Cochlear Implants in Special Cases: Deafness in the Presence of Disabilities and/or Associated Problems

Abstract

The aim of the present study is to construct a reference model with the indication for the attitude, the requirements and the resources needed in order to be able to deal with deafness in the presence of disabilities or associated problems. The study group consisted of 13 adults and 18 children affected by profound deafness, with associated problems and disabilities, who were implanted with Clarion® and Med-El® devices. Selection criteria for candidacy to cochlear implantation and counselling, hospitalization, fitting and speech therapy/rehabilitation are described. Findings were assessed evaluating: (i) use of acoustic feedback, on the ground of Erber's model; (ii) self-sufficiency: assessed by a questionnaire; and (iii) social and family relationships: qualitative judgment based on direct observation, analysis of drawings and structured interviews with family teachers and therapists. The whole group showed benefit from cochlear implantation, with particular satisfaction for post-lingual deaf-blind adults, as well as for subjects with associated psychopathologies and mental retardation. In conclusion, cochlear implants can improve life quality in profoundly deaf subjects with associated disabilities, increasing both listening and communication skills as well as self-sufficiency while family and social relationships tend to remain stable.

Cross-modal plasticity in cuban visually-impaired child cochlear implant candidates: topography of somatosensory evoked potentials

“…While one might consider the sample size small for supporting the results, we hold that, given the diffi culty of studying visually-impaired deaf children, [9][10][11][12] the cohort studied is actually rather substantial. It is important to underscore that results were consistent in the 12 CI candidates compared to healthy children; there was no expansion of SEP N20 response in the control group, but this occurred in every CI candidate and in the grand-average map.…”

“…[9][10][11][12] It has been demonstrated that CI is less effective if the child is implanted late, when there is greater cortical reorganization in the auditory cortex. [1,34] It has been posited that implant effectiveness is greater in deaf-blind persons, even with long duration.…”

“…[6] There are few published papers on deaf-blind children, all case descriptions, providing limited information. [9][10][11][12] Saeed et al of the Manchester Cochlear Implant Programme studied the largest sample of deaf-blind subjects: 10, 2 of whom were children. [10] We have not found published papers on neuroplasticity in deafblind children that assess dual sensory deprivation-specifi cally cortical reorganization of touch in auditory and visual areasaddressing its possible implications for progress or effectiveness of rehabilitation in deaf-blind children who receive a cochlear implant (CI).…”

A Look at the Other 90 Per Cent: Investigating British Sign Language Vocabulary Knowledge in Deaf Children from Different Language Learning Backgrounds

“…This is further compounded by the existence of additional needs in approximately 30-40% of deaf children (Lesinski et al, 1995;Fortnum et al, 2002;Filipo et al, 2004) although this number is confounded by differing definitions of what constitutes these needs (McCracken & Turner, 2012). Among the most frequently observed needs are learning disabilities, visual impairment, specific learning disability, dyslexia, cerebral palsy and emotional/behavioral problems (McCracken, 1998 It has been established from research on hearing children that specific language impairment and dyslexia, as well as disorders that primarily affect non-linguistic cognition, including Down Syndrome, Autism, Williams Syndrome, can impact on vocabulary acquisition and phonological production (Condouris, Meyer & TagerFlusberg, 2003;Luyster, Lopez & Lord, 2007;Scarborough, 1990;Schwartz, 2009).…”

Cochlear Implants in Children: A Review

“…Similarly, a further study of children with a variety of disabilities, such as attention-deficit disorder, cerebral palsy, central auditory processing disorder, dyspraxia and autism, showed some speech perception skill development at a slower rate than for the general population (Waltzman et al, 2000). Children whose additional disability is mild can derive significant benefit from cochlear implants, whereas children with more severe disabilities have much less favourable outcomes, with some showing almost no progress (Edwards, Frost & Witham, 2006;Filipo et al, 2004;Hamzavi et al, 2000;Meinzen-Derr et al, 2011;Vlahovic & Sindija, 2004). Most studies have highlighted that children with additional disabilities require longer periods of implant use before demonstrating any benefit, and as for children in the general cochlear implant population, variation in outcomes is wide for children with additional disabilities (Hamzavi et al, 2000;Waltzman et al, 2000).…”