Children with cochlear implants on the way to inclusion-eng-ru 2011-10-07

The Freedom Cochlear Implant: Another Innovation from Cochlear

Children with Cochlear Implants on their Way to

Inclusion Детискохлеарнымиимплантатаминапутик

инклюзии

Dr. Dr. h.c. Monika LehnhardtKiev, October 7th, 2011

"90% of children with a CI will be successfully included in mainstream education provided they do not have an additional handicap and they get adequate rehabilitation with family support".

Step 1: Is there a hearing loss?

Neonatal Hearing Screening Programmes

Accurate diagnosis

Neonate’s response to sound

DeCasper & Fifer (1980)

Spring and Dale 1977

Eimas et al (1971, 1979)

Infant vocalizations

Stoel-Gammon &

Otomo, 1986

Kent, et al 1987

The Window of Opportunity

Sharma et al, 2002

Ear and Hearing, December 2002

Sharma et al, 2004

Archives of Otolaryngology – Head & Neck Surgery, May 2004

050

100150200250300350400450

0 5 10 15 20 25 30

Age

P1

late

ncy,

ms

Normal limits

14 month old recipient

0

50

100

150

200

250

300

350

0 12 24 36

Age

P1

late

ncy,

ms

Normal limits

13 month old recipient

At CI activation

1 week post CI

1 month post CI

3 months post CI

12 months post CI

Система кохлеарной имплантацииCochlear™ Nucleus® 5

Систему Nucleus 5 фирмы CochlearПредставляем

Звуковой процессор Nucleus CP810

Дистанционное управление Nucleus CR110

Custom Sound™ Suite 3.0

Кохлеарный имплант Nucleus® CI500 Series

Categories of Auditory Performanceref: P Govaerts, C De Beukelaer et al., Neurotology and Audiology 2002 (Antwerp)

response to speech sounds

discrimination of speech sounds

use of telephone

Children with normal hearing

Govaerts, et al. 2002

Otology & Neurology, vol 23; 2002

Age at Mainstream Integration

0

20

40

60

80

100

0 3 5 7

Age (in years)

Per

cent

age

of c

hild

ren

Under 2 yrs2 to 4 yrs

Age at implantation

Manuel Manrique, et al (2004)

Laryngoscope, August 2004

Reynell

01234567

0 1 2 3 4 5 6 7

Chronological age (years)

"Rey

nell"

age

(yea

rs)

PPVT

01

23

45

67

0 1 2 3 4 5 6 7

Chronolgical age (years)

"Pea

body

" ag

e (y

ears

)

>2 yrs

2 to 6 yrs

Average Language Development

0

12

24

36

48

60

72

84

0 12 24 36 48 60 70 84

AGE (months)

Expr

essi

ve L

angu

age

Age

(m

onth

s) 12-24 months25-36 months37-48 months

Svirsky, et al (2004)

Audiology and Neuro-Otology, vol. 9, 2004

Factors

Key Factors supporting the dramatic changes in indication-          Continuous advances in technology (diagnostic equipment, hearing aids, implants, FM, assistive listening devices)-          Improved imaging and surgical techniques-          User friendly software for fitting and trouble shooting of cochlear implants-          Proven rehabilitation methodologies (e.g. oral education, auditory verbal approach)  

Indication

Broadening of indication-          Age (6 months - > 80 years)-          Severity of hearing loss  (“totally deaf” – “severely hearing impaired” – “partially deaf”)-          Bilateral deafness – unilateral deafness-          Unilateral CI – bilateral CI – bimodal (HA + CI)-          Children whose mother tongue is not the language of the country they are living in-          Multiple handicapped children / autistic children-          Deaf children with deaf parents

"90% of children with a CI will be successfully included in mainstream education provided they do not have an additional handicap and they get adequate rehabilitation with family support".

Чудесный мир звуков

Спасибо за внимание!