To determine if a child is a candidate for a cochlear implant, a comprehensive evaluation is conducted by a multidisciplinary team of surgeons, audiologists, speech-language pathologists, developmental psychologists and an educational liaison.
This evaluation consists of the following:
- Otoscopy – Visual inspection of the ear canal and tympanic membrane (ear drum)
– Immittance testing (tympanometry)
– Tympanometry measures the mobility of the eardrum to assess eardrum integrity and middle ear function
- Acoustic Reflex Testing
– Provides information regarding the integrity of the auditory and facial nerves in addition to middle ear function
– Otoacoustic Emissions Testing: Assess cochlear (outer hair cell) function
- Auditory Brainstem Evoked Response (ABR/BAER) Evaluation
– Measures a child’s general auditory system from the mid – high frequencies
- Auditory Steady State Response Evaluation (ASSR)
– A frequency specific measurement of a child’s auditory sensitivity from the low to high frequencies (500-4000Hz)
- Pure tone air and bone conduction testing
– Ear specific, frequency specific testing
– Often requires numerous appointments to obtain consistent and reliable results, especially in young children
– Speech Perception Testing (Dependent upon child’s speech / spoken language level)
– Testing completed to determine the child’s ability to understand speech via listening alone.
Often looks at both single words and sentences as well as in quiet and/or simulated noise
- Assessment to determine each child’s communication levels prior to cochlear implantation
- Assessment conducted to evaluate the child’s cognitive levels, attention and behavior. Requires both parents to attend.
- Conducted to assess the family structure and support as the family’s involvement in the process is imperative to maximize the child’s potential for success with a cochlear implant.
- An evaluation of the child’s support and placement within the educational system is obtained in order to insure that the child is placed in an environment that will allow for day to day use of the implant.
- CT Scan: allows the surgeon to view the bony structures in the auditory system, including the cochlear formation
- MRI Scan: allows the surgeon to view the soft structures in the auditory system, including the auditory nerve. The scan is only able to determine if the nerve is present, it is not able to indicate the integrity of the nerve or its ability to transmit the signal to the brain.
- Vision Testing
- Genetic Testing as appropriate