What to Expect Before and After Cochlear Implantation
There are a number of commitments for both patients and families before and after cochlear implant surgery at Bristol-Myers Squibb Children's Hospital (BMSCH). You will receive a plan of care and more detailed information about each of the specific appointments, including meetings with the following specialists:
- Speech language pathologist
- Pediatric development evaluation
- Psychological evaluation
The appointment with our clinical psychologist is important because it gives our clinicians — who assess your child’s developmental or thinking abilities — information about how to use different approaches to help families to cope with anxieties and changes associated with implant surgery. More than one appointment may be needed.
Medical Evaluation
Your child will be required to visit our pediatric otolaryngologists twice to obtain a full medical evaluation for CI candidacy. A visit to our pediatric medical geneticist may be required if your child’s cause of hearing loss has not been worked up before. The visits will address the following:
- Whether your child is medically a candidate for a cochlear implant
- The cause of hearing loss (genetic testing, MRI and/or CT scan)
- The surgery and risks involved
Once your child has completed the evaluation at BMSCH, we will discuss your child’s candidacy profile in our next multidisciplinary team meeting. The profile is composed of various factors including the medical, developmental, audiologic, communication, social, and educational aspects of your child. Understanding the profile helps identify areas that can be affected by change, and helps families develop.
Post-Operative Follow-up
After surgery, your child will need follow-up appointments with audiology, pediatric otolaryngology, and speech language pathology.
Audiology
Because of the quick adaptation of the hearing system, many mapping changes are needed in the first year of cochlear implant use. For this reason, there are several important follow-ups needed. The first fit should be scheduled within three to four weeks of the surgery. After the first fitting, there will be about six more follow-up appointments in the first year, then subsequent three-month intervals while children are pre-school aged; then typically in six-month intervals. Parents may schedule more appointments as needed.
Pediatric Otolaryngology
Your child will need about five follow-up appointments with our pediatric otolaryngology office after the surgery. Most of these visits can be scheduled together with the audiology visit except for the first post-op visit.
Speech Language Pathology
Our speech language pathologist will work closely with the audiology team to assess your child’s speech rehabilitation and development after the cochlear implant surgery. Typically, our speech language pathologist will see your child at the device activation (one-month) and three-month visit.
The frequency of the subsequent visits will depend on the child’s educational/school support, family needs and availability of appropriate speech therapy locally or in school. Speech, language and listening skills are then assessed on an annual basis.
Benefits and Expectations
Before children with normal hearing learn to speak, they spend over a year listening to sounds around them. Speech and language develops with time and experience. It’s best to manage your expectations around how the cochlear implant can help your child and to understand how get the maximum benefit. Here’s what you can do:
- Expose your child to a lot of spoken language by reading aloud every day and by talking about things that happen in your home and during the school day.
- Use implant consistently during all waking hours.
The guidance of an experienced speech and hearing professional is important to help parents learn the best ways to help a child make progress. With full-time use and appropriate therapy in place, expect the implant to provide useful sound and improved hearing. Patience and practice are key. Intensive and on-going auditory-based therapy is critical to your child’s success with a cochlear implant.
Every child is unique. Good family support is the key to maximize the speech and language benefits derived from cochlear implants.
