American Speech-Language-Hearing Association

To Sign or Not? Advising Families of Pediatric Cochlear Implant Candidate

Response by Mary E. Koch

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Cochlear implants work. However, without rehabilitation, sound can be meaningless. Professionals need to provide effective rehabilitation programs that foster integration of listening, while minimizing cognitive and linguistic delays.

Cochlear implants have become an effective alternative in the treatment of profound hearing loss in children. Children are arriving on the doorsteps of agencies and schools with a device that enables them to hear a pin drop but without the training to make sense of the sound they hear. How should professionals respond?

  • Rehabilitation: Because understanding of sound occurs in the brain, the cochlear implant can only be effective if followed by a comprehensive rehabilitation program.
  • Team communication and support: A system of communication should be maintained between the cochlear implant team, school-based professionals, and families to ensure that expectations are consistent throughout a child' s learning environment.
  • Communication methodology: The development of listening skills through a cochlear implant should not preclude the need to foster a child' s global cognitive and communication development. Although the goal of cochlear implantation is (typically) the development of spoken language, supplemental visual systems may be necessary to maintain cognitive and communication growth while a child is learning to process spoken language through listening. Strategies for use of visual support should be determined based on the needs and skills of the individual child.

Cochlear implants work. They effectively transmit sound past the damaged cochlea to the brain. Without rehabilitation, however, that sound can be meaningless for a child who has never heard. Professionals need to provide effective rehabilitation programs that foster integration of listening, while minimizing cognitive and linguistic delays.

Wolfson should introduce this approach (and supporting evidence) at a staff meeting so that future implant candidates will be sufficiently evaluated and appropriate recommendations offered to families.

Mary E. Koch
Auditory Education Consultants
Baltimore, MD

A graduate of Smith College and Gallaudet University, Koch has worked in Oral, Total Communication, and Auditory-Verbal programs. She began working with a child with single channel cochlear implants in 1983, and, in 1994, developed the children' s cochlear implant rehabilitation program at The Listening Center at Johns Hopkins. Currently working with Baltimore County Infants and Toddlers, and providing cochlear implant rehabilitation training workshops throughout the United States and Canada, Koch is also serving on the National Association Task Force to develop a revised position statement on cochlear implants and children.

To submit cases or to be added to the list of respondents please contact: Roy Shinn, e-mail: shinn@edinboro.edu

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