depending on the level of support
available locally and how the child is progressing,
the frequency of appointments with the speech and
language therapist at the Cochlear Implant Programme
will reduce. The support of local professionals is
required wherever the child lives to ensure that the
child makes the most use of the sound provided by the
implant.
The cochlear implant team works closely with the
family and local professionals. Outreach support is also
provided to the child’s home and school to ensure that
everyone involved locally has the necessary expertise
and skills to support use of the implants. The most
important members of the team are, however, the child
and the family themselves. While other team members
provide advice and guidance, it is the support and
language rich environment provided by the family that
plays the main part in determining the child’s effective
use of their cochlear implant.
In addition to ongoing speech and language therapy
sessions to facilitate listening and spoken language
development the speech and language therapist also
carries out regular formal assessments to monitor
progress. These are carried out at set intervals:
›› Pre-cochlear implant
›› Year 1,2,3,4,5,7 and 10 post implant
The results of these assessments help us to plan
therapy programmes best suited to the child’s needs,
and are always made available to parents and local
professionals to make sure that we are all working
together. Over time the implant centre speech and
language therapist aims to hand over much of the
regular therapy to the local speech and language
therapist, but will always be available to liaise and
advise as necessary.
The teacher of the deaf will liaise with the local visiting
teacher of the deaf and/or school, and may visit the
child at home or in school. Broadly speaking, the role
of the Implant Centre teacher of the deaf is to ensure
that local teachers and families have all the specialist
information they need to ensure that good implant use
forms the basis of effective learning.
9
9%
43%
21%
The National Paediatric Cochlear Implant Programme / Helping Deaf Children to
Hear and Talk
43%
21%
17%
2%
0%
3%
Outcomes
Category 0
5%
4%
8%
4%
8%
9% 11%
Category 2
8%
31%
23%
17%
31%
8%
4%
7%
0%
3%
7: uses the telephone with a known speaker
6: understands conversation without lipreading
5: understands common phrases without lipreading
4: discriminates some speech43%
sounds
31% without
lipreading
3: identifies environmental sounds
2: responds to speech sounds
1: aware of environmental sounds
0: no awareness of sound
5%
1%
0%
2%
Category 0
0%
3%
Category 1
5%
9%
Category 2
9%
49%
Category 3
Category 5
Category 6
21%
21%
Category 7
31%
17%
17%
4%
4%
8%
8%
Category of Auditory
Performance 5 Yrs Post
CI: All Children, National
Cochlear Implant
Programme
0%
As approximately 40% of deaf children have additional
0%
15%
needs, for example learning difficulties, autistic 1% 0%
15% disorder, additional speech and language
spectrum
difficulties, we also looked separately at outcomes for
this group of children.
11%
8%
Category 0
20%
10
31%
49%
Category 1
Category 2
49%
21%
23%
20%
17%
Category 3
Category 4
Category 3
Category 4
Category 5
Category 6
Category 7
Category 5
17%
Category of Auditory
Category 6
Performance 5 Yrs
Category
7
Post CI:
Children
with
No Additional Needs,
National Cochlear
Implant Programme
7%
The Speech
Intelligibility Rating scale (SIR) was devised
15%
by Dyar and
Allen (1998) and measures the progress
Category 0
in speechCategory
intelligibility
for children acquiring spoken
1
language Category
post 2implant, and the rating scale is outlined
below: Category 3
20%
8%4
Category
Category 0
Category
5
›› 6: speech
intelligible
to all listeners
Category
1
Category
6
›› 5: speech intelligible to listeners with little
experience
Category
7
Category
2
of deaf speakers
Category
3
›› 4: speech
intelligible to a listener who concentrates
17%
Category
4
23%
and lipreads
Category
5
›› 3: speech is unintelligible
›› 2: primary mode of communication is manual,
Category 6
vocalisations may give some additional information
Category 7
›› 1: pre recognisable words in spoken language
The charts below show speech intelligibility for all
children, children with additional needs and children
4%
with no additional needs 5 years post cochlear implant.
7%
As with listening skills, the children with additional
needs are likely to struggle more to achieve intelligible
speech.
