Post Operatively Speech and Hearing Rehabilitation

By Sanjeev Kumar

This is the most important part of cochlear implant programme. The success of the implant depends on good speech hearing rehabilitation. The implanted child needs to understand the auditory signals perceived by his brain to comprehend the speech and communicate using acquired speech and language abilities.

Switch on
Swit ix weeks of your operation, the audiologist will fit the external speech processor and switch on the device. He will also connect it to the computer adjust the settings on your device. So as the device is switched on, the speech processor will start sending signals to the electrodes in the cochlea for the first time. After this the speech processor’s microphone is activated and the patient will hear for the first time and it is usually like buzzing sound or mechanical sounds.

Mapping
Mapping or Mapping is the term used for programming a cochlear implant according to the needs of its user.

These programs actually stimulate the electrodes of the implant and there by determine the exact amount of signal (electric activity) required for the patient to optimize the cochlear implant to any sound. The computer can thus make changes in the input to the electrodes array that is implanted into the cochlea. This is done by connecting the cochlear implant processor to a computer. By giving series of acoustic signals in form “beeps” and measuring the patient response, the audiologist adjusts the T- and C- levels for each electrode. T-Levels, or Thresholds, are the softest sounds the cochlear implant users can detect while C-Levels are Comfortable loudness levels that are tolerable for the implant users. The audiologist also adjust the stimulation rate or programming strategy that is used to translate acoustic sound into the correct combination of electrode stimulations to give the cochlear implant user the same sensation of sound which a normal person would have.

Speech and Hearing rehabilitation sessions
After your implant is ‘switched on’ the patient usually takes few weeks to get used to hearing with the implant.

The audiologists will keep on making adjustments to the computer settings as per the requirement and the performance of the child.

Along with this implanted child will receive lessons from a Speech & Hearing Therapist who will help in identifying different sounds and distinguish vowels and consonants. Rehabilitation is important stage of cochlear implant where the patient learns to make meaningful response to various sound stimuli coming to the brain. Speech therapy is an important part of rehabilitation process where the child learns about oro-motor control to produce meaningful words and sentences.

The training is usually longer and more complicated in the case of children who are born deaf. While recently deafened adults generally adapt faster to the use of their implant.

(The author is Audiologist, Cochlear Implant Program, Lok Nayak Hospital, New Delhi)