After receiving a cochlear implant, one of the most important steps to hearing is rehabilitation. Rehabilitation, the process of actively learning to hear with an implant, is important for both children and adults after implantation. Routinely practicing hearing skills can help provide faster and better improvement in hearing abilities.
MED-EL's Rehabilitation Team explains how children with cochlear implants can learn to speak as well as their peers.
In what circumstances are cochlear implants (CIs) suitable for a child?
CIs are considered for children diagnosed with a type of hearing loss known as sensorineural at a severe to profound level in one or both ears. In some countries, children with moderately severe sensorineural hearing loss may also be considered when insufficient benefit is derived from hearing aids. Access and commitment to auditory training, also known as (re)habilitation is very important, too.
Why is auditory training necessary?
After a CI is fitted, a person receives stimulation that provides a message of sound to their brain. An understanding of this message isn’t necessarily immediate, and skills for understanding these sounds need to be practised. During auditory training, CI users learn to recognize sounds and words, gradually improving over time. For adults, the average rehabilitation period takes six to 12 months, but for young children, (re)habilitation programmes often last for several years, as this is a critical time for speech and language learning.
How does the training of babies and young children who have never been able to hear differ from the rehabilitation of adults?
The process of a child learning to speak is complex and relies heavily on their ability to hear. Babies must have adequate access to all the sounds of speech and numerous opportunities to listen to spoken language before they, in turn, can develop it. If a child is fitted with a CI in the early years of life, their habilitation model can follow a development that’s very similar to the way children without hearing problems would learn to listen and speak. The brain is born ready to receive sound and is in a sensitive period for language learning.
For people who lose their hearing after learning to speak, the rehabilitation model will follow a re-learning pathway, where sound provided by the CIs is shaped to match their pre-existing knowledge of spoken language.
How can implanted children be best supported in learning to speak?
A team approach is most effective with support from the surgeon, audiologist, speech and language pathologist and rehabilitation specialist, as well as the family and teachers. The family’s role is extremely important. Listening, speech and language are learnt through abundant, meaningful exposure, so families must be given the right information on suitable strategies to achieve this. For a baby or a young child, this may involve singing songs to stimulate particular speech sounds that they don’t yet have in their repertoire, or playing games and activities that include certain features of language. It’s a case of closely monitoring the child’s progress while incorporating specialist knowledge, and adapting goals to further improve the child’s outcomes.
Can deaf children with implants learn to hear and speak as well as their normal-hearing peers?
In the early years of a child’s life, the brain is at its most adaptable, ready to receive sound and develop language. With early cochlear implantation and rehabilitation, this prime period for development can be maximised, and deaf children with CIs have the potential to achieve listening and speaking skills that are comparable to those of their peers who don’t have a hearing impairment.