The big advantage of a cochlear implant over a normal hearing aid is that you are able to hear spoken language and speech sounds more acutely, and this facilitates more natural speech development. The implant is particularly adept at facilitating the perception of certain frequencies of speech and the individual is also able to monitor their own speech more successfully.
When children receive a cochlear implant they will require a huge amount of input from the Speech and Language Pathologist/Therapist, the professional implant team, and the parents/care-givers of the child. For adults acquiring a cochlear implant, it is likely that they once had some hearing and already have speech skills, so any input from professionals may be less demanding.
Normal hearing aids amplify the sound, implants attempt to bypass the damaged parts of the hearing mechanism and take the sounds straight to the auditory nerve.
Speech development has a number of elements:
One of the most successful approaches for facilitating speech and listening for children with cochlear implants, is Auditory Verbal Therapy. This approach focuses on listening and sound awareness, as this is the most natural and efficient way that children learn speech. With auditory verbal therapy every possible opportunity to listen and learn is used through the day, using the child's environment as a learning tool.
Auditory Verbal Therapy (AVT) involves the family and Speech and LanguageTherapist/Pathologist (SLT) who facilitate the child to learn to talk through listening (as a naturally hearing child would learn). Listening, speech, and language are all developed through active listening activities which become a part of play, education and communication on a daily basis. Parents are encouraged to be the primary facilitators of their child’s listening and speech development.
The process is helped by early diagnosis of hearing impairment and the fitting of hearing aids or a cochlear implant for optimal amplification. Parents also have to be committed to participate and work closely with the relevant professionals. The child learns through listening rather than watching. AVT should be administered by a qualified Auditory-verbal therapist who will guide and work with the parents so that they re-produce therapy activities at home in a natural way. Many of the activities we have discussed earlier will be part of the AVT program.
One of the techniques used in AVT is called an “auditory sandwich” where the therapist sits on the aided side of the child repeating auditory information several times, then presenting a visual clarifier (object, picture etc), and then presenting the auditory information again, making sure to use language that is rich in suprasegmental qualities (e.g. Pitch, prosody etc).
Acoustic highlighting is also used to stimulate the listening environment. This involves using variables such a background noise, distance, complexity and rate of utterance to vary the acoustic conditions and really train the child to listen.
At the same time as teaching listening, we also want to promote speech. Trying to get children to repeat or name items on request is not the best way to teach speech, we need to find a way for the child to speak on their own terms, where they are in control and in a relaxed environment with no pressure. We need to provide good models for speech, not only naming things for the child, but also repeating back a correct version of their attempts at speech, and praising them every time they attempt speech.
Once the child is actively listening, discriminating and using some speech we can start to look at some speech therapy ideas that focus on speech as well as listening. Usually it helps if the child is a little older when you want to start speech work, because the younger child is often either unaware of what the therapist is trying to achieve, and/or it is difficult to describe certain concepts such as back and front sounds etc. However, listening activities should still be the priority.
It will take time for the child to develop their new listening skills and speech. We have to remember that for some children it will be as if they have the hearing of a newborn and every sound they hear will be new. A cochlear implant can be very effective at promoting listening and speech skills and many children’s speech will eventually become as good as their peers.
Yes. The surgically implanted internal processor is placed underneath the skin, making it waterproof. The external processor traditionally is NOT waterproof and should be removed (similar to a hearing aid). Some currently available models of external processors do have waterproofing options that can be used in the pool, bath or shower. You should discuss these options with your cochlear implant audiologist.
The surgeon will typically only need to shave a very small area of hair immediately behind the ear (1cm to 2 cm).
This is a tough question to answer, as it varies for all patients. Initially, the most commonly reported sound qualities are described as “mechanical,” “robotic,” “cartoonish” and like people are “talking with marbles in their mouth.” Some patients will only “feel” the stimulation when it is first turned on. It is very important to realize this is a process. Over time the sound quality will change as the brain re-learns the stimulation patterns provided by the cochlear implant. For the majority of patients, the sound quality will continually improve over the first six to twelve months.
Yes. All cochlear implants have internal t-coils available for use and available connectivity to FM systems or Bluetooth.
The cochlear implant is a lifelong commitment. You will be set up for three to four programming appointments starting approximately one month after surgery. These appointments are set up to provide you with a transitional period to help you acclimate to the new sounds you will hear through your cochlear implant. Following those initial appointments, you should expect to be seen every three to six months for the first two years and then AT LEAST every year after that.
The simple answer is no. You will likely still have a lot of frustration and difficulty when listening in large groups or noisy situations. However, you may find that over time your ability to communicate in those situations gets easier as you have greater access to information and your brain can ignore some of the noises you don’t want to hear.
No. The implant is likely to come off during sleep, and it could get damaged. It is recommended that you remove the device prior to going to bed. If you live alone, please consider additional assistive listening devices for alerting purposes.