2%
Category 0
8%
Category 2
8%
Category 4
43%
Category 1
4%
49%
0%
5%
Category 0
2%
7%
17%
11%
8%
Category
of Auditory
Performance 5 Yrs
Post CI: Children with
Additional Needs,
National Cochlear Implant
Programme
Children with no additional needs are likely to make
0%
progress more quickly, and to achieve better listening
15% language
0% skills in the long term.
and spoken
1%
2%
Outlined below are charts that should give some idea
of outcomes for speech understanding using listening
0%
1%
only.
Intelligibility
8%2%Speech
4%
4%
3%
Category 7
Category 0
Category 1
9%
0%
Category 5
Category 6
21%
The Categories of Auditory Performance (CAP)
scale
11%
was devised by Archbold et al (1995) and measures
a child’s progress in ability to make sense of the
2%
sound provided by the implant, categorising auditory
perception as outlined below:
2%
Category 4
15%
23%
4%
Category 3
0%
11%
Functional Hearing
››
››
››
››
Category 1
0%
15%
Every child who has a cochlear implant is an individual,
and as such outcomes and progress vary hugely from
child to child. However, the National Cochlear Implant
43%
Programme in Ireland has now been running for some
considerable length of time, and we are able to provide
information about predicted outcomes and average
performances. But it is important to remember that
there are many factors that affect performance and
each child’s individual situation should be discussed
with the team.
››
››
››
››
17%
Category 1
Category 0
Category 2
Category 1
Category 3
20%
Category 2
Category 0
Category 3
Category 1
Category 4
Category 2
Category 5
Category 3
Category 6
Category 4
Category 7
Category 5
Category 6
Category 7
2015 Edition
4%
4%
4%
8%
8%
8%
Category 1
Category 2
10%
10%
10%
Category 3
4%
The charts below show current numbers attending
8% the
different types of school.
Category 4
10%
Pre School Placement
Category 5
35%
35%
35%
22%
22%
22%
4%
4%
4%
100
35%
Pre School Placement
Speech Intelligibility
Rating 5 Yrs Post CI:
All Children, National
Cochlear Implant
Programme
21%
21%
21%
12%
Category 6
80
100
22%
Pre School Placement
60
80
100
40
60
80
21%
19%
19%
19%
12%
12%
Category 1
20
40
60
4%
Category 2
Category 3
0
20
40
Category 4
19%
15%
19%
19%
15%
15%
Category 5
Category 6
Speech Intelligibility
Rating 5 Yrs Post CI:
Children with Additional
Needs, National
Cochlear Implant
Programme
31%
31%
31%
1%
1%
1%
7%
7%
7%
Category 1
7%
7%
Category 2
At home
Regular
Preschool
Deaf
Dual Preschool Special Pre
Preschool Placement
School
Category 5
39%
23%
39%
39%
Category 6
23%
23%
23%
23%
23%
Speech Intelligibility
Rating 5 Yrs Post
CI: Children with No
Additional Needs,
National Cochlear
Implant Programme
Educational Placement
There are many options with regard to educational
placement for children with cochlear implants. Some
attend their local mainstream school, some attend a
school for the deaf and some attend a unit with facilities
for deaf children attached to a mainstream school.
Again every child has different needs and the visiting
teacher of the deaf, implant centre teacher of the deaf
and other team members will help with making the right
decision for each child. Now that the Cochlear Implant
Programme has been running for over 20 years many of
the children have made the transition to adulthood, and
a number have progressed to third level education and
beyond.
