2. Cochlear Implants: what are they and who are they for? Suzanne Harrigan Specialist Speech and Language Therapist The Ear Foundation

3. 2 Before we start….. Tell me a little bit about yourselves Any questions or issues?

4. So what is a cochlear Implant and what does it aim to do?

6. HOW THE IMPLANT WORKS. The internal device. 22 electrodes. The external fittings. The processor. The microphone. leads. coil.

7. So what is a cochlear implant able to offer in terms of listening levels?

8. What are we aiming for? For children with no residual hearing. To give the child access to speech sounds across all the frequencies. For children who have some access to low frequency speech sounds. Access to high frequency speech sounds.

9. Hearing Thresholds

10. Terms to consider. Threshold: The level of the quietest sound detected. Comfort levels: The loudest comfortable sounds. Sound level: Recorded in decibels in logarithmic scale. Frequency: The speed in which a sound vibrates.

11. s th f dt oo aw ahay ee m n ng Hearing Thresholds

12. Unaided thresholds.

13. Hearing Thresholds

14. Aided Thresholds

15. Hearing Thresholds hearing aids

16. Implant Thresholds

17. Aided Hearing Thresholds: Cochlear implant

18. Does a cochlear implant provide normal hearing? ?

19. NO! They still have a mild to moderate, and possibly unilateral loss So…. What does it sound like?

20. © The Ear Foundation 2009 1-channel channel 2-channel channel 4-channel channel 8-channel channel 16-channel channel Original Simulation: listening with a cochlear implant This demonstration uses the noise-band vocoder technique of Robert Shannon. Start with 1-channel and then increase the number of channels

21. TYPES OF PROCESSOR.

22. Processors. COCHLEAR Nucleus 5 Medel ADVANCED BIONICS

23. How Processors are worn Ear level with body worn battery pack, or body worn microphone and processor For younger children, children with disabilities Ear level, integrated battery compartment and microphone and processor For older children and adults

24. So what about children with additional needs Cochlear Implants are an option for children with additional needs You may need to think carefully about the issues Pre implant assessment and planning may take more time 23 © The Ear Foundation 2009

25. Questions….. What are the strengths of your child that make it likely that they can cope with, and make effective use of an implant? Is there anything about your child that will make it difficult for them to cope with and make good use of the implant? Will your be able to cope with the tuning process? Is there anything about the operation or follow up process that is likely to be significantly stressful for your child or your family?

26. Questions….. What are the likely benefits of a cochlear implantation for your child, and do they outweigh any difficulties? Family issues: What are you and your family’s expectations of the implant? Are they realistic??

27. You may have to push! “ I originally asked about cochlear implants at school, and it was actually ‘no chance’ and they said they can’t do that because of his other needs. I pushed again not long ago and we actually went through the whole process going for a cochlear implant, and one of the first things she said to me is why didn’t you come to see us years ago he is perfect.”