The Development of a Children's Implant Profile

Abstract

The decision to provide a child with a cochlear implant is quite complex, as it must include consideration not only of the implant itself but also of the habilitative services necessary following the surgical procedure. To provide a systematic means of selecting hearing-impaired children for cochlear implants, a team at Children's Hearing Institute, Manhattan Eye, Ear and Throat Hospital, developed the Children's Implant Profile (ChIP). There is no one profile of a successful implant user—at least 11 factors appear to contribute to successful implantation. In the ChIP, each factor is evaluated on a three-point scale: (1) no concern, (2) mild-to-moderate concern, and (3) great concern. A profile showing "no concern" on all 11 factors denotes clear acceptability of the child as an implant candidate. A profile including several ratings in the "mild-to-moderate concern" category suggests a need for further study to determine if improvements could be made in projected outcomes before initiating surgical procedures. Finally, ratings of "great concern," especially on more than one factor, indicate a very limited probability of successful implant outcomes, at least at the time of evaluation. A case study is presented to demonstrate the relationship between the evaluated factors and to show how the profile is used to address and remedy areas of concern.

Cochlear Implants for Children With Significant Residual Hearing

“…4,5 The efficacy of multichannel cochlear implants for children with profound hearing loss has been well established, in terms of speech perception benefit, [6][7][8][9][10][11][12] language acquisition rates, [13][14][15] and speech production/intelligibility improvements. [16][17][18][19] Published research is now able to define the variables leading to optimum speech perception and language outcomes for children using the cochlear implant, such as younger age at implantation, [20][21][22][23][24][25][26][27] use of the most current speech processor technology, 28 a communication mode emphasizing an aural/oral approach, 10,29,30 absence of a developmental delay, 12,[31][32][33] shorter duration of profound hearing loss, 34 and preimplant residual hearing. [35][36][37] Based on outcomes and comparisons with hearing aid users, the application of implants has broadened to include children with a pure-tone average (PTA) in the range of 82 to 98 dB HL (hearing level).…”

Child and family factors associated with deaf children's success in auditory-verbal therapy

“…A questionnaire and information form were developed from a compilation of sources (3,(5)(6)(7) and the combined experiences of a committee comprised of an otolaryngologist, an audiologist, an educational psychologist, and a teacher of students who are deaf and hard of hearing. Therapists at the clinic reviewed the questionnaire and made suggestions, which were incorporated into the final questionnaire.…”

Integrated Profile to Assess Auditory Nerve-Auditory Pathway Integrity

“…Value of Speech Development Level Assessment of the API Speech development level, which is also valuable for assessing the API, is an important criterion when selecting cochlear implant candidates [7][8][9] . Speech is acquired through learning after birth.…”

“…In 1989, Gantz [6] proposed medical and surgical criteria for cochlear implantation on adults and children. Hellman et al [7] reported the Children's Implant Profile (ChIP), which was used to systematically select the candidates for cochlear implantation. Since then, the ChIP or a variant of it has now been widely used by many cochlear implant centers [8,9] .…”