10%
200 Figure 6: Pre-school placement of children with cochlear implants
At home
Regular
Deaf
Dual Preschool Special Pre
School
Primary School
Placement
Preschool
Preschool Placement
1000
19%
35%
At home
Primary
80
100
15%
22%
Regular
Deaf
Dual Preschool Special Pre
PreschoolPlacement
Preschool Placement
School
School
Primary School Placement
60
80
100
31%
21%
4%
20
40
60
0
20
40
200
4%
1%
12%
Category 3
Category 4
19%
8%
12%
40
60
80
7%
4%
19%
8%
7%
7%
Mainstream
Mainstream
School for
the Deaf
Unit for Deaf
19%
35% for
School
the Deaf
Unit for Deaf
10%
Special School
Special School
Secondary School
39% Placement
0 Figure 7: Primary school placement of all children with cochlear
Mainstream
School for
Unit for Deaf
Special School
100 implants
15%
22%
23%
the Deaf
Secondary School Placement
80
100
Secondary School Placement
31%
21%
60
80
100
23%
4%
40
60
80
1%
12%
19%
7%
20
40
60
0
20
40
200
0
7%
Mainstream
School for
the19%
Deaf
39%
Unit for Deaf
Special School
15%
Mainstream
School for
the Deaf
Unit for Deaf
Special School
Mainstream
School for
the Deaf
Unit for Deaf
Special School
23%
Figure 8: Secondary school placement of all children with cochlear
implants
31%
23%
1%
11
7%
7%
The National Paediatric Cochlear Implant Programme / Helping Deaf Children to Hear and Talk
Frequently Asked Questions (FAQs)
Q Can my child participate in sports with a cochlear
implant?
Yes. The implant should not prevent participation in
leisure activities, with a few exceptions eg. boxing,
rugby, and martial arts. It is advised that a helmet
be worn for any contact sports to avoid damage to
the internal or external components of the implant.
When swimming the processors can be removed or a
special swimming accessory (Nucleus Aqua + or Aqua
Accessory) can be worn over the processors to allow
continued use in the water.
Q Are there any costs I need to cover for the
operation/ implant/ processor?
No. The National Cochlear Implant Programme provides
a public service and can therefore offer all services
and devices free of charge to patients who are implant
candidates. However you are responsible for travel
costs to and from appointments, although in some
circumstances you may be able to obtain financial
assistance through your local Community Welfare
Officer. If you do not have a medical card you will also
be charged for the stay in hospital, which you can
reclaim if you have medical insurance. You may also
choose to buy batteries rather than use rechargeable
options.
Q Where do I get spare leads/accessories?
The Cochlear Implant Programme is able to supply
a limited number of spare leads and accessories per
patient. However, the family is able to purchase extra
accessories directly from the implant manufacturer.
Some parts have a one year warranty, after which they
will need to be purchased privately if replacement is
needed, and other optional accessories also need to
be purchased separately. This will be clearly explained
before surgery.
Q Can I have a spare processor?
No. We are only funded to issue each patient with
one processor per internal implant as they are very
expensive.
Q Can I purchase a spare processor?
Yes. The team can provide you with information as to
how you can purchase your own speech processor.
Just keep in mind the cost is approximately €6000.
Q What happens if I go on holiday and need spare
parts?
You are able to avail of the 'Travel Programme’ from the
implant company (Cochlear Europe Ltd), which includes
all spare parts and a speech processor. There is a fee
for this service and it is an agreement between you and
the implant company.
Q What is the life expectancy of the external speech
processor?
The speech processor is an electronic device and
is therefore subject to faults or breakdowns. A wellminded processor should last for 3-5 years.
Q When the implant is in place, does it stay there
for life?
The system is designed to accommodate growth so
that very young children can be implanted. Cochlear
implants can and do break down like any electrical
device, however the failure rate is extremely low.
It is usually possible to replace the implant if there
is an internal problem. If later in life technological
advances would be of benefit replacement may also be
considered.
Q What happens when the implant is not working/
broken?
You can do minor repairs (i.e. replacing leads) at home.
However if the processor is still not functioning properly
it can be checked over by someone on the team during
standard working hours. If we are unable to fix the
processor we will issue you with a replacement and
send the other for repair.
Q Can patients hear when they wake up after
surgery?
Not yet. The surgeon has only fitted the internal parts of
the device. There is a wait of approximately one month
after surgery before the external parts of the device can
be fitted and activated. This is to allow healing to take
place, and for any swelling or tenderness around the
implant site to subside
It is important for you or other family members to ask
any questions that you have. If you are unsure about
anything please ask. It can be useful to make a note
of any questions that you may have so that you do not
forget when you are in the hospital.
