cochlear implant programming for infants and toddlers l.
Skip this Video
Loading SlideShow in 5 Seconds..
Cochlear Implant Programming for Infants and Toddlers PowerPoint Presentation
Download Presentation
Cochlear Implant Programming for Infants and Toddlers

Loading in 2 Seconds...

play fullscreen
1 / 19

Cochlear Implant Programming for Infants and Toddlers - PowerPoint PPT Presentation

  • Uploaded on

Cochlear Implant Programming for Infants and Toddlers. Roxanne J. Aaron, MA, CCC-A, FAAA Board Certified in Audiology with a Specialty in Cochlear Implants February 2006 The Moog Center for Deaf Education St. Louis, Missouri. Faculty Disclosure Information.

I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
Download Presentation

PowerPoint Slideshow about 'Cochlear Implant Programming for Infants and Toddlers' - wayland

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.

- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
cochlear implant programming for infants and toddlers

Cochlear Implant Programming for Infants and Toddlers

Roxanne J. Aaron, MA, CCC-A, FAAA

Board Certified in Audiology with a Specialty in Cochlear Implants

February 2006

The Moog Center for Deaf Education

St. Louis, Missouri

faculty disclosure information
Faculty Disclosure Information

In the past 12 months, I have not had a significant financial interest or other relationship with the manufacturers of the products or providers of the services that will be discussed in my presentation.

This presentation will not include discussions of pharmaceuticals or devices that have not been approved by the FDA.

goals for ci programming
Goals for CI Programming
  • Audibility
    • Average speech inputs
    • Soft speech inputs
  • Comfort for all sounds
  • Facilitate acquisition of spoken language
set up for success
Set-Up for Success
  • Audiologist must prepare in advance
    • Mentally
    • Physically
set up for success5
Set-Up for Success
  • Mentally
    • Decide how frequently to schedule programming
    • Find out what works best for each child
      • Review previous sessions
      • Involve EI Service Providers
    • Create a plan of action for each session
set up for success6
Set-Up for Success
  • Physically
    • Assistant for programming
    • Seating
      • High chair
      • Parent’s lap
      • Table
set up for success7
Set-Up for Success
  • Physically
    • VRA equipment
    • Age-appropriate toys for different purposes
      • Waiting times
      • VRA distracters
      • CPA manipulatives
set up for success8
Set-Up for Success
  • Physically
    • Food/Stickers
      • Motivator
      • Reward
    • Materials for counted T’s and loudness scaling activities
    • Chart, worksheets
      • Careful notes during programming about what techniques worked or did not work, how child responded to stimulation, etc.
  • Psychophysical/Behavioral Measures (Gold Standard)
    • Thresholds for stimulation through CI (T’s = minimum stimulus level patient perceives as very soft)
      • BOA
      • VRA
      • CPA
      • Counted
  • Psychophysical/Behavioral Measures
    • Loudness Measures
      • Scaling is the goal
        • M’s = comfortably loud, not too loud
        • C’s = loud, but OK
      • BOA for loud vs. too loud
        • Astute observation
      • Scaling readiness activities (big vs. little, good sound vs. bad sound, etc.)
  • Electrophysiologic
    • tNRT/tNRI
      • Use levels for training a conditioned response
      • Use cautiously to create MAP’s
      • Use to assess responsiveness of child’s system to each electrode and monitor for changes over time
    • ESRT
      • Estimates C or M levels
      • Below UCL
      • Requires normal ME status and cooperation
  • Record Keeping
    • Write it all down!
      • Assess different sets of electrodes at each session so that all electrodes are eventually assessed (includes behavioral and electrophysiological measures)
      • Continue to rotate electrode assessment until all electrodes can be tested in each session
      • Use records to track changes over time
  • Audibility with new program/MAP
    • Informal assessment using Ling sounds, words, and phrases at a distance
    • Aided detection of soft sounds in booth for each new MAP
      • Target 20 to 30 dB HL detection of warbled tones
  • Comfort
    • Sweeps at C or M levels
      • BOA
      • Loudness judgements (Big/Loud vs. Stop/Too Loud)
    • With live MAP test with variety of loud sounds/noisemakers and carefully observe reactions
    • Make corrections as needed
  • Speech Understanding
    • Speech Perception Testing
      • Ling thresholds
      • ESP
      • GASP
      • MLNT
      • LNT
      • Etc.
  • Progress in therapy
    • Regular contact with EI teacher/therapist
    • Team Tracking form
need a map check
Need a MAP Check?
  • Child may need additional programming if changes noted in the following:
    • Hearing skills
      • No longer detects sounds
      • Less attentive to sounds
      • Confuses sounds already learned
      • Requests repetition or clarification
need a map check18
Need a MAP Check?
  • Speech skills
    • Decreased vocalizations
    • Changes in pitch or loudness of voice
    • Increased nasality
    • Loss of intonation
    • Changes in speech articulation
  • General behavior
    • Slower response times
    • Change in demeanor
    • Trying to manipulate CI controls
    • Withdrawn/less interactive