Cochlear Implants

A "Cochlear Implant or Implantation" is a surgical procedure that implants a device into an individual’s inner ear. It takes the place of part or all the function of the damaged inner ear structures.

The goal of the implant process is to improve recognition of speech and acoustical information by converting sounds into electrical impulses that are projected over nerve endings of the 8^th cranial nerve (auditory nerve) to the central nervous system. The implanted device, however, eliminates residual hearing in the implanted ear.

"Mapping" at the time of implant, each device is individually calibrated by an audiologist to custom fit each recipient. This is called mapping the cochlear implant device.

"Demapping" is the loss of individual calibration of the device. See this fact sheet for information on static electricity producing objects that may cause the demapping of the device.

IMPLANT COMPONENTS AND FUNCTIONS:

Internal

Receiver/stimulator
Receives/sends sound to electrodes threaded through the cochlea.

Electrode array

Stimulates nerve fibers of the cochlea; sound is perceived (implanted part).

External

Microphone

Receives/captures sound.

Speech/signal processor

        Encodes electronic incoming sounds through a small computer unit worn on the body.

        Contains a small battery to provide power to the entire system.

Headset/transmitting coil covers

        The covers resemble baskets. They are held behind the ear by small magnets in the coil and receiver/stimulator.

Adapted from Cochlear Corporation, 1996; Stienberg & Knightly, 1997

PROFILE OF INDIVIDUALS WHO MAY BENEFIT FROM A COCHLEAR IMPLANT

Children	Adults
Profound sensorineural hearing loss in both ears	Severe to profound sensorineural hearing loss in both ears
Ages 2-17 years. Acquired hearing loss after learning oral language/speech (post-linguistic)	Little or no useful benefit from hearing aids
No medical contraindications	No medical contraindications
High family/child motivation and expectations Desire to be included in hearing world	Availability of adult support group
Placement in educational program emphasizing appropriate auditory supports
Adapted from Cochlear Corporation, 1996

PRECAUTIONS FOR INDIVIDUALS WITH COCHLEAR IMPLANTS

Speech processor (part that looks like a radio) should be worn securely in a cloth carrier pocket. The carrier or pocket should have a way to be closed so the processor does not fall out.

Cords should be tucked into clothing so they will not be snagged pulled or damaged.

External parts of the implant must be kept dry due to the system not being waterproof. In case of rain, a hooded raincoat and waterproof clothing should be worn.

Spare batteries and cords should be kept on hand.

Processor should be placed in a plastic bag to protect it from food and drink when eating and perspiration during activity. The device can be completely removed with parents’ approval.

SPECIFIC ACTIVITY TEACHING CONSIDERATIONS

	Avoid implant demapping due to static electric buildup by:
		Removing the external parts.
		Discharging static electricity by touching a conductive object.
		Preventing static electricity build up by using anti-static sprays on clothing and equipment or purchase shields or grounding straps for computer monitors and other technical equipment.
	Avoid activities that could result in head injuries/serious blows to implant side of the head: football, hockey, rugby, soccer, wrestling, tumbling, and other contact sports.
	Individuals activities may participate in: baseball, basketball, and swimming if the device is removed.
	Outdoor activities that pose a threat to falls or blows to the implant side of the head: climbing (outdoor/indoor) walls, repelling, rope courses, roller blading, roller skating, and skate boarding. However, with proper instruction, removal of the device, and use of a helmet these activities may be pursued.
	Camping and hiking activities require carrying types of equipment about the body may be pursued if the device is removed. While outdoors store parts in watertight containers.
	Water play/activities: boating, sailing, and canoeing remove device and place in watertight containers.
	Risky activities: rafting, tubing, skiing, and diving. Use caution when considering participation.
	Snow/cold/winter activities: skiing, snow boarding, sledding, ice skating are considered risky. Use caution when considering participation.
	While implant is off follow communication and teaching tips suggested for any deaf/hard of hearing student:

Learn some basic signs to use during instruction.

When necessary, secure a qualified interpreter to present information, as individual may need.

Position self where individual can see your lips and maintain eye contact. Do not turn your back on the individual while talking.

Do not move while giving instructions and keep instructions simple and direct.

When outdoors, position yourself so you face the sun rather than having students face the sun.

Demonstrated skill or activity.

Use visual aids or attention-getters (bright cones, jersey flags, etc.).

Teach words that are specific to a sport, game, or activity. Use posters communicating in word and picture key activity equipment, positions, and pointers.

Provide adequate lighting in the teaching environment.

Refrain from having long lines and circle formations when giving information.

Select activities that allow the student to be actively involved throughout.

Familiarize the student with the rules and strategies of the game or activity before introducing the activity to the rest of the class.

Encourage the use of what hearing the student may have. (Adapted from Schmidt, 1985)

POTENTIAL STATIC ELECTRICAL PRODUCING OBJECTS

	Clothes: Wools, synthetic fibers, acrylics, nylons, polyesters, and rayon.
	Play dress-up clothes.
	Synthetic materials: Nylon carpets, vinyl flooring, trampolines (large and small), gymnastic mats, and items covered in car upholstery, rope/climbing equipment, nylon parachutes, scarves.
	Playground equipment: Key component - plastic!
	Place the word plastic in front of each item: slides, crawl-through tubing, ball pits, sit-in cars, rocking horses, furniture/houses, coverings/bags, etc. Particularly those found at fast-found restaurant play areas; some indoor amusement areas and playgrounds.
	Motor vehicles: Getting in and out of vehicles; after movement.
	Computer/TV screens: Technology devices that create electrostatic charge.
	Surfaces: Painted, finished or varnished surfaces.

Links

Cochlear Implants in Adults and Children
The article is a draft statement from the 1995 Consensus Development
Conference on Cochlear Implants in Adults and Children. It answers
5 major questions in length about cochlear implants.

Hearing ... A New Choice for Deaf Children and Adults
Nice site that is not technical in nature, but has some good
solid information. It is an article that is designed in a question
and answer format. Very basic.

Information Sheet Home

Information on this sheet contains only suggested guidelines. Each person must be considered individually, and in many cases, a physician's written consent should be obtained.

This page was created by Linda Hilgenbrinck, Doctoral Student in Adapted Physical Education, Texas Woman's University, Summer, 1999.