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OPINION: Hear to communicate: A journey from silence to sound

"I can't imagine the disconnect with the world my hearing impaired daughter and father have. It must be frustrating, lonely and frightening not to hear all the sounds or part of the sounds the world has to offer," stated Marc.

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"I can't imagine the disconnect with the world my hearing impaired daughter and father have. It must be frustrating, lonely and frightening not to hear all the sounds or part of the sounds the world has to offer," stated Marc.
"Yes, but technology has come a long way. Cochlear implants are making advancements by leaps and bounds," I said.
"I am interested in knowing more," Marc replied.

"A Cochlear Implant (CI) is a surgical device which stimulates the auditory nerve via a direct electrical impulse implanted in the cochlea. It does not result in 'restored' or 'cured' hearing, but provides the perception of sound sensation. It has external and internal components which work together to provide the wearer the perception of sound. Cochlear implants differ from hearing aids because they bypass the cochlear hair cells which are damaged and directly stimulate the auditory nerve."

"What are the qualifications for my dad and daughter?" Marc asked.

"A medical workup is necessary to insure that your daughter and father are good candidates medically. You'll be glad to know this surgery is considered a minor same day operation. A short recovery period is typical for most patients. One must qualify to be implanted. This occurs via an audiologist who is part of a cochlear implant team. Adult candidates are growing in numbers annually. According to the FDA, adults can now be considered candidates if they have a severe-to-profound hearing loss and understand less than 50 percent of sentences spoken to them. They must have realistic expectations, be motivated to learn to hear and there are no medical contradictions for surgery. These adults who have already developed speech skills are often dependent on their hearing aids for any amount of sound they are able to perceive. They are seeking more sound than the hearing aids provide. The cochlear implant can possibly allow the wearer to hear more overall even at a distance or over the phone.

The criteria for children has changed from 18 months to 12 months of age. CI assists in providing the child the ability to understand sound meaning. This occurs only after we, the CI team, have determined the child is not progressing in acquiring speech/language skills utilizing powerful hearing aids. CI provides the opportunity for many children to acquire age appropriate speech skills with less effort than hearing aids.

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CI are covered by Medicare, Medicaid and most third party payers (insurance). They have been covered for years so payment sources are not new. The CI team will help navigate the reimbursement portion.

For both children and adults, rehabilitation after implant is highly recommended. Initially speech may sound 'weird like Charlie Brown's teacher' or 'robotic'. However, after programming the processor (mapping) and providing families with the correct rehabilitation, counseling (prior and after), practice and patience, the journey from silence to sound occurs. The rehabilitation process consists of your brain learning/relearning environmental sounds including doorbell rings, birds chirping and of course speech. Informal training consists of wearing daily to learn how to hear with your CI and formal training is often carried out, mostly for children, by speech therapists, aural rehabilitation specialists or deaf educators.

This is a very small glimpse into the CI world, but if you are interested, seek out an Audiologist, Speech Language Pathologist, counselor, or CI surgeon who are part of the team."

"I will and thanks!" exclaimed Marc.

-- Dr. Patricia Larson-Shields, of Mitchell, is a doctor of audiology and a speech language pathologist.

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