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Cochlear Implants: Navigating a Forest of Information...One Tree at a Time
tree-Getting Started
Getting Started

This document was developed as part of KidsWorld Deaf Net (KWDN), a national communication network sponsored by the Laurent Clerc National Deaf Education Center at Gallaudet University with support from the AT&T Foundation.

Growing numbers of children and families from a variety of backgrounds and using a variety of communication methodologies are choosing use of cochlear implant technology.

More than 700 professionals involved with cochlear implants attended the February 2001 symposium on Cochlear Implants in Children, hosted by the House Ear Institute in Los Angeles. Of note is the fact that just five years before, this conference attracted only 20 people.

During its early history, a cochlear implant was felt to be most beneficial for adults, especially adults who had lost their hearing later in life. As the technology has improved and the risks related to the surgery have lessened, use of this technology is increasing for a growing population of persons with hearing loss, specifically young children who are implanted prior to learning language.

As the number of implanted children has increased, so has the variability in student outcomes related to the use of spoken language. Many long-term outcomes continue to be unknown due to the changing characteristics of both the cochlear implants themselves and the children who are receiving them. Cochlear Implants are improving in their potential to provide implant users with increasingly sophisticated sound-processing systems. In addition, the pool of children receiving cochlear implants is growing quickly in number and diversity and now includes greater numbers of students implanted at younger ages than in the past. All of these factors make early research difficult to apply to the outcomes for the new generation of students obtaining cochlear implants.

Variability in student outcomes with cochlear implants necessitates a look at educational and communication programming for these students through the same lens that we look at variability in the population of deaf children who do not use cochlear implants. Just as there is no single profile of a "deaf" child, there is no single profile of a deaf child with a cochlear implant. As professionals provide information and families make decisions about cochlear implant technology, there are many things to consider ranging from the medical aspects of the procedure and educational and communication aspects of the technology, to the practical, day-to-day life issues surrounding the implant.

As coordinator of the Cochlear Implant Education Center at Gallaudet University's Laurent Clerc National Deaf Education Center and an audiologist by training, I have been working since 1977 with deaf children and their families. Through my direct experiences and the opportunities to network—with families, audiologists, doctors, speech-language pathologists, school administrators, teachers, and cochlear implant users throughout the country—I have had the opportunity to discover and evaluate the wealth of excellent (and not so excellent) available resources on cochlear implants for children and adolescents.

This Web document is designed to assist parents and educators in navigating the way through this extensive "forest" of information. It additionally provides insights into topics where the Web has limited information—specifically educational considerations related to the diverse group of children with cochlear implants now assimilating into our schools. As you read this document, keep in mind that while cochlear implants provide a range of opportunities, they are not appropriate for every deaf child. It is important that decisions to utilize this technology be made looking at the whole child within the family unit and with respect for individual choice.

Hopefully, my hours of investigating resources can cut down on the time needed for others to find their way through the often dense forest of information on cochlear implants, as well as provide a few new insights into this topic. Let's navigate the path one tree at a time.

Note: These modules are not in a specific order.

yellow tree What is a Cochlear Implant? Includes:
Components of the Device
How an Implant Works
blue tree Cochlear Implant Candidacy Includes:
Who is a Candidate?
Who is Not a Candidate?
Other Factors Impacting Candidacy
green tree Factors Influencing Performance Includes:
The Benefits and Limitations of Cochlear Implants
Performance: Things to Keep in Mind
Factors Impacting Performance
In Summary
red tree The Decision-Making Process Includes:
Realistic Expectations
Level of Commitment
Looking at the Whole Deaf Child
Including Older Students
Gathering Information
yellow tree Considerations in the Implantation Process Includes:
Beginning the Process
What's Involved in the Process?
Choices During the Implantation Process
Things to Ask the Cochlear Implant Center
blue tree What About Insurance? Includes:
Issues Related to Coverage
Six Services Associated with Cochlear Implantation
green tree Surgical Considerations Includes:
During Surgery
After Surgery
Associated Risks
red tree Choosing an Educational Setting Includes:
Placement Options
Considerations for Making Decisions
yellow tree Choosing a Communication Methodology Includes:
Issues to Keep in Mind
Communication Environment
Blue tree Considerations for the Use of Sign Language Includes:
The Debate
Growing Support for the Use of Sign Language
Basic Beliefs
Reasons to Consider Sign Language Use for Children with a Cochlear Implant
Varied Roles of Sign Language
What Literature Reports About Sign Language and Cochlear Implants
Considerations for Educational Placement
Developing Spoken Language in Signing Environments
green tree Cochlear Implants and the Deaf Community Includes:
Definition of the Deaf Community
Definition of Deaf Culture
Deaf Community View on Cochlear Implants
National Association of the Deaf Position Paper
red tree Fitting the Speech Processor Includes:
Setting a Map
Speech-Processing Strategies
yellow tree Training the Ear to Listen Includes:
Considerations for Training
Equipment Troubleshooting
The Stages of Listening and Speaking Development
Skill Assessment
Curriculum Guides
Adjusting Communication Variables
Sign Language as a Support to Listening
About Auditory-Verbal Therapy
Blue tree Resources

Includes:
Manufacturer Information
Agencies/organizations
Web Resources
Suggested Scales of Development and Assessment Tools
Computer Software for Developing Spoken Language Skills
Curricula/Training programs
Books
Additional Resources

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