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Benefits of Cochlear Implants in children

Do deaf children benefit from having a Cochlear implant and if so how? Does it give them a better future, improved opportunity for education and are there social benefits?

Research into the benefits of Cochlear Implants in children focuses on the acquisition of language. In an overwhelmingly majority of cases where children have no health issues except deafness, Cochlear implantation enhances quality of life. The earlier the implantation the more likely the child will develop hearing, speech, language and cognitive skills at a level similar to a normal hearing child. They can be educated in mainstream schools leading to the same career opportunities. Parents of implanted children report their child after implant is easier to manage, shows less frustration and interacts better socially. The child fits in and can do most of the things their hearing peers can (eg use a phone, go to the movies). Bi-lateral implantation generally gives them better sound direction and music understanding.

In 2002 there were 45,000 child cochlear implantees with 50% of these under 18 years of age.(10) Since 90% of deaf children are born to hearing parents, the parents who chose implants for their children did so because they felt they would have a better chance and more options in life if they were able to hear and speak well.(10)
• Children with Cochlear Implants are more likely to speak clearly.(6)
• Age when implant occurs is critical and needs to be in the early hearing development phase before children are two years old.(4,5,10)
• Language development in children who receive implants before the age of 12 months was greater than for those who received implants from 1 year to 2 years of age and matched the development of normally hearing peers.(5)
• Svirsky et al(9) in 2002 found that children after implant developed language at a rate which was greater than expected for deaf children and “was similar to that of children with normal hearing” and their method of learning was similar to that of hearing children.
• The Dettman et al study(5) found that children implanted before 12 months old developed language and comprehension at a similar rate to their hearing peers. And these children were significantly better than those implanted after 12 months of age.
• Children implanted before 12 months generally overtake those implanted later in terms of speech and linguistic development.(5)
• Testing linguistic development in children with implants under 2 years of age is difficult. However testing in children who are old enough to understand found that those who received a Cochlear Implant before 2 years of age did not face as many quality of life issues as those who did not receive treatment.(5)
• In 1999 a study showed that with 2 years of implant use deaf children implanted early had intelligible speech.(2)
• Visual attention in deaf children 6-13 years was considerably worse than their hearing peers. However, older children with a Cochlear Implant had caught up.(6).
• In a research on visual attention “hearing children and older deaf children using a cochlear implant reached higher levels of performance with age than did deaf children without enhanced access to sound.”(7)
• The Smith et al(7) study found that hearing/sound information is essential for the “cognitive, behavioural and social development” in children and Kochkin et al(1) found that all children implanted demonstrate better sound recognition. Therefore, a Cochlear Implant must have an impact on normal behavioural and social development.
• Children with cochlear implants who have no other development issues are able to attend mainstream schooling as opposed to specialist deaf schools and they keep up with their hearing peers.(8)
• In 1999 a study conducted by Tomblin et al(9) found that children with a cochlear implant outperformed their deaf peers as well as those who wore hearing aids in language achievement. This lead Tomblin to the conclusion that “children who receive Cochlear Implants benefit in the form of improved English language comprehension and production.”
• The greatest benefits of using a Cochlear implant at school were seen as the awareness of sounds, hearing music, language, the teacher and better able to participate.(10)
• The greatest frustrations of using a Cochlear implant were seen as other people expect the child to be fully hearing, background noise, batteries dying, teasing by other children and the processor falling off.(10)
• In the Christiansen et al study(10) very few reported psychological difficulties after implantation.
• In a study of 17 students who had had cochlear implants between the ages of 5 and 11 years it was found:(11)

Open-set speech perception All children got 26% to 100%
Speech intelligibility All scored 90% or higher
Language & reading compared to normal hearing children 65% within average for language

>70% within average for reading

• Sydney Cochlear Implant Centre (SCIC) has implanted more than 600 children.(12)
- 90% of them attend a normal school
- Speech intelligibility is good for those who were implanted under 2 years of age
- ½ the children were within or above the normal range for word reading efficiency

• Research by Khan et al(13) showed that children with a Cochlear Implant had the same non-verbal cognitive level as hearing children. However, hearing impaired children without implants were below the other two groups.
• Bi-lateral implantation in children may result in unconscious acquisition of language mirroring the way normal hearing children learn.(4)
• Cochlear’s Parents Guide(14) says that in response to the question “Describe how your child’s behaviour has changed since receiving a cochlear implant,” parents answered
• more self-confident
• much calmer
• less frustrated
• much more social
• less aggressive
• easier to manage
• relies on hearing and can speak intelligibly, so interacts much more readily with others
• participates in neighbourhood activities with hearing peers
• less fearful

Most of the issues deaf children face; social interaction difficulties, behavioural issues, language and communication difficulties, poor education and so on, come about because these children have poor linguistic skills.

