The question you are probably asking yourself as your audiologist, therapist and ENT surgeon recommend cochlear implantation for your child with hearing loss is, “Why does my child need surgery?” The answer put simply is because the cochlear implant bypasses the non-functional structures of your baby or young child’s cochlea to deliver sound directly to the hearing nerve or auditory nerve and onward to the brain.
Hearing aids, no matter how sophisticated, merely make sound louder and continue to deliver this amplified sound to ear structures, which because of the hearing loss, are not completely functional.
Fitting your baby or child with hearing aids helped to keep the hearing nerve or the auditory nerve active. However, given the severity of your child’s hearing loss, s/he would not be able to hear soft sounds or understand quiet conversation or listen in noisy places with hearing aids. This would make your baby feel increasingly isolated as s/he grew, widening the gap between him or her and other children the same age. This would also deprive your child of the best learning time, because your child’s young brain is making connections to everything.
Research shows that every interaction with a baby or child facilitates connections in his or her brain to be formed. Everytime you sing, play, talk to, smile at or engage your child, you are building "the architecture" of your child’s brain. Therefore, cochlear implants are your baby’s best chance to hear sound in a manner that your baby’s brain can understand and use to grow.
Your baby’s brain is very able to adjust or re-wire itself. This quality is termed Neural Plasticity. This means that even though the cochlear implant generates an electronic signal, your baby’s brain is sufficiently plastic and will understand it as sound and respond to it using clear speech. Your baby’s brain is highly plastic in the first year of life. This ability of the brain to re-wire itself continues in the first three years of life, after which the brain is not as malleable as in infancy. It is for this reason, that in the absence of additional difficulties, children implanted before eighteen months learn, listen, talk clearly, read and enjoy music with the least diffciulty and can attend school like other children the same age. Delaying cochlear implant surgery may cause irreversible delays in your child’s development.
The only time is “now”. As sophisticated as cochlear implant technology is today, it cannot compare with the technologies of the future. In order to build a bright future for your child, you need to feed your child’s brain, now. Waiting for this elusive technolgy to materialise deprives your child of opportunities to learn and develop now. Your baby’s brain if not appropriately stimulated now, will lose its plasticity, and will be unable to avail of the benefits that future technology provides.
Further, all the leading manufacturers of cochlear implants have developed their software and systems to be compatible with future technologies. Their implant systems (which are surgically inserted) have capabilities several generations ahead of the current technology. Competent E.N.T. surgeons are confident that current surgical techniques will in no way obstruct potential changes to procedure necessitated by future technologies.Therefore, do not delay. Your child will always be able to upgrade his external Sound Processor to future technologies.
Surgery is invasive by nature and you are justified in worrying about the possible risks in putting your child through surgery at such a young age. Speak to your surgeon and s/he will explain to you that the levels of risk associated with cochlear implant surgery are the same as those related to other types of surgery. Your surgeon and your audiologist will explain the specific risks associated with cochlear implant surgery, so that you may make an informed choice.
Given that the human body has been designed with two ears, it follows that bi-lateral cochlear implantation is the preferred option, your financial situation permitting. The recommendation for bi-lateral implantation will be made by your audiologist, based on the hearing levels of your child in both ears and based on your child’s history and CT and MRI test results. Your audiologist may recommend bi-modal amplification (in which one ear is cochlear implanted and the other hearing aided) and explain to you reasons for this recommendation.
At the present time in India, funding is not available for bi-lateral cochlear implantation. Research shows that bi-lateral cochlear implantation provides significant help in localisation (i.e. being able to identify where the sound or spoken message is coming from) and also in listening in noise. Simultaneous bi-lateral cochlear implantation facilitates synchronous brain development, as both sides of the brain grow together in response to the new stimulation provided by the implants. However, it is expensive.
School, the work place and social meeting places such as restaurants, clubs and malls, where most of the day is spent, are invariably noisy environments. We know from our high-functioning adults with hearing loss, that listening all-day is extremely tiring and that listening in noise is particularly challenging. Yet, being connected to our communities and social circles is critical to personal success and our sense of belonging. Bi-lateral cochlear implantation reduces the effect of both these challenges, providing as close to optimal a hearing configuration that technology can currently offer.
Research shows that recipients who receive their second cochlear implant within a year of their first, are able to derive the maximum benefit from their bi-lateral amplification. It is recommended that your child continue to wear the hearing aid in his or her non-implanted ear so as to continue to stimulate it auditorily, in the event that you opt for bi-lateral implantation, at a subsequent date. Parents at Sound Steps, who chose simultaneous bi-lateral implantation share how thankful they are for their choice and ofcourse for their financial situation, because they saved themselves the trauma of putting their child through surgery a second time.
In the early days following device activation, families get so impressed by how quickly their child detects sound that they mistakenly assume that listening, learning and talking will happen spontaneously and that they no longer need to attend Auditory-Verbal Therapy. Mere detection of sound is not sufficient; you need to be guided to train your child to understand this electronic signal and how to respond to it verbally.The truth is that cochlear implantation does not make your child’s hearing loss disappear. Your child’s hearing loss has just become easier to manage.
Feed your baby’s brain now and enjoy his or her childhood together.
Continuing with weekly or sometimes fortnightly Auditory-Verbal Therapy sessions is critical to guiding your child to learn to listen and to applying those listening skills to learning to talk. Auditory-Verbal Therapy will continue in much the same way as it did prior to surgery, as your child’s brain is re-oriented to accessing the hitherto acoustic spoken language signal, as an electronic signal. The benefit of Auditory-Verbal Therapy pre-surgery, allows your child to retrieve this information much faster, accelerating learning. This faster pace of learning is critical, if the developmental gap is to be closed, so that your child can be like other children of the same age.
Your decision to cochlear implant your child is an investment in his or her future. Safeguard your child’s future today, by systematically saving money and dedicating it to servicing the cost of accessories and upgrades, for as long as your child cannot assume this financial responsibilty on his or her own.
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