What to expect - children
Referral
WEHIP receives a referral from a GP, ENT Consultant or other
healthcare professional.
Early referral is best.
Months matter. Delay in implantation and a long period of
deafness significantly affects the overall outcome. We aim to
implant children who were born deaf at around their first birthday,
when they are still at an age when learning language comes
naturally. We aim to implant adults and older children soon
after they lose all or some of their hearing, especially if they
have had meningitis, which can cause bony growth in the
cochlea.
Early referral and assessment makes a difference to long-term
outcomes.
Initial clinic visit - St Michael's
Hospital
On this visit you will meet several team members, including
Audiological Scientists, a Consultant ENT Surgeon, a Paediatrician
in Audiology and a Teacher of the Deaf or Speech and Language
Therapist. We take a medical history and talk to you about cochlear
implants. We carry out hearing tests to see if your child is likely
to do better with hearing aids or with a cochlear implant.
Sometimes this takes several visits and a hearing aid trial. If we
think your child might benefit from an implant, we will arrange for
a full assessment.
Full assessment
The full assessment takes several weeks. It includes:
- CT/MRI scans to assess the state of the cochlea, and whether
the operation is possible (it usually is!)
- Medical reports - is the child fit for surgery?
- Counselling and information visit at home with WEHIP Teacher of
the Deaf, to share and gather information. Get your questions
ready!
- Assessments at home/school by WEHIP Teacher of the Deaf and
Speech and Language Therapist. This will involve liaison with local
services, functional hearing assessments and communication
assessments.
- A visit to a Clinical Psychologist, to talk through your
feelings and expectations relating to the implant. Your child's
development, learning and cognitive abilities may be assessed.
Decision clinic
At this stage, if the team thinks your child would benefit, they
will offer one or two cochlear implants, and you will decide
whether or not you want your child to have them. Older
children and teenagers need to be included in the decision making
process. Once you've made your decision, the child will go
onto the waiting list for surgery.
If the team thinks the child is not likely to benefit from a
cochlear implant, they will carefully explain why. We can also
arrange a further follow up visit to talk things through, if you
feel that would help.
Pre-op visit
A WEHIP Teacher of the Deaf visits home/school to answer any
questions, explain what happens next and to complete the
pre-operative agreements. She will also discuss the BCIG
safety guidelines, which talks about what you can and can't do with
an implant.
Download
Safety Considerations for Cochlear Implant Users.
The operation
The operation is carried out at Bristol Children's Hospital by a
team led by our experienced surgeons, Mr Robinson or Mr Hajioff.
Both have performed hundreds of cochlear implant operations.
The operation is usually straightforward and significant
complications are rare.
Each ear
takes 2-3 hours, but your child may be away from the ward for
longer, because of the anaesthesia. The operation is
straightforward and carries very few risks. The risks will be
discussed with you. Most children make a very swift recovery and
are bouncing around at home within a couple of days. We
advise families to keep the child quiet at home (!) for a couple of
weeks.
Your child won't hear anything until the speech processor is
fitted, four weeks later.
Pre-tuning visits at home
These visits are to explain what happens next and check you are
familiar with the new technology. Your child will have a chance to
try a dummy processor. You will be given ideas to help your child
learn to listen.
Fitting the speech processor - the 'switch
on'
This is the moment your child's speech processor is
switched on for the first time. The child's processor is linked up
to a computer, and the audiologist plays a series of beeps and
buzzes to set the parameters right for your child. Most families
expect something extraordinary to happen, but it's usually very
quiet - maybe a little eye widening here, or a blink there.
A series of individual programmes will be created and loaded into
the speech processor. The early programmes are very gentle,
so as not to startle your child. Your child will hear when
they first go home, but they won't hear very much. At this
stage, they begin to learn what sound is, and that it
matters.
The first goal is for the child to wear their sound
processor. The more they wear it, the faster they will make
progress.
It takes weeks or months:
- For the audiologists to adjust the programmes so that they are
right for your child
- For your child to learn to listen and possibly talk
Follow up visits at home or school
You will have follow up visits at home or school from your
child's rehab worker, who will be a teacher of the deaf or a speech
and language therapist. These visits help to ensure your child
is making best possible use of their new hearing.
Every child is different and makes progress at their own
rate. Some children love the sound and launch straight in,
others find it more bewildering, and may need to be coaxed into
wearing their speech processors. Visits from your rehab
worker are designed to help you over any early hurdles, and to help
your child learn to enjoy listening with their new cochlear
implant. Together, you will discuss ways to help your child
progress.
Follow up visits to the hospital
In the first two years, your child will need regular 're-tuning'
of their cochlear implant by the audiologist, to ensure their
speech processor is perfect for them.
Every child is different, and the 'programmes' or 'maps' they
need in the processors are different too. It takes time and careful
testing to get the map right for your child. This means you
will visit Bristol or a more local clinic many times in the first
couple of years, and at least once a year after that. The West of
England Hearing Implant Programme offers ongoing maintenance
and support of your child's cochlear implant.
Download
Safety Considerations for Cochlear Implant Users.