Do not hesitate to ask. It’s your child and we will do our
best to answer your questions.
12
2015 Edition
Testimonials
Testimonials
Susan & Emmet, Parents of Thomas, Unilateral CI March 2009,
Aged 2 ½
was diagnosed profoundly deaf
SusanThomas
& Emmet,
and
was
fitted
with two hearing aids at 19
Parents of Thomas,
months. He had no speech and
Unilateral
CI March using gestures for his
communicated
2009, needs.
Aged He
2 ½was implanted at 29 months
and at “switch on” had no real reaction.
The first time Thomas displayed a real
Thomas
was diagnosed
reaction to sound was around two weeks
profoundly
deaf and
was Pier and Thomas
later walking
on Howth
started
fitted with
twoclapping
hearingto the sound of a
playing the accordion. It was a
aids atmusician
19 months.
very emotional moment for us as a family.
He had(Thomas
no speech
has two older hearing brothers).
and communicated
using gestures for his
Karen, Unilateral CI August 2009, Aged 9
needs. He was implanted at 29 months and at
In the
early
days,
weeks,
and
months
the
implant
team
and
Thomas’s
visiting
“switch on” had no real reaction. The first time
teacher gave us invaluable advice, encouragement and support as a family
Thomas displayed a real reaction to sound was
Karen, Unilateral CI
towards helping Thomas on his journey to hear and talk.
around two weeks later walking on Howth Pier
August 2009,
My Aged
name9is Karen, I’m 11 now
Thomas
be five next
monthclapping
and has just
school.ofWhat his implant
Cochlear Implant when I wa
andwill
Thomas
started
to started
the sound
has helped him achieve is unbelievable. He can talk on the phone, he can
deaf and at first my pa
a musician playing the accordion. It was a very
My name isborn
Karen,
hear upstairs if we call him from downstairs, he can sing “Happy Birthday”,
know
was deaf because I co
emotional
moment
forofus
asofathe
family.
(Thomas
I’m 11 now. I got Ithe
and he
can tell you
the names
most
Barcelona
FC team! His passion
so
I
was
nearly 3 when I g
is football
both
Gaelic
and
soccer.
His
favourite
book
is
“The
Troll”
by
Julia
has two older hearing brothers).
Cochlear Implant when
Donaldson and he can recite chunks of the story by heart! He is constantly
Aids.
It’s
been
I was 9. I was born deaf almost 2 years
asking us questions and is generally a little chatterbox! The sound of his voice
Implant and I’m so glad I
In the
early
days,
implant
and at first the
my parents
chatting
away
is the
most weeks,
beautiful and
soundmonths
and one the
we never
dreamed as a
go
for
I thought I could he
team
Thomas’s
teacher
us
didn’t know I was it.
deaf
family
mightand
happen
when we visiting
were at the
start of gave
this journey.
Hearing
Aids
invaluable advice, encouragement and support
because I could lip-read but since I got t
(Written in 2011)
I realised
I couldn’t hear very
as a family towards helping Thomas on his
so I was nearly
3 when
I
rely
entirely
on my Cochle
journey to hear and talk.
I got Hearing Aids. It’s
now!!!
J
been almost 2 years since I got the Implant and
Thomas will be five next month and has just
I’m so glad I decided to go for it. I thought I could
started school. What his implant has helped
hear with my Hearing Aids but since I got the
him achieve is unbelievable. He can talk on the
Implant
realised
couldn’t
hearlisten
very well
at all.on
I my phone and
I can hear
theI TV
a lot Ibetter,
I can
to music
phone, he can hear upstairs if we call him from
rely
entirely
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Cochlear
ImplantBefore
now!!! IJwas always asking ov
have to
ask
everyone
what’s
happening?
downstairs, he can sing “Happy Birthday”, and he over again to repeat what they’re saying and I mostly had to lip-r
can tell you the names of most of the Barcelona
TV switch
a lot better,
can listen
music
school.I can
Oh, hear
and the
I can
it off I when
I’m to
annoyed!J
I never u
on my
phone
and I the
don’tclock
haveticking,
to ask everyone
FC team! His passion is football both Gaelic and
hear the
phone
ringing,
water running. It was stra
what’s
happening?
was
always
asking
soccer. His favourite book is “The Troll” by Julia
first, so
I didn’t
even knowBefore
what Ithe
sound
was!!!
