University of Edinburgh
 

Outcomes of Paediatric Cochlear Implantation

Presented in February, 2005

Optimising Outcome from Cochlear Implants: Our Experience

Agnes A Allen
Head of Department
Scottish Cochlear Implant Programme for Adults and Children

Scottish Cochlear Implant Programme for Adults & Children

crosshouse hospital
Crosshouse Hospital, Kilmarnock

Purpose of Measuring Outcome

Monitor Progress

Test for Reception of Grammar

Test for Reception of Grammar

Measure Effectiveness

Perceptions / Expectations

  • Implant Team
    Purpose Statement
  • to enable profoundly deaf individuals to acquire or retain functional spoken language.   
  • Child
  • Parents
  • Local Team
  • Health Economists
  • Benchmarking
  • Predict CI outcome and ‘shape’ Selection Criteria

Selection Criteria

Puretone Audiometry

Average Thresholds (1, 2 & 4KHz) greater than 95dB HL

Puretone Thresholds

Puretone thresholds

Aided Thresholds

Aided Thresholds greater than 55dB @ 2&4 KHz

Aided Thresholds

aided thresholds

Evaluating HA Benefit

  • Aided Thresholds
  • Hearing Aid Fitting
  • Speech Perception Tests
  • Quality of Sound
  • Anecdotal Evidence

Functional Hearing

  • Will a cochlear implant improve speech understanding (c.f. a conventional hearing-aid) ?

Speech Perception Tests

  • Lings Sounds
  • Nonsense Syllables
  • Monosyllabic Words
  • Sentence Lists (BKB, CUNY, CID) – HA alone, LR alone, HA+LR
  • McCormick Toy Test / Manchester Picture Test (PARROT System)

Other Considerations

  • the cochlea and inner-ear

MRI Imaging

MRI Imaging

  • integrity of auditory system
  • age and duration of deafness

Children who have acquired spoken language

  • No upper age limit

Congenitally Deaf Children

congenitally deaf children

  • communication skills
  • general health

cochlear implant operation

  • ability to participate in ‘mapping’
  • expectations
  • commitment

using audiometric equipment

  • spoken language

Outcome Measures

  • Aided Thresholds
  • Sound Detection / Discrimination / Recognition
  • Speech Perception
  • Spoken Language
  • Educational (Accessing Curriculum etc.)
  • Observational Outcome Measures
  • Quality of Life

BKB sentences

Observational Outcome Measures

CHILDREN

1. Displays no awareness of sound. 0%

2. Is aware of environmental sound. 100%

3. Responds to speech sounds. 100%

4. Recognises environmental sounds. 99%

5. Discriminates at least two speech sounds. 99%

6. Discriminates reliably among five speech sounds. 96%

7. Understands common phrases without lip-reading. 78%

8. Understands conversation without lip-reading with a familiar talker. 45%

9. Can use the telephone with a familiar talker. 24%

Achieving a Successful Outcome

  • Must wear external equipment
  • Commitment / Home Support
  • Spoken language exposure
  • Mode of Communication
  • No significant behaviour / learning difficulties