Download 13th International Conference on Cochlear Implants and Other

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Redefining the borders: Stretching the criteria for paediatric benefit from cochlear implantation for 2014
Abrahams Y. , Fulcher A. , Neal K.
The Shepherd Centre, Sydney, Australia
Intro: Over the past 10 years there has been a significant shift in the audiological and functional listening criteria
that would suggest a child will have improved access to sound over and above what can be provided by acoustic
amplification. In an integrated cochlear implant program that is embedded in a comprehensive listening-based
early intervention service the opportunity exists to closely monitor the progress of children with different levels of
hearing over up to five years and the ever improving outcomes for children with cochlear implants has also
driven shifts in candidacy criteria. This retrospective study reviews the changing criteria in a paediatric cochlear
implant program over the past 3 years, and the changes in speech, language and listening outcomes.
Additionally, medical, audiological and psychosocial outcomes are also reviewed and compared to those of
children using traditional amplification.
Methods: A retrospective file review was conducted to review the candidacy criteria, medical and surgical
outcomes and long terms outcomes with respect to listening, speech, language and the family. The candidacy
characteristics and subsequent outcomes for 148 implant procedures over 3 years was reviewed in order to
clarify the current criteria for paediatric cochlear implant evaluation in 2014.
Results: Audiological criteria has been gradually shifting over the past 3 years. Children with more residual
hearing are now being considered appropriate candidates for implantation and are showing improved outcomes
compared to pre-operative listening and compared to children using traditional amplification. Surgical and
medical aspects of cochlear implantation have not shown any significant change in the impact on the individual
or their post-operative residual hearing. Other characteristics are emerging as likely outcomes such as reduced
effort in listening and improved confidence.
Conclusion: Over the past three years, the audiological criteria for implantation has changes significantly and
has become just one component of the information driving a family to consider cochlear implantation rather than
the sole piece of evidence for consideration. The value of the description 'borderline' needs to be reconsidered
as it is defined differently by different clinicians and at different points in history, and this has proved only to add
confusion for families and professionals. The criteria for benefit from cochlear implants has shifted significantly
and will continue to shift and professionals need to keep abreast of these shifts in order to ensure candidates are
obtaining the best access to sound that technology can provide.
Learning outcomes: Participants will have the opportunity to review current cochlear implant candidacy criteria,
current clinical practices in an integrated paediatric implant program and how the longer term outcomes for
children compare to those of children with similar hearing levels using traditional amplification.