Cochlear Implants

1. Cochlear Implants Heather Hall Kentucky School for the Deaf Outreach Consultant

2. True or False • Cochlear Implants restore hearing to normal. • False: A cochlear implant does not restore normal hearing. It is a communication tool but not a "cure" for deafness. • Anyone with a hearing loss can get a cochlear implant. • False: There are specific qualifications for candiates for cochlear implants. • Hearing equals understanding. • False: Hearing something does not mean you understand it. Cochlear Implant recipients have to learn how to understand the things that they hear.

3. What in the World is a Cochlear Implant? • A cochlear implant is a small, complex electronic device that can help to provide a sense of sound to a person who is profoundly deaf or severely hard-of-hearing. The implant consists of an external portion that sits behind the ear and a second portion that is surgically placed under the skin. U.S. Department of Health & Human Services ∙ National Institutes of Health ∙ National Institute on Deafness and Other Communication Disorders

4. What are the Parts to a Cochlear Implant? An implant has the following parts: • A microphone, which picks up sound from the environment. • A speech processor, which selects and arranges sounds picked up by the microphone. • A transmitter and receiver/stimulator, which receive signals from the speech processor and convert them into electric impulses. • An electrode array, which is a group of electrodes that collects the impulses from the stimulator and sends them to different regions of the auditory nerve. U.S. Department of Health & Human Services ∙ National Institutes of Health ∙ National Institute on Deafness and Other Communication Disorders

5. How do Cochlear Implants Work?

6. Hearing Does Not Equal Understanding! • Just because a person can hear a noise or sound does not mean that they understand it. • Children with cochlear implants have to learn what sounds are and connect them to an object or idea. • The brain takes time in interpreting what a new noise is and connecting it to something meaningful to the child. • Think of it this way, the day the implant is turned on the child is like a newborn in the area of listening. They must be exposed to new sounds and make the connections to where they come from and what they mean. A telephone ringing and the word “cat” are just new sounds to a cochlear implant child till they make the connects to what they are.

7. Precautions to Take with Children with Cochlear Implants Head trauma • A blow to the head in the area of the cochlear implant may damage the implant and result in a failure of the internal device, resulting in the need for revision surgery in some cases. Young children who are developing their motor skills are at greater risk to receive an impact to the head from a hard object (chair or table). • Children, including those with cochlear implants, should take caution when participating in contact sports. Whenever possible, they should use a helmet and refrain from direct contact to the head. While participating in sports such as boxing is highly discouraged, children may choose to participate in basketball, soccer, hockey, football or baseball, knowing that they are at a greater risk of damaging the internal device. • Prior to participation in any of these activities, please discuss details with your surgeon. http://www.stlouischildrens.org/content/medservices/Precautions.htm

8. Precautions to Take with Children with Cochlear Implants Discharge of static electricity • Your student will be safe if he/she receives a static electric shock, on the arm for example; however, a discharge of static electricity directly to the external speech processor can cause damage. Specifically, the programs or maps stored in the speech processor can be erased/degraded. • There is an internal shock protection in the speech processor that protects the internal cochlear implant (receiver/stimulator & electrode array) from being damaged. However, if an initial shock to the processor erases its protective features, any subsequent shocks to the external speech processor could travel to the internal cochlear implant. • In rare cases, this discharge could potentially damage the internal cochlear implant requiring revision surgery to replace the internal device. To prevent accidental electrical shocks to the external speech processor, always ground yourself (i.e. touching your hands to your child’s leg or arm) before touching the speech processor. Activities that generate static electricity: Plastic slides Computer Screens Trampolines Plastic Playground Equipment Playing w/ Balloons Plastic Ball Pits (It is recommended that the external speech processor be removed when engaging in the above activities.) http://www.stlouischildrens.org/content/medservices/Precautions.htm

9. Precautions to Take with Children with Cochlear Implants Solutions to reduce the occurrence of static electricity: • Carpet: spray a mixture of half water/half fabric softener on your carpet throughout dry months • Dry air: use a humidifier or vaporizer to increase the air’s humidity • Sweaters / sheets: use fabric softener when doing laundry • Computer screen: anti-static shield • In general, touch something else before touching the speech processor in order to ground yourself, getting rid of the possible charge on that object. http://www.stlouischildrens.org/content/medservices/Precautions.htm

10. Tips for Classroom Teachers What can I do to help children with Cochlear implants be successful? o Ensure the cochlear implant is on and working o Reduce background noise in the classroom o Use carpeting, drapes, and non-sound reflective surfaces to absorb and reduce noise o Reduce fan noise, air conditioner noise, and television/radio/computer noise o Close the classroom door to eliminate distracting hallway noise o Use an FM System in the classroom to improve the speech signal in noise and provide the best acoustic environment o Position the child with a cochlear implant to be close to speakers o When speaking with a child, sit on the same side as the child’s cochlear implant o Speak at a slightly slower rate when presenting new information o Explain to children what is coming up in discussions or studies o Don’t raise your voice or shout; this distorts the speech signal, making it more difficult to understand. Rather, move closer to the child’s cochlear implant. o Gain the child’s attention prior to giving directions o Allow the child extra time to process auditorally o Repeat new vocabulary often and give alternative words when teaching new vocabulary o Use a buddy system with projects o Use written outlines to help the child follow directions

11. Websites • http://www.theitinerantconnection.com/teachers.htm • http://www.utdallas.edu/~loizou/cimplants/cdemos.htm • http://journals.lww.com/thehearingjournal/pages/default.aspx • http://www.hearingjourney.com/Listening_Room/preview.cfm?langid=1 • http://www.hei.org/research/aip/audiodemos.htm