Hearing rehabilitation is usually initiated with conventional acoustic hearing aids, which are intended to be used throughout the period of being awake. If the child benefits from the aids, he/she will learn to listen and react to the environment’s sounds and speech by making sounds. If the adoption of speech and language proceeds properly, it can be said that the devices are the suitable aid for the child. But if such hearing cannot be achieved with the device, which is sufficient for spoken language learning, a cochlear implant is considered.
Before a cochlear implant/implants surgery is considered, a variety of examinations are carried out. Among the most important is a hearing test for establishing the level of the child’s hearing. There are several different kinds of hearing tests that can be carried out, both clinical ones and ones based on observation.
An important examination before a cochlear surgery is the ABR test, which examines the automatic auditory brainstem response. The examination is painless and it takes approximately 30–40 minutes. The child must be asleep during the examination.
In the case of severe hearing loss, the cause of the hearing impairment, and any other potential diseases, are also aimed to be determined. The child will usually get a referral an ophthalmologist, paediatric neurologist and for genetic studies. Before the surgery, magnetic resonance examinations and a computed tomography should also be done, which will determine the structure of the inner ear, auditory nerve and the brain. In this way, any possible structural impediments for the cochlear implant are also identified.
The multidisciplinary working group at the Hearing Centre will consider the child’s opportunities to benefit from the cochlear implant. The working group will discuss with the parents the implant activity, constraints and opportunities, as well as related intense rehabilitation related with the implant therapy. However, the final decision for surgery is always made by the parents. The use of cochlear implants requires parental commitment to long-term rehabilitation.
Even when considering implants, as well as after the decision for surgery, it is good to meet other parents of children with cochlear implants. Peers can exchange thoughts related to surgery, rehabilitation and language, as well as gain understanding and support for issues of concern and possible fears.