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Michael Scott, Au.D., CCC-A Cochlear Implant Program Coordinator, CCHMC President, NOCCCI

Michael Scott, Au.D., CCC-A Cochlear Implant Program Coordinator, CCHMC President, NOCCCI. All questions will be honored and answered at the end of today’s proceedings. Please write your question/s on a provided note card. What is a Cochlear Implant?.

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Michael Scott, Au.D., CCC-A Cochlear Implant Program Coordinator, CCHMC President, NOCCCI

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  1. Michael Scott, Au.D., CCC-A Cochlear Implant Program Coordinator, CCHMC President, NOCCCI

  2. All questions will be honored and answered at the end of today’s proceedings. Please write your question/s on a provided note card.

  3. What is a Cochlear Implant? Having a Great School Year…

  4. Goals:1. Review hearing loss 2. Provide a basic understanding of how a cochlear implant works3. Compare hearing aids & Cochlear implants4. List the current candidacy criteria

  5. Why are we all here today? • Because hearing loss has the potential to negatively impact ANY of our students at ANY time. • A quick review to explain how…

  6. Access to Soundwithout access to the entire “speech banana”, a child would be miss out on vital parts of speech…

  7. For example: • To the right, is a hearing loss that may be considered for a cochlear implant:

  8. For example: • The blue region is the range of sounds heard by this child • That means that they do not hear: /f/, /s/, /h/, /th/, among others

  9. Why an implant?Cochlear implants provide children with severe to profound hearing losses with access to sound.Don’t hearing aids do this?

  10. Hearing aids vs. Implants- hearing aids have their limitations-even with the best hearing aid, a child may not hear high pitches

  11. Access to Sound-A cochlear implant can provide access to the entire speech banana without the limitations of hearing aid output levels and without feedback.- An implant is much more complicated than a hearing aid.

  12. How a Cochlear Implant differs from a Hearing Aid • Hearing aids amplify the signal, which passes through the auditory system and utilizes surviving hair cells to carry the signal to the auditory nerve. • No matter how loud a signal the hearing aid produces, some profoundly hearing-impaired ear cannot process the information due to the damaged hair cells. • With a cochlear implant, the electrode array bypasses damaged hair cells in the cochlea to directly stimulate the surviving auditory nerve fibers.

  13. Access to SoundRather than just making sounds louder, cochlear implants send sound directly to the child’s hearing nerve, electrically.

  14. Hearing aid Microphone Battery Circuitry Speaker Earmold Sounds made louder Cochlear Implant Microphone Battery Circuitry Transmitting Coil Sounds delivered electrically Hearing Aids vs. Implants

  15. Access to SoundRather than just making sounds louder, cochlear implants send sound directly to the child’s hearing nerve, electrically.

  16. Processor Anatomy 1. Circuitry 2. Power source 3. Program/volume/ sensitivity controls 4. Microphone 5. Cable 6. Transmitting coil with magnet

  17. Processor Anatomy 1. Circuitry 2. Power source 3. Program/volume/ sensitivity controls 4. Microphone 5. Cable 6. Transmitting coil with magnet

  18. Processor Anatomy • 1. earhook • 2. microphone • 3. circuitry • 4. program selector button • 5. display • 6. battery compartment • 7. cable • 8. coil with magnet • Photo courteous of Cochlear Americas

  19. Implant 1. Magnet 2. Receiving Coil 3. Circuitry 4. Electrode array

  20. Implant • Silicone/ceramic casing • Electronics • Electrode array • Ground electrode • Magnet • NO POWER SOURCE • Photos courtesy of Advanced Bionics

  21. Access to SoundTherefore, without the speech processor (outside part)….

  22. Demo • http://www.youtube.com/watch?v=SmNpP2fr57A&feature=player_embedded

  23. 1. sound is picked up by the processor 3. the surgically implanted receiver accepts the signal and transmits it down the electrical array Demo 2. After the sound is changed to electrical energy, it is transmitted across the skin via the transmitting coil 4. The electrical array stimulates the hearing nerve, which sends the signal directly to the brain http://www.nidcd.nih.gov/health/hearing/ear_coch_img.htm

  24. Manufacturers

  25. WHO CAN GET A COCHLEAR IMPLANT?FDA Criteria • Severe/Profound sensorineural hearing loss in both ears • 12 months to 17 years of age (in the case of meningitis with ossification, implantation can be done earlier) • Receive little to no benefit from appropriately fit hearing aids • No medical/surgical contraindications • Motivated and supportive caretakers, as well as appropriate expectations (parents and child, when appropriate) • Failure to reach developmentally appropriate auditory milestones • Less than or equal to 20% correct on a open-set word recognition test OR less than or equal to 30% on an open-set sentence test (HINT for Children).

  26. Pediatric Candidacy:Take-home message • 12 months or older • Severe to Profound sensorineural hearing loss in both ears • Delayed auditory skill development • No medical contraindications

  27. Coordinator/ Cochlear Implant Audiologist Administrative Assistant Aural Rehabilitation Audiologist Speech/Language Pathologist Surgeon Social Worker Developmental Pediatrician Representative from school Candidate & family The Cochlear Implant Team

  28. Cochlear Implant Evaluation Protocol • Audiologic evaluations showing no benefit from consistent hearing aid usage over at least a 3-6 month period • Cochlear Implant Consultation • Aural Rehabilitation evaluation (independent of or in conjunction with Speech Pathology) • Speech/language evaluation (independent of or in conjunction with Aural Rehabilitation)

  29. Cochlear Implant Evaluation Protocol • Evaluation of family support systems and counseling regarding the psychosocial impact of obtaining a cochlear implant • Pre-surgical counseling and evaluation • Coordination and consultation with child’s school placement

  30. Resources • Cochlear Implant Awareness Foundation: http://www.ciafonline.org/index.html • American Speech and Hearing Association: http://www.asha.org/default.htm • Natural Communication, Inc.: http://www.nciohio.com/ • Auditory Options Project: http://www.auditoryoptions.org/ • Listen-Up: http://listen-up.org/ • Let Them Hear Foundation: www.letthemhear.org • NOCCCI: http://groups.yahoo.com/group/NOCCCI • AG Bell Association: www.agbell.org • Manufacturers: • Advanced Bionics: www.bionicear.com • Cochlear Americas: www.cochlearamericas.com • MedEl: www.MedEl.com

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