J I love playing spor
over
again
repeatas
what
they’re
Donaldson and he can recite chunks of the story
find it over
a lot and
easier
with
the to
implant
I can
hear saying
the coaches, the refer
andmates
I mostly
had to lip-read in school. Oh, and
by heart! He is constantly asking us questions
my team
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switch
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J I never
and is generally a little chatterbox! The sound
OverallI can
it has
madeit my
life so I’m
much
easier.J
used to hear the phone ringing, the clock ticking,
of his voice chatting away is the most beautiful
(Written
in 2012)
water
running. It was strange at first, so I didn’t
sound and one we never dreamed as a family
even know what the sound was!!! J I love playing
might happen when we were at the start of this
Iman,sport
Unilateral
CI itFebruary
2005,
Aged
2
and I find
a lot easier
with the
implant
as
journey. (Written in 2011)
I can hear the coaches, the referee and my team
mates calling.
Hello everyone, my
Iman Ahsan. I am 9
Overall it has made my life so much easier. JI live in Dublin.
(Written in 2012)
cochlear implant surg
age of 2 years. Doc
Viani and her team o
13
and audiologists ope
me. The cochlear im
I rely entirely on my Cochlear Implant
divisions and multiplication. I wish to thank the cochlear implant team for all
now!!! J
their help and support.
in 2012)
The National Paediatric Cochlear Implant Programme / Helping Deaf Children(Written
to Hear
and Talk
Christine
and David, Parents of Jack, Unilateral CI November 2009,
I can hear the TV a lot better, I can listen to music on my phone and
I don’t
Aged 3 ½
have to ask everyone what’s happening? Before I was always asking over and
Our son Jack was born in March 2006
over again to repeat what they’re saying and I mostly had to lip-read in
and in and
2007 David,
was diagnosed with a
Christine
mitochondrial disorder. Simply put he is
school. Oh, and I can switch it off when I’m annoyed!J
I never used to
Parents
missingof3 Jack,
of his energy cells. He was
hear the phone ringing, the clock ticking, water running. It was strange at
diagnosed
as
being profoundly deaf,
Unilateral
CI
November
suffers chronic renal failure which entails
first, so I didn’t even know what the sound was!!! J I love playing sport and I
2009,
Aged
3 ½6 nights a week, he has
being
on dialysis
find it a lot easier with the implant as I can hear the coaches, the referee and
poor muscle tone and probable
development delay. He had his cochlear
my team mates calling.
implant
operation
November
Our son
Jack
was inborn
in 2009 and
Overall it has made my life so much easier.J
was “switched on” in January 2010. We
March
2006 and in 2007
made the decision to accept a place for
him on the cochlear
was diagnosed
with aimplant programme
as we felt we wanted to give him every
(Written in 2012)
mitochondrial
disorder.
chance of communication. Life is hard
enough
foris him
with dialysis, not
Simply
put he
missing
walking, special needs and so on, that
Iman, Unilateral CI February 2005, Aged 2
3 of his
energy
cells.
Hebe a benefit to
having hearing would
him.
was diagnosed
as being
far as we are concerned the implant is a miracle technology and the
suffers chronic renal failure which
Iman, Unilateral
CI everyone, As
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to me, I can huge
understand
and we think he is trying to “sing” when we have the radio on in the car. He
listening to music, I can hear the wind blowing and rain drops falling. amazing.
