Dr. Linda Thibodeau is a Professor at the University of Texas at Dallas since 1996 where she co-directs the Pediatric Aural Habilitation Training Specialist Project. Prior to that she worked at The University of Texas at Austin, at the University of Texas Speech and Hearing Institute, in otolaryngology clinics and in the public schools. She teaches in the areas of Amplification and Pediatric Aural Habilitation. Her research at the Advanced Hearing Research Center of the Callier Center for Communication Disorders involves evaluation of the speech perception of listeners with hearing loss and auditory processing problems as well as evaluation of amplification systems and hearing assistance technology to help those persons.

Introduction

Perhaps the most challenging decision that a parent must make for their child with a hearing loss is how they will communicate. Most parents choose a communication method that relies on auditory input provided through some type of amplification or alternate stimulation, such as a cochlear implant. Research has shown that neuronal connections are rapidly forming during the first years of life, so that the sooner the amplification or cochlear implants are provided, the more likely the child will develop normally functioning acoustic pathways (Sininger, Doyle, & Moore,1999). Typically hearing aids will be the first consideration regardless of the child’s age. Bringing sound to the child either through amplification or a cochlear implant will be equally important whether the family is using only speech to communicate or a combination of speech and sign language.

If the child is receiving limited benefit from hearing aids after a four-to-six month trial and the child is over 12 months of age, a cochlear implant may be considered. One situation in which cochlear implants would be recommended without a hearing aid trial would be when a child has suffered a hearing loss as a result of meningitis (an infection of the tissue linings of the brain and/or spinal cord). Because bony growth in the inner ear may occur after meningitis and could affect proper insertion of the implant, a cochlear implant may be recommended within a few months of the child’s recovery. During the course of the journey parents will meet many professionals. Among them are:

1. Otologists or Otolaryngologists—Medical doctors who treat ear, nose and/or throat problems and perform cochlear implant surgeries;
2. Audiologists—Professionals who fit and/or provide hearing aids, cochlear implants and hearing assistive technology that aid reception of sound;
3. Speech-Language Pathologists—Therapists who teach the child and family how to develop communication consistent with developmental expectations;
4. Educators—Parent-infant advisors who come into the home or teachers in the classroom who facilitate early communication, cognitive, social and physical development; and
5. Parents—Others who have already been through many of the challenges can often respond to the concerns and celebrations in a context of their own experiences.

Some or all of these professionals will be involved in the selection and use of the hearing aids or cochlear implants. Therefore, one may consider this the beginning of a new journey with new techniques of travel and caring hosts to meet along the way. As with any journey, there are many decisions to make and much information to gather ahead of time or along the way that will hopefully lead to not only quick but comfortable travel. The process begins with the audiological diagnosis followed by the selection of each type of device. In addition to hearing aids and cochlear implants, hearing assistive technology will often be needed to help compensate for reduced sound when there is distance from the speaker or interfering background noise.

Success with amplification, cochlear implants or assistive technology will depend on not only the expertise of the audiologists to match the features of the technology to the needs of the child, but also the psychological acceptance of the devices by the family. The introduction of technology with a positive regard for the benefits it can provide is critical. Depending on the age of the child and his or her siblings, there may be opportunities to explain how hearing aids are needed by some, like glasses or braces are needed by others. When children develop a focus that the hearing devices are tools to access information rather than a mark of abnormality, they’ll be establishing a means to address challenging communication situations with openness and assertiveness. Because even the most sophisticated hearing aids or cochlear implants do not restore perfect hearing, children will need positive coping skills in addition to the technology to maximize communication. . .