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06 If Hearing Aids Aren't the Answer, Learn About Cochlear Implants

So Your Child has a Hearing Loss: Next Steps for Parents

If your child receives negligible benefit from hearing aids after wearing them for a reasonable time, has a severe-profound hearing loss, and is at least 18 months of age, he/she may be a candidate for a cochlear implant. At this writing, the desirability of earlier implantation is being considered and some research centers have begun implanting earlier.

A cochlear implant is an electronic device designed to provide sound detection as well as improved speech understanding and speech production. The cochlear implant is surgically implanted in the ear. It bypasses the damaged parts of the ear and sends electrical "sound" directly to the hearing nerve (the auditory nerve). Research suggests that implantation during the critical ages for speech and language development (between 2 and 5 years), is important for obtaining the best results. The earlier a child can be implanted within this "window of opportunity", the greater the likelihood that he/she will make
optimal use of a cochlear implant and achieve good speech and hearing results. However, researchers are still not able to predict how well an individual child will do following a cochlear implant.

The surgery takes two to three hours and can be undertaken on an outpatient basis or, at most, an overnight stay. The procedure is covered by most insurance companies. For an eligible child with a severe-to-profound hearing loss, cochlear implantation can significantly improve a child's success with speech development and listening but only if parents are highly motivated, and there is
a quality follow-up program available. The literature on cochlear implants is extensive. Additionally, there are a number of informative Web sites addressing all aspects of cochlear implantation.

For more information on cochlear implants, contact AG Bell to request a free copy of our brochure titled Kids and Cochlear Implants: Getting Connected. In addition, many books and informational materials are available from the AG Bell Publications department.

Will My Child Need Early Intervention? All children with hearing loss require some degree of educational and habilitative intervention. Any level of loss can create challenges for a child, especially in an academic environment. Even a child with a mild to moderate loss-provided it goes undetected or untreated- has a higher likelihood of repeating a grade than does a child with normal hearing.

Mild Loss: A child with a mild loss may have subtle problems which are not obvious either to parents or teachers. In fact, in the past, mild hearing losses have generally been overlooked as a significant factor in a child's speech and language development or academic performance. Recent studies, however, debunk this myth. A child with a mild loss will benefit from favorable acoustics, hearing aids and/or a personal FM system. Soundfield amplification may be helpful if the classroom is noisy or reverberant (echoes). Favorable
seating and lighting, as well as ongoing monitoring of language and speech development, is important as well. Depending on the level of loss, your child may benefit from speech-language therapy and speechreading skills.

Moderate Loss: A child with a moderate hearing loss will benefit from routine audiological evaluations and ongoing monitoring of speech and language development, reading, and written language. Amplification-hearing aids and
assistive devices such as personal FM systems-are imperative. Classroom acoustics should also be addressed. A child with a moderate loss will benefit from speech-language therapy to work on any language delays or difficulty in pronouncing certain sounds. If your child is not yet school age and is showing speech and/or language delays, a parent-infant or preschool program with special emphasis on developing these skills is recommended.

Severe to Profound Loss: Children with severe or profound losses should be enrolled in a parent/infant program that addresses their specific needs as soon as possible. These types of programs are outlined in the next section. When school-age, children in this category need ongoing monitoring of
speech and language progress and routine audiology checks. Hearing aids and assistive listening devices (like FM systems) are essential, as is a favorable acoustical environment. Your child may also benefit from the use of an interpreter and/or notetaker in the classroom.


Hearing loss is measured in decibels: the greater the decibel level, the louder the sound. Hearing is considered normal when a person chan hear sound at a loudness of between 0-15 decibels. The table below shows the four categories of hearing loss and the decibel level needed to detect sounds in each category.

Level of Hearing Loss Decibel Level Sound Equivalent
Mild 15-40 dB Cannot hear a whispered conversation in a quiet atmosphere at close range.
Moderate 40-60 dB Cannot hear normal conversation in a quiet atmosphere at close range.
Severe 60-90 dB Cannot hear speech; can only hear loud noises such as a vacuum cleaner or lawn mower at close range.
Profound over 90 dB Cannot hear speech; may only hear extremely loud noises such as a chain saw at close range or the vibrating component of loud sound.


© 2011 by Alexander Graham Bell Association for the Deaf and Hard of Hearing

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