I enjoy We did all the preparation information days
prior
Now I amone
blessed
be able tomovie
hear everything,
going to the cinema,
of mytofavourite
is “The Muppets”. I lovetotoimplant and knew what was ahead of us. Our
now hears and 2 years on he is actually listening
can hear
my friends
talking
to me,
I can and skating in theson
swim and like I going
to Phoenix
Park,
I enjoy
cycling
park
I
and
It has not given him speech yet,
my mom
and dad sister.
are saying
enjoy playing understand
just dancewhat
3 with
my younger
I can understand understanding.
my
and
I
say
yet
as
we
never
give up hope for him, but
to me,toI me
enjoy
listening
to music,
I can
hear the
teacher explaining
very
well, my
favourite
subject
is maths, I like doing
we
have
always
understood
speech is not guaranteed.
wind blowing and rain drops falling. I enjoy going
However,
from
the
time
you
put
the implant on him in
to the cinema, one of my favourite movie is
the
morning,
he
is
babbling
all
day.
We understand
“The Muppets”. I love to swim and like going to
what
his
happy,
excited
sounds
are
and which his
Phoenix Park, I enjoy cycling and skating in the
“not-so-happy”
sounds
are.
He
now
points at his CI
park I enjoy playing just dance 3 with my younger
harness
as
he
wants
it
put
on
as
soon
as possible in
sister. I can understand my teacher explaining to
the
morning.
me very well, my favourite subject is maths, I like
doing divisions and multiplication. I wish to thank
The first year and a half was difficult as he constantly
the cochlear implant team for all their help and
used his magnet piece as a chewing toy. He would
support.
(Written in 2012)
also knock the magnet off if he didn’t want to listen
to you or if he wanted to get your attention. It was
frustrating for us, but we would just pop it back on
and pretend nothing happened. You have to do a lot
of “hearing” work with him to help him understand
and distinguish sounds, things hearing people take for
granted and it is a huge learning curve for parents. We
work closely with the CI team, our visiting teacher for
the deaf and his special needs school and continue to
use Lamh and ISL to enhance any communication.
Eventually he has learned that without it, he has no
sound. He loves music and we think he is trying to
“sing” when we have the radio on in the car. He is
more focused on things and hopefully it will enable him
to live a full hearing life.
To anyone contemplating this little miracle, you have
nothing to lose for your child and a whole new world to
give them.
14
(Written in 2012)
ou have nothing to lose for your
nd CI October 2014 aged 9
m
Then I woke up. The lady brought me juice,
toast and beans. Then I got sick. Then there
was a dinner in the evening. I had a bandage on my hea
Dad and Mum took me home. My neighbour
2015 Edition auntie was
sisters and Hashir. There was a surprise – a cake. There
“You are a brave girl.” After I cut the cake everyone c
card. It wasn’t a birthday. It said “Get Well Soon.” Then
to bed. Now I have got a second cochlear implant. I
second implant until I get my second processor. (May
after Christmas.) My operation was okay.
(Written in 2014)
Fatima, 1st CI May 2007
aged 18mths, 2nd CI
October 2014 aged 9
My Second Cochlear
Implant Operation
Tom and Clare, Parents of Sam, Bilateral CIs July 2
When our son Sam was only three d
Tom and Clare, Parents
was picked up with the Newborn Sc
of Sam, Bilateral CIs July
was just eight days old we had
2014, Aged 1
e
I went to hospital. Me
and mum played loom
bands. Then we went
.
to the playroom. Then
,
it was time to go for
operation. The mask
wasIreally
it was strawberry. It
on my head.
justhorrible.
slept First
again.
auntie was smells
theregood.
andThen
myit changed
three to horrible smell.
Then all the doctors dropped me back to my
ake. There was
poster.
said
room. a
I slept
a little It
while.
everyone clapped. There was a
I woke
up. The
brought me juice, toast
Soon.” ThenThen
I was
tired.
I lady
went
and beans. Then I got sick. Then there was a
implant. I won’t
withI had
mya bandage on my
dinner in hear
the evening.
head.
I just slept
Dad and Mum took me
ssor. (Maybe
before
oragain.
maybe
CIs July
home. My neighbour auntie was there and my
three sisters and Hashir. There was a surprise
– a cake. There was a poster. It said “You are a
brave girl.” After I cut the cake everyone clapped.
There was a card. It wasn’t a birthday. It said
“Get Well Soon.” Then I was tired. I went to bed.
