Impact of Cochlear implants in children with hearing impairment

Hearing impairment has a significant impact on the child and his family. This impact is seen on every aspect of life including cognitive, communication, psychosocial, educational, and personality development as well as on financial condition of the family. Considering the wide ranging impact of hearing impairment early identification and intervention during the critical learning years, has been found to be very important to minimize the impact of the hearing impairment in the child’s over all development.


With the recent advances in hearing technology including cochlear implants, children with severe to profound hearing loss have access to most of the sound of spoken language. Most of children who are born deaf of hard of hearing can learn to listen to their own voices, listen to the voices of others and listen to the sounds of life1.


It is important to know about impact of cochlear implants in young children as it involves high cost, surgery, and a high level of family expectations. Factors including age at onset of deafness, age at implantation, amount of cochlear implant experience, and educational training determine the overall benefits a child will have post cochlear implantation. Following sections will highlight the various impacts on the children’s lives post implantation of cochlear implants.

Auditory skills - children with cochlear implants achieve performance levels that exceeded those of their non-implanted peers who used other sensory aids, including conventional hearing aids and vibrotactile aids.2 The improvement of hearing in terms of purely audiological performance is remarkable: audiological tests including monosyllabic word and sentences tests show a noticeable increase in open word recognition after implantation of cochlear implants3. The improved auditory skills enhance the opportunity for acquisition of speech and language.

Speech and language - Children with cochlear implants often achieve speech, language, and reading skills equal to those of their peers4. Studies have shown improvement in speech production skills and overall speech intelligibility in children with prelingual deafness5.  These children have greater likelihood of acquiring oral language6. Children who use cochlear implants develop language at a faster rate than children with similar degrees of hearing loss who use hearing aids7. The improved speech and language skills facilitate academic development as both are complementary to each other.

Academic development – With the enhanced language skills there is enhanced engagement and integration in primary education leading to greater scholastic achievement. This leads to enhanced social versatility and robustness permitting a successful transition to secondary education. Primary factors associated with the development of literacy in children with profound hearing impairment who are orally educated are good use of residual hearing, early amplification and educational management8. Children with cochlear implants have greater likelihood of being integrated in regular school.9 Children with cochlear implants frequently read better than peers who utilize hearing aids. The enhanced educational qualifications allow greater opportunities in further education and employment.  

Psycho-social – The greater likelihood of higher education and employability leads to enhanced social independence and quality of life in adulthood for persons with cochlear implants.  Even preschool children using cochlear implants can attain overall quality of life measures similar to their normal hearing peers10. Children with six years of cochlear implant use have reported high satisfaction, indicating good levels of well being and self esteem, as well as above average scores in achievement, demonstrating success in academic functioning and peer relations. Overall children with cochlear implants do not view themselves as “less healthy” than their normal hearing peers11. The quality of life measures have shown that there is increased quality of life with decreased age of implantation while it increases with increase in duration of cochlear implant use. Parents have perceived cochlear implants to have positive effects on self-reliance, communication, general functioning and social relations especially of their children.12

Thus we find that cochlear implant may act as panacea for the children with severe to profound hearing loss and may act as a catalyst for the development of speech, language, literacy skills as well as social skills in this population. There is a need to study the impact of cochlear implants in children in India as already about ten thousand implantation have been done and such study will provides us data to analyze the efficacy of cochlear implants and will help us to create awareness among people as well as in formulation of policies.

References:
  • Warren Estrabooks, 2000. Talk and Sing songs for Hearing Impaired Children      
  • Miyamoto, R.T., Robbins, A.M., Osberger, M.J., Todd, S.L. (1995). Comparison of tactile aids and cochlear implants in children with profound hearing impairments. Am J Otol, 16:8-13.
  • Fetterman BL, Domico EH., 2002. Speech recognition in background noise of cochlear implant patients. Otolaryngol Head Neck Surg,126(3): 257-63.
  • Tomblin, JB, Barker, BA, Spencer, LJ et al., 2005. The effects of age at cohlear implant initial stimulation on expressive language growth in infants and toddlers. J Speech Lang Hear Res, 48(4):853-67.
  • Osberger, M.J., Robbins, A.M., Todd, S.L., Miyamoto, R.T. (1993). Speech production skills of children with multichannel cochlear implants. Advances in cochlear implants (pp. 503-508). Manz, Vienna: Datenkonvertierung, Reproduktion und Druck.
  • Geers AE. Speech, language, and reading skills after early cochlear implantation, 2004. Arch Otolaryngol Head Neck Surg, 130(5):634-8.
  • Svirsky, M., Robbins, A., Iler-Kirk, K., Pisoni, D., & Miyamoto, R.(2000). Language development in profoundly deaf children with cochlear implants. Psychological Science, 11, 153–158.
  • Geers, A., & Moog, J. (1989). Factors predictive of the development of literacy in profoundly hearing impaired adolescents.Volta Review, 91, 69–85
  • Daya H, Ashley A, Gysin C, Papsin BC., 2000. Changes in educational placement and speech perception ability after cochlear implantation in children. J Otolaryngol, 29(4):224-8.
  • Andrea D. Warner-Czyz, Betty Loy, Peter S. Roland, 2009. Peter S. Roland, 2009. Parent versus child assessment of quality of life in children using cochlear implants. Int J Pediatr Otorhinolaryngol. 73(10): 1423–1429.
  • Rachel L. Meserole, Christine M. Carson, Anne W. Riley et al, 2013. Assessment of health-related quality of life 6 years after childhood cochlear implantation. Qual Life Res. DOI 10.1007/s11136-013-0509-3.
  • K. Huttunen, S. Rimmanen, S. Vikman et al., 2009. Parents’ views on the quality of life of their children 2–3 years after cochlear implantation. International Journal of Pediatric Otorhinolaryngology. 73, 1786–1794
‘ Contributed by : Md. Noorain Alam, Clinical Assistant (Speech & Hearing), Composite Regional Center, Ahmadabad. Email- noorain.aslp@gmail.com

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