Read frequently asked questions on cochlear implantation below.
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If your child has major hearing loss and hearing aids do not enable both ears to hear all the sounds that are part of speech, an implant for each ear may be recommended. The reason is that there are many advantages to having two hearing ears. Benefits include improved hearing when background noise is present and spatial hearing (knowing where sound is coming from). Whether we recommend a cochlear implant for one or both ears is determined by the audiology and imaging evaluations.
Our program has experience with surgery and programming of all cochlear implant systems. We work with all major cochlear implant manufacturers to provide children with the latest technology. In some cases, a specific type of device may have features that are advantageous for your child’s anatomy or medical history. We will give you an expert opinion.
There is a small increase in risk of bacterial meningitis, a serious infection, in individuals that have a cochlear implant. Vaccinations that reduce this risk are recommended by the Centers for Disease Control (CDC). The vaccinations include Prevnar 13 (PCV 13) and Haemophilus influenza type B (Hib) that are part of routine childhood vaccinations recommended for all children. It is also recommended that children who have a cochlear implant receive Pneumovax (PPSV23) once they become two years of age. We will let you know what vaccinations are necessary before or after surgery.
There are many advantages to your child using hearing aids before moving ahead with cochlear implantation:
Confirms the degree of hearing loss determined by your child’s ABR or testing done in the sound booth. This is reassuring for everyone.
Helps us to determine if one ear is more responsive to hearing aids, which can be very important in some cases.
The audiologist, therapist and parents also learn to recognize when a child is detecting sound amplified by hearing aids. Your child learning to react consistently to any sound, is very helpful. This skill makes it easier to evaluate your child’s hearing in the sound booth and enables the audiologist to more quickly provide custom, finely tuned programming once your child is implanted. Think of listening therapy as brain training for your child. It’s like putting oil in an engine – makes everything run smoother and more efficiently. Faster acceleration (progress) often results.
If your child has a profound loss in both ears and will not be helped by hearing aids, the evaluation process may be rapid, as long as your child regularly wears their hearing aids and is receiving hearing therapy.
Our program has loaner hearing aids when a period of hearing aid use is necessary and the child does not have aids, or the aids are not powerful enough.
Often, one ear is implanted at a time. A single implant surgery is much shorter and easier to recover from, and your child will almost certainly not need to stay overnight for observation. Research has also shown that, depending on the degree of hearing loss, there are advantages for children to hear though the implant while continuing to use a hearing aid in the opposite ear during the adjustment period.
The decision to implant one or both ears is individualized and will depend on many factors.
Most children return home on the same day as surgery. Children may return to school the following week.
The cochlear implant system will be activated (turned on) by your child’s implant audiologist three to four weeks after surgery. At the first activation visit the child will be given the speech processor. This is worn on the side of the head or behind the ear, depending on the design. It contains a battery, a computer chip, a microphone and a transmitter.
Multiple appointments with the audiologist to fine-tune computer programming of the implant are necessary. Lurie Children's implant program specializes in custom programming to meet the needs of your child’s ear(s) and brain. We believe custom programming is essential. Evaluation of the softest sounds your child can hear and how well they understand speech through the implant are also done periodically. More audiology visits are needed during first year while your child is adjusting to sound. After the first year, routine visits are usually twice a year and may be reduced to once a year depending on your child’s age and progress.
Therapy to build listening skills is critical, especially during the first few years after implantation. For preschool age children, it is important that the therapy involve the parent or caregiver so they can help the child during normal every day activities to learn to listen and understand the meaning of what they are hearing. As listening skills improve, the therapy has greater emphasis on the child making sounds, saying words and sentences. For school age children, listening therapy is also very important. If listening and spoken language therapy are to be provided at school, they need to be included in your child’s Individual Education Plan (IEP) that defines school services.
Listening therapy for pre-school and school age child is available at Lurie Children’s in Chicago and several suburban locations. Teletherapy may also be an option.
Children with cochlear implants experience success in a variety of educational settings with differing educational philosophies. Many children with cochlear implants communicate using listening and spoken language of varying degree. The children that primarily listen and talk may be in an oral classroom or school that provides intensive listening and spoken language for children with hearing loss in preparation for mainstream education with hearing children, or they may be mainstreamed. If mainstreamed, these children may have support from a hearing itinerant (educator who supports and monitors child). Some children with cochlear implants use sign language and when they enter school may be in a Total Communication (TC) classroom where both spoken and sign language are used, or they may be mainstreamed with a sign language interpreter. Other children are placed in a special education classroom, often because they have other conditions that impact learning more than hearing loss and therefore need a different approach to learning. Depending on how they learn, children in special education programs may use spoken and/or sign language or augmentative and alternative communication (AAC). A child’s school placement depends on many factors including their hearing history, parental preference, learning style and special needs, and availability of services and programs in the child’s school district.
Our cochlear implant team educator is available to the families we serve to discuss school programs and services.
Yes. Research has demonstrated that hearing through an implant has a positive impact on how rapidly deaf children learn language, including sign language. Sign language is a visual language and many children who have an implant can learn to listen and speak as well as sign. However, children who are born deaf are not likely to develop age-appropriate listening and spoken language and be mainstreamed unless they are implanted at a young age, use their implant(s) consistently and are supported by parents and professionals to develop listening and spoken language skills.
Lurie Children’s cochlear implant team has pioneered treatment of deaf children with cochlear nerve deficiency (abnormally small nerve of hearing). Even a very small nerve may be stimulated by an implant which may give the brain useful information about sound. This problem needs to be carefully diagnosed using high resolution MRI. If the nerve is small, the MRI may not be able to detect it. If the nerve is small in both ears, we may recommend implanting at least one ear. Although progress is usually slow, if implanted at a young age, if special programming is done and the child consistently uses the device, most will develop improved awareness of sound and some are able to understand spoken language and learn to talk. Often these children communicate using both sign and some degree of spoken language.
However, we do not recommend a cochlear implant in an ear with a very small nerve if the opposite ear has normal hearing.