Now I have got a second cochlear implant. I
won’t hear
with my
2014,
Aged
1 second implant until I get my
second processor. (Maybe before or maybe after
Christmas.) My operation was okay.
only three days
his deafness
(Writtenold
in 2014)
Newborn Screening. When Sam
d we had his first Audiology
was confirmed that he was
hearing aids were fitted at five
ear that the benefits would be
he Newly Diagnosed weekend
s who are considering Cochlear
n, which were a huge help and
under the excellent care of Dr.
Cochlear Implant Department.
just two weeks after his first
re was no major reaction upon
s and react to his name. At first
l them off and chew on them or
gan to realise that these were
appointment where it was confi
profoundly
Whilst hearing aid
When
our sondeaf.
Sam was
weeks
of
age,
it
was clear that th
only three days old his
minimal.
We
attended
the Newly
deafness was picked
and
a
meeting
for
parents
who are
up with the Newborn
Screening.
Samchildren, which w
Implants When
for their
was
just
daysourselves under the
soon
weeight
found
old
we and
had her
his first
Viani
team in the Cochlear Im
Audiology appointment where it was confirmed
that
he was
profoundly
deaf. Whilst
hearing aids
Sam
received
his bilateral
cochlear
implants just two
were
fitted
at
five
weeks
of
age,
it
was
clear
that there was no
birthday. What a present he got! While
the benefits would be minimal. We attended the
switch on, he soon began to utter new sounds and react
Newly Diagnosed weekend and a meeting for
it was a little bit of a struggle as he would pull them off a
parents who are considering Cochlear Implants
them into
food,
buthelp
heand
soon began to real
forthrow
their children,
whichhis
were
a huge
soon we found ourselves under the excellent care
of Dr. Viani and her team in the Cochlear Implant
Department.
Sam received his bilateral cochlear implants just
two weeks after his first birthday. What a present
he got! While there was no major reaction upon
switch on, he soon began to utter new sounds
and react to his name. At first it was a little bit of
a struggle as he would pull them off and chew
on them or throw them into his food, but he
soon began to realise that these were making a
difference to him.
Six months on and the words have started to
come. He now has eight words and a few ISL
signs. He loves music and singing and dances
along to all genres! He seems to love musicals
and "Annie" seems to be his favourite at the
moment! Sam will now leave the implants on
all day until he is going to bed and has recently
began to look for them when we take them off
him at bath time etc.
A whole new world has opened up for Sam and
we get to share it with him every day. A huge
thanks to the Cochlear Implant team.
(Written in 2015)
15
The National Paediatric Cochlear Implant Programme / Helping Deaf Children to Hear and Talk
Useful Websites
Books, videos and CDs about deafness
In the UK, there are three main manufacturers of
cochlear implants:
and deaf issues
Cochlear
www.cochlear.com
Advanced Bionics
www.advancedbionincs.com
Medel
www.medel.com
Forest Books
The New Building
Ellwood Road
Milkwall
Coleford
Gloucestershire
GL16 7LE
Tel: 00 44 1594 833858
www.forestbooks.com
Other useful websites include:
National Deaf Children's Society
www.ndcs.org.uk
British Cochlear Implant Group
www.bcig.org.uk
Ear Foundation, Nottingham, UK
www.earfoundation.org.uk
Deaf Education Through Listening and Talking
www.deafeducation.org.uk
DeafHear
www.deafhear.ie
Sound Advice
www.sound-advice.ie
The Elizabeth Foundation
www.elizabeth-foundation.org
Information for teenagers
www.ci-4teenz.com
Comprehensive website for current and future CI
users
www.cochlearimplantHELP.com
16
2015 Edition
17
The National Paediatric Cochlear Implant Programme / Helping Deaf Children to Hear and Talk
The National Paediatric Cochlear Implant Programme
Beaumont Hospital/Children’s University Hospital Temple Street
Tel 01 809 2191 - General Enquiries & Spare Parts
Tel 01 809 2013 - Paediatric Appointments
18
Fax 01 809 2753
Text tel 087 953 5423
e-mail [email protected]