Cochlear Implant Program
We recognize that every child is unique in his or her hearing journey, and we aim to provide quality care that best fits your child’s needs. Just like your child, every hearing loss is unique as well. Your child may be a candidate for a cochlear implant in one or both ears. A cochlear implant is an implantable device that stimulates the auditory nerve to help individuals have better access to sounds when hearing aids are not providing adequate benefit.
Our cochlear implant team consists of audiologists, speech-language pathologists (certified auditory-verbal therapists), an educational liaison, and cochlear implant surgeons. Each member of the team evaluates children with sensorineural hearing loss to determine if they are an appropriate candidate for a cochlear implant. Referrals may also be made to other professionals if additional information is needed. Upon completion of the evaluation, the team meets to discuss factors important for successful cochlear implant use. When recommending a cochlear implant, we strive to create an individualized plan for therapy and parental/educational support to ensure that children become successful cochlear implant users.
Cochlear Implant Clinic in Houston, TX
We also believe that parents are a vital part of the cochlear implant team. We honor and value parents’ choices for their children. We are dedicated to providing parents with the knowledge that they need so that they can make informed decisions for their children. We know that parents and extended family members deserve support from professionals, other parents, and other cochlear implant users. We aim to provide that support and help all of our children reach their fullest potential.
A cochlear implant is a device that can allow individuals to hear speech and environmental sounds when hearing aids are unable to provide enough power to hear all the sounds of speech. An implant does not restore normal hearing, but it can give a person with significant hearing loss access to sounds in the environment to help him or her to understand speech.
The implant consists of a surgically implanted processor and electrode array that is stimulated by an external speech processor that sits behind the ear. During surgery, the internal processor with the magnet is placed underneath the skin behind the ear, and the electrode array is carefully inserted into the cochlea. After healing from surgery, the external processor will be turned on by an audiologist and placed behind the ear with the magnet holding the external processor directly over the internal processor. The activation (turning on the cochlear implant) appointment marks the first time the patient will hear with his or her cochlear implant.
A cochlear implant is an electronic device that provides auditory information to a child with significant sensorineural hearing loss. It is different from a hearing aid because it uses an electrical current to directly stimulate the cochlear nerve. The cochlear implant bypasses the damaged hair cells in the cochlea (the organ of hearing) to directly stimulate the auditory nerve. The cochlear implant consists of a surgically implanted internal processor and an external processor worn on the head. The FDA has approved cochlear implants for children as young as 9 months with bilateral, profound sensorineural hearing loss. Research has concluded that the sooner a child receives a cochlear implant, the more likely it is they will develop spoken language and understand speech.
Our cochlear implant team uses a multistep process to verify your child is a cochlear implant candidate, address realistic expectations with your family, make sure the need for appropriate long-term follow-up care and (re)habilitation can be met, and ensure an appropriate educational environment and support system is in place.
- Audiology Evaluation (Audiologist)
- Comprehensive hearing evaluation to determine type and degree of hearing loss
- Fitting of appropriate hearing aid technology
- Hearing evaluation with hearing aids to determine if the hearing aids are providing appropriate access to speech
- Speech and Language Evaluation (Speech Pathologist)
- Comprehensive speech and language evaluation to determine your child’s current receptive and expressive language skills
- The speech pathologist may recommended speech therapy prior to a cochlear implant
- Education Consultation (Educational Liaison)
- Our education liaison will assist in making sure your child is receiving outside sources through early childhood intervention (ECI) and/or the school districts
- Medical Evaluation (Surgeon)
- Medical evaluation with a cochlear implant surgeon to review all medical testing and results
- Assessment to determine if there are any medical contraindications to a cochlear implant
- Assess your child’s health and ability to undergo surgery
- Discuss risks, benefits, and expectations of surgery
- CT Scan/MRI (Surgeon)
- Evaluate the internal structures of the ear
- Cochlear Implant Team Meeting
- Our cochlear implant team will meet to discuss your child’s case and make a formal recommendation regarding a cochlear implant
- Cochlear Implant Counseling
- Your audiologist will review the cochlear implant team recommendations
- Counsel regarding different cochlear implant manufacturers
- Counsel regarding realistic expectations of obtaining a cochlear implant
The cochlear implant team may request additional information as a part of the cochlear implant candidacy process to ensure your child is provided with the best care and support. Other specialists might include:
- Cardiology
- Assesses your child’s heart function
- Genetics
- Investigates a possible genetic cause for your child’s hearing loss
- Neuropsychology
- Assesses your child’s overall development
- Assesses your child’s ability to learn
- Helps provide guidance to caregivers on the best way to interact and communicate with your child
- Ophthalmology
- Assesses your child’s vision
- Social Work
- Provides emotional support and community resources for caregivers
- Vaccinations
- It is a known risk that children with hearing loss are at a higher risk of contracting meningitis. Meningitis is an infection that causes serious and possible life-threatening inflammation of the brain and spinal cord. Vaccinations again streptococcus pneumonia reduces that risk.
- If your child is younger than 24 months, please consult your pediatrician or healthcare provider to ensure the child is up to date on all routine vaccinations, particularly Prevnar 13 (PCV 13).
- If your child is 24 months or older, the Pnuemovax 23 (PPSV 23) vaccine is recommended by the U.S. Centers for Disease Control and Prevention (CDC). Please consult your pediatrician or healthcare provider for administration.
Cochlear implant surgery is commonly performed as outpatient surgery under general anesthesia, and typically lasts three to four hours. Minimally invasive techniques and vigilant monitoring of neighboring nerves provide surgical access to the inner ear for a safe and effective operation with a short recovery time. After the incision has healed and any swelling has subsided, your child will be ready for the next step: initial stimulation and programming of the cochlear implant.
Your child will return to Texas Hearing Institute two weeks after surgery for the initial stimulation and orientation of the external cochlear implant processor. During this appointment your child will be fitted with the cochlear implant’s external equipment, and the device will be programmed/mapped. The initial stimulation is exhilarating, because it’s the first time your child will hear with their new cochlear implant.
The initial simulation of a child’s cochlear implant opens a door to a whole new world of sounds and is the beginning of an exciting journey!
The sounds children hear through the cochlear implant are adjusted in a process called mapping. An audiologist will use a computer with specialized software and take measurements from each electrode to program levels your child can hear. Consistent follow-up is critical to achieve success with a cochlear implant. We have carefully considered the number and type of appointments needed for children to achieve optimal benefit with their cochlear implant.
A typical follow-up schedule for cochlear implant mapping and testing, which begins two weeks after surgery, includes the following:
- Initial Activation Day 1
- Initial Activation Day 2
- 2 Weeks Post-Activation
- 1 Month Post-Activation
- 3 Months Post-Activation
- 6 Months Post-Activation
- 9 Months Post-Activation
- 12 Months Post-Activation
After the first year, your child will be monitored every three months until the age of 5 years old. Children 5 years old and older should be seen at least every six months for cochlear implant mapping and aided/unaided testing. However, it is not uncommon for children to need interim mapping sessions between these appointments for additional testing, help with troubleshooting the equipment, or fine-tuning adjustments. Your child’s audiologist, speech pathologist, teacher, cochlear implant surgeon, and other specialists will continuously collaborate with Texas Hearing Institute to make sure your child is achieving success with their cochlear implant.