The significant benefit a Cochlear Implant gives to children is the ability to learn language and with language comes good speech and communication skills thus reducing the negative impacts deafness brings giving them the foundations upon which to build their life.

(1) Kochkin, S; Luxford, W; Northern, J; Mason, P; Tharpe, Anne Marie; Hearing Review September 2007: Are a million dependents with hearing loss being left behind? http://www.betterhearing.org/pdfs/marketrak7-children.pdf Accessed 6/8/08
(2) O’Donoghue, Gerard M; BMJ 1999: Hearing without ears: Do cochlear implants work in children? http://www.bmj.com/cgi/content/full/318/7176/72 Accessed 7/8/08
(3) American Academy of Audiology: Cochlear Implants in Children, http://www.audiology.org/publications/documents/positions/PedRehab/cochlear.htm Accessed 7/8/08
(4) Kochkin, S; July 2005: MarkeTrak VII: Hearing Loss Population Tops 31 Million People http://www.betterhearing.org/pdfs/MarkeTrak7_Kochkin_July05.pdf Accessed 7/8/08
(5) Dettman, S, Pinder, D, Briggs, R, Dowell, R and Leigh, J; Communication Development in Children Who Receive the Cochlear Implant Younger than 12 Months - Risks versus Benefits 0196/0202/07/282 Supplement-0011S/0 • Ear & Hearing • Copyright © 2007 by Lippincott Williams & Wilkins • Printed in the USA
(6) Tye-Murray N, Spencer L, Woodworth GG, University of Iowa Hospitals and clinics; Acquisition of speech by children who have prolonged cochlear implant experience. http://www.ncbi.nlm.nih.gov/pubmed/7596098?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=2&log$=relatedarticles&logdbfrom=pubmed Accessed 7/8/08
(7) Smith L, Quittner A, Osberger MJ, Miyamoto R; American Psychological Association, 1998 Audition and visual attention: The developmental trajectory in deaf and hearing populations http://psycnet.apa.org/?fa=main.doiLanding&doi=10.1037/0012-1649.34.5.840 Accessed 7/8/08
(8) Miller Bethany; 2008; I believe in Miracles http://www.c-a-network.com/bethany.php Accessed 7/8/08
(9) Svirsky M, Robbins A, IllerKirk, Pisoni D, Miyamoto R; Association for Psychological Science: Language Development in profoundly Deaf Children with Cochlear Implants http://www3.interscience.wiley.com/journal/120705475/abstract Accessed 7/8/08
(10) Christiansen J, Leigh I, 2002 Cochlear Implants in Children: Ethics and Choices Washington, DC: Gallaudet University Press Accessed 7/8/08
(11) Moog J; 2202 Changing expectations for children with Cochlear Implants http://cat.inist.fr/?aModele=afficheN&cpsidt=13684402 Accessed 7/8/08
(12) Sydney Cochlear Implant Centre http://www.scic.nsw.gov.au/showarticle.asp?faq=2&fldAuto=52&header=header2 Accessed 7/8/08 http://www.scic.nsw.gov.au/pdf/scic_research_review_2002.pdf Accessed 7/8/08
(13) Khan S, Edwards E, Langdon D; Department of Psychology Royal Holloway University of London and Cochlear Implant Programme 2005; The Cognition and Behaviour of Children with Cochlear Implants, Children with Hearing Aids and Their Hearing Peers: A Comparison http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=AUD2005010002117 Accessed 7/8/08
(14) Cochlear Ltd; Parents’ Guide A handbook for Parents Considering a Nucleus Cochlear Implant for their Child.

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