CI: Navigating a Forest

Getting Started	What is a CI?	Candidacy	Performance
Decision Making	Process	Insurance	Surgery
Education	Communication	Sign Language	Deaf Community
Speech Processor	Listening	Resources	Versión en Español

By Debra Nussbaum, M.A., CCC-A
Coordinator, Cochlear Implant Education Center

Getting Started

During its early history, a cochlear implant was viewed as most beneficial for individuals who had lost their hearing after they had already developed competence in using spoken language. As the technology improved, and the risks related to the surgery lessened, use of cochlear implant technology expanded to include young children in the early language development years. As the candidacy requirements expanded and the number of implanted children increased, so did the variability in the characteristics of the children obtaining them and the outcomes in speech perception and production, spoken language, academic, psycho-social, and identity development. While the demographics of children using cochlear implant technology are wide-ranging, professional recommendations surrounding language and communication approaches for these children often do not reflect the diversity of the children using the technology.

As coordinator of the Cochlear Implant Education Center (CIEC) at Gallaudet University's Laurent Clerc National Deaf Education Center and an audiologist by training, I have worked with deaf and hard of hearing children and their families since 1977. Through my direct experiences and the opportunities to network-with families, audiologists, doctors, speech-language pathologists, school administrators, teachers, and cochlear implant users throughout the country-I have had the opportunity to discover and evaluate the wealth of excellent (and not so excellent) resources available on cochlear implants for children and adolescents. I have also had the opportunity to investigate and gather information related to effective practices to facilitate language development, social-emotional growth, and learning for the diverse group of individuals using cochlear implant technology. From these experiences, there is a clear message to share. That message is: There is no one approach that matches the characteristics and needs of all children with a cochlear implant. Each child with a cochlear implant is unique and should not be defined by the technology he or she is using but rather his or her overall needs as a child. What the CIEC has observed and said many times in interactions with professionals and families is, "If you have met one child with a cochlear implant, then you have met one child with a cochlear implant."

This web document, originally developed in 2003, is designed to assist parents and educators in navigating their way through the extensive "forest" of information available on pediatric cochlear implantation. All of the "trees" and the associated resource list were updated as of the summer of 2011 to reflect the changes that have emerged since the original document was developed in 2003. Research for this update uncovered many changes since the original document. The biggest change noted specific to the technology itself (other than updates in the internal and external devices), relates to the increase in pediatric bilateral implantation. The biggest change noted, specific to resources is the large increase in on-line professional training resources and on-line spoken language habilitation resources available at no charge. There are still only limited resources available to guide families in making language, communication, and educational choices for their children that look beyond spoken language development and reflect all areas of a child's development.

Hopefully my work scouring the Internet for resources (which took hundreds of hours) can reduce the time needed for others to find their way through the often dense forest of information on cochlear implants and provide a few new insights into this topic. Let's navigate the path one tree at a time.

~ Debra Nussbaum