«Auditory-verbal therapy is essential for children with cochlear implants»
27. September 2018
Cochlear implants have to be surgically implanted. What happens after the surgery?Right after the implantation of the CI, the patient cannot hear yet, because the external transmitter part is missing. The patient receives this part only about a month after the surgery during the first programming session. The time in between is necessary for the operative incision to heal completely. Once the swelling is gone, the clinician can do the first fitting and programming of the cochlear implant system. The audiologist may use the time period between surgery and initial stimulation to set up a programming plan.
How does the activation work?This first fitting is often referred to as the initial stimulation, activation or hook-up. During the activation an audiologist adjusts the sound processor to fit the implanted patient, tests the patient to ensure that the adjustments are correct, determines what sounds the patient hears, and gives information on the proper care and use of the device.
And how does the activation work with children?Audiologists who specialize in pediatrics use their experience to fit the device. Because programming a cochlear implant for children is different than it is for adults. Children typically do not have the experience to report when a sound is perceived as soft or loud. In addition, children do not have the attention span to sit for an hour of programming. Further, programming requires frequent adjustments as the child adapts to the device. While some children adjust very quickly, others require several weeks or months. How much sound a child perceives depends on several factors, including the age at implantation, length of deafness, previous experience with sound, and access to aural rehabilitation and therapy services.
What kind of sounds do the patients hear in the beginning?At first, speech and sound from the environment can sound or feel like vibrations, clatter, or garbled noise. Some people can recognize speech right away, it may start out sounding natural, just like they remember. Very young children may not have association of sound, so they don’t know right away that they are hearing.
For children who have already learnt to speak (post-lingual), adjustment and progress with a CI may be faster than for children who didn’t learn to speak yet or who were born deaf. The Post-Lingual child has developed a “bank” of auditory skills from which to compare and expand with the new sound. The new sound with the CI is most likely different at first compared to sound remembered prior to the CI; however very quickly the difference fades and sound becomes natural.