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How Do I Know if the Cochlear Implant is Working?. Gail S. Murray, Ph.D., CCC-A Associate Professor, CWRU Director, Audiology Services Clinical Director, Cochlear Implant Program UH Case Medical Center Rainbow Babies & Children’s Hospital August 5, 2009 Gail.murray@uhhospitals.org.

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Gail S. Murray, Ph.D., CCC-A

Associate Professor, CWRU

Director, Audiology Services

Clinical Director, Cochlear Implant Program

UH Case Medical Center

Rainbow Babies & Children’s Hospital

August 5, 2009

Gail.murray@uhhospitals.org

introduction
Introduction
  • Cochlear Implant Manufacturers
    • Cochlear Americas (Nucleus)
    • Advanced Bionics (AB)
      • Also known as Clarion
    • Med-EL
introduction4
Introduction
  • Each manufacturer supports multiple sound processor models.
  • Each manufacturer has “current” sound processor technology that is back-ward compatible with “older” implant technology.
  • Each sound processor requires slightly different troubleshooting procedures.
troubleshooting made easy
Troubleshooting made easy . . .

Identical Main Modules

Different Controllers

recommendations for schools
Recommendations for Schools
  • At least one person at school become familiar with the student’s sound processor.
  • Learn the model name of your student’s sound processor.
  • Learn the components or parts of the sound processor by name.
  • Practice preventative maintenance
troubleshooting toolbox
Troubleshooting Toolbox
  • Be prepared to troubleshoot
  • Work with the parents & audiologist to have the following on hand:
    • Appropriate back-up batteries
    • Appropriate battery holder/rack
    • Monitor Headphones
    • Signal Check
    • Back-up transmitting cables
    • Lapel or Auxiliary Microphone
nucleus freedom standard bte sound processor
Nucleus Freedom Standard BTE Sound Processor
  • Sound Processing Module
  • Microphone(s)
  • Transmitting Coil/Cable Coil
  • Coil & Magnet
  • Controller
  • Batteries or Rechargeable Battery Module
nucleus freedom body worn sound processor
Nucleus Freedom Body Worn Sound Processor
  • Sound Processing Module
  • Microphone(s)
  • Transmitting Cable/Coil
  • Coil & Magnet
  • Controller
  • Controller Shoe & Cable
  • Batteries or Rechargeable Battery Module
nucleus esprit 3g sound processor
Nucleus Esprit 3G Sound Processor
  • Sound Processor
  • Microphone(s)
  • Transmitting Cable/Coil (missing in slide)
  • Coil & Magnet
  • (missing in slide)
  • Controls
  • Battery module
advanced bionics harmony bte sound processor and components
Advanced Bionics Harmony BTE Sound Processor and Components
  • Sound Processing Module & Controller
  • Microphone & Ear Hook
  • Transmitting Cable/ Coil
  • Coil & Magnet
  • Rechargeable Battery Module
advanced bionics harmony bte sound processor and components13
Advanced Bionics Harmony BTE Sound Processor and Components

