1. The Freedom Cochlear Implant: Another Innovation from Cochlear Children with Cochlear Implants on their Way to Inclusion Дети с кохлеарными имплантатами на пути к инклюзии Dr. Dr. h.c. Monika Lehnhardt Kiev, October 7th, 2011

3. "90% of children with a CI will be successfully included in mainstream education provided they do not have an additional handicap and they get adequate rehabilitation with family support".

4. Step 1: Is there a hearing loss? Neonatal Hearing Screening Programmes

5. Accurate diagnosis

6. Neonate’s response to sound DeCasper & Fifer (1980) Spring and Dale 1977 Eimas et al (1971, 1979)

7. Infant vocalizations Stoel- Gammon & Otomo, 1986 Kent, et al 1987

8. The Window of Opportunity

9. Sharma et al, 2002 Ear and Hearing, December 2002

10. Sharma et al, 2004 Archives of Otolaryngology – Head & Neck Surgery, May 2004 14 month old recipient 13 month old recipient  At CI activation  1 week post CI  1 month post CI  3 months post CI  12 months post CI

15. Categories of Auditory Performance ref: P Govaerts, C De Beukelaer et al., Neurotology and Audiology 2002 (Antwerp) response to speech sounds discrimination of speech sounds use of telephone Children with normal hearing

16. Govaerts, et al. 2002 Otology & Neurology, vol 23; 2002 Age at implantation

17. Manuel Manrique, et al (2004) Laryngoscope, August 2004 >2 yrs 2 to 6 yrs

18. Svirsky, et al (2004) Audiology and Neuro-Otology, vol. 9, 2004

19. Factors Key Factors supporting the dramatic changes in indication - Continuous advances in technology (diagnostic equipment, hearing aids, implants, FM, assistive listening devices) - Improved imaging and surgical techniques - User friendly software for fitting and trouble shooting of cochlear implants - Proven rehabilitation methodologies (e.g. oral education, auditory verbal approach)

20. Indication Broadening of indication - Age (6 months - > 80 years) - Severity of hearing loss (“totally deaf” – “severely hearing impaired” – “partially deaf”) - Bilateral deafness – unilateral deafness - Unilateral CI – bilateral CI – bimodal (HA + CI) - Children whose mother tongue is not the language of the country they are living in - Multiple handicapped children / autistic children - Deaf children with deaf parents

21. "90% of children with a CI will be successfully included in mainstream education provided they do not have an additional handicap and they get adequate rehabilitation with family support".

22. Чудесный мир звуков Спасибо за внимание!