There are two other models of BTE processors

Auria

Platinum/CII BTE

med el ear level speech processors
MED-EL Ear-level Speech Processors
  • Tempo+/OPUS 1
    • Program/volume switches
    • Sensitivity dial
  • OPUS 2
    • Switch free design
    • FineTuner™
med el tempo bte sound processor
MED-EL Tempo+ BTE Sound Processor
  • Sound Processing Module & Controller
  • Microphone(s)
  • Transmitting Coil & Magnet
  • Transmitting Cable
  • Ear Hook
  • Battery Module
med el opus bte sound processor
MED-EL Opus BTE Sound Processor
  • Sound Processing Module & Microphone(s)
  • Coil & Magnet
  • Transmitting Cable
  • Earhook
  • Battery Module
  • Connecting piece
basic troubleshooting concepts
Basic Troubleshooting Concepts
  • Establish a two-way communication & notification method with the student’s parent.
  • Incorporate an action plan for daily equipment checks into the student’s IEP
basic troubleshooting concepts18
Basic Troubleshooting Concepts
  • Establish reliable speech-base feedback tools to use for daily listening check.
    • Ling 6 sounds test (aa, oo, ee, sh, ss, mm)
    • Closed set spondees (baseball, airplane)
    • Closed set words (colors, familiar names)
    • Open set words/sentences (What did you eat for breakfast; Who drove you to school).
cochlear implant accessories to have on hand
Cochlear Implant Accessories – to have on hand
  • Monitor Headphones
  • Lapel or Auxiliary Microphone
  • Signal Check or System Sensor
  • Battery Charging System
  • Earhooks (T-Mic, Direct Connect, etc)
  • Audio or Interface Cables
  • User Manual (CD)
nucleus freedom bte accessories
Nucleus Freedom BTE Accessories
  • Monitor Headphone
  • Lapel or Auxiliary Microphone
  • Signal Check/System Sensor
  • Battery Charging System
  • Earhooks (T-Mic, Direct Connect, etc)
  • Audio or Interface Cables
  • User Manual (CD)
sprint body worn accessories
Sprint Body Worn Accessories
  • Monitor Headphone
  • Lapel or Auxiliary Microphone
  • Signal Check/System Sensor
  • Battery Charging System
  • Audio or Interface Cables
  • User Manual (CD)
freedom sound processor help messages24
Freedom Sound ProcessorHelp Messages
  • H1 = Battery flat
    • Check for proper battery insertion
    • Change batteries; change battery holder
  • H2 = Battery low
    • Change batteries
  • H3 = Coil error
    • Check for proper coil insertion & placement
    • Check for cable damage
    • Change coil
freedom sound processor help messages25
Freedom Sound ProcessorHelp Messages
  • H4 = Sound/stimulation error
    • Turn processor “Off”, “On”
    • Check/change microphone protector cover
    • Check/change coil
    • Check sensitivity & volume settings > 0
    • Use the lapel microphone to sound processor check microphone
    • Contact parent &/or student’s cochlear implant center
freedom sound processor help messages26
Freedom Sound ProcessorHelp Messages
  • H5 = MAP corrupt
    • Try alternate program
    • Contact student’s cochlear implant center
  • H6 = RF interference
    • Contact student’s cochlear implant center
harmony bte 3 color help messages
Harmony BTE 3 Color Help Messages
  • Red:
    • A communication error with implant
    • Processor/ear is mismatched
    • Headpiece off or loss of communication
  • Green:
    • Microphone is working
    • Program slot is empty
  • Orange:
    • Battery is low
    • Battery needs to be changed/dead
    • Battery charge status
med el verifying normal equipment function
MED-EL: Verifying normal equipment function
  • The red LED will illuminate 4-5 seconds when the processor is first activated (brief flashes for Opus 2)
  • This uploads the map, & performs a diagnostic check.
  • LED light continues to blink only when communicating a problem.
led indicator in med el processors
LED Indicator in MED-EL Processors
  • Processor status
  • Program errors
  • Low battery
  • Flashing patterns can be deactivated by the CI audiologist
finetuner tips
FineTuner Tips
  • Not needed during the day unless:
    • Child has need of the telecoil feature
    • Child needs to make a program or volume change
  • If processor batteries are changed, it reverts to the same settings previously in use
    • One exception: Telecoil on reverts to mic on
basic troubleshooting concepts33
Basic Troubleshooting Concepts
  • Check for power
    • Processor turned on & in proper program
    • Check for visible signal light or LCD display
    • Replace batteries
power options
Power Options

Ask parents to provide disposable battery pack option

basic troubleshooting concepts35
Basic Troubleshooting Concepts
  • Check for visible defects
    • Frayed cables
    • Cracked casing or controller
    • Loose connections
      • Cables, component parts, batteries
basic troubleshooting concepts36
Basic Troubleshooting Concepts
  • Check Transmitting Coil & Cables – Steps:

1. Confirm that cable(s) is plugged in correctly.

2. Hold the signal check over the transmitting coil when power is on.

basic troubleshooting concepts37
Basic Troubleshooting Concepts
  • Check Transmitting Coil & Cables – Steps:

3. Red light should illuminate.

4. Replace transmitting coil one at a time; apply signal check after each component change.

5. Check microphone if no transmission.

MED-EL signal check: Nucleus:

basic troubleshooting concepts41
Basic Troubleshooting Concepts
  • Microphone Check Steps:
    • Turn off sound processor
    • Attach monitor headphones
    • Turn sound processor on
    • Perform listening check
      • Use Ling sounds & running speech
      • Own voice should be clear & static free
      • Move cables around & listen for static or intermittency
    • Apply Aux mic & compare sound
use of auxiliary microphone
Use of Auxiliary Microphone
  • When the student’s headset or sound processor microphone produces no sound or sound of poor quality, the Aux/Lapel microphone may be used until a replacement microphone is available
  • Attach the lapel mic outside the student’s shirt, near the chin, and away from objects that may produce sound interference (e.g. jewelry).
don t forget about the internal device
Don’t forget about the internal device
  • When all else fails – refer the student back to the implant center &/or surgeon
other learning tools
Other Learning Tools
  • Join the hands-on demonstration at today’s Break-Out Sessions.
  • Accompany your student to the CI Center for a mapping session.
  • Attend the Greater Cleveland Cochlear Implant Support Group Meetings – 3 per year.
help by phone
Help by Phone . . .
  • Cochlear Americas 800-523-5798
  • Advanced Bionics 800-678-2575
  • MED-EL 888-633-3524

Ask for Customer Service, or for the “Audiologist on call”

  • The student’s Cochlear Implant Audiologist
help on the web
Help on the Web . . .
  • http://www.cochlearamericas.com/PDFs/TeachersGuide.Chpt6.pdf
  • http://www.bionicear.com/tfs_
    • Interactive Troubleshooting guide on-line
  • http://www.medel.com/ENG/INT/60_Contact_and_support/020_download_center.asp
slide47
All questions will be honored and answered at the end of the morning proceedings. Please write your questions on a provided note card.