Pediatric Cochlear Implant Mapping Via Telepractice

2016 ◽  
Vol 1 (18) ◽  
pp. 12-18 ◽  
Author(s):  
Michelle L. Hughes ◽  
Jenny L. Goehring ◽  
Margaret K. Miller ◽  
Sara N. Robinson
Keyword(s):  
Young Children ◽  
Cochlear Implant ◽  
Cochlear Implants ◽  
Study Design ◽  
Behavioral Responses ◽  
Behavioral Testing ◽  
Testing Methods ◽  
Speech Processor ◽  
Potential Benefits ◽  
Behavioral Methods

Several studies have empirically examined the feasibility and outcomes of remote programming for adults with cochlear implants. Results indicate that equivalent programming levels can be obtained in both the remote and in-person conditions, suggesting that distance technology is a viable alternative to traditional in-person programming methods. Young children, however, require different audiological testing methods to obtain the behavioral responses necessary for speech-processor programming. No studies have empirically evaluated the use of remote programming with the behavioral methods specific to testing young children. Further, young children present additional challenges to behavioral testing (e.g., ability to condition or cooperate) that can lead to the need for additional visits beyond those required for regular programming. This paper describes the potential benefits of remote programming over those achieved for adults, and describes the study design and preliminary results from our current study aimed at validating the use of remote processor programming for young children with cochlear implants (CIs).

scholarly journals Remote programming of cochlear implants

CoDAS ◽  
2014 ◽  
Vol 26 (6) ◽  
pp. 481-486 ◽  
Author(s):  
Paola Angelica Samuel ◽  
Maria Valéria Schmidt Goffi-Gomez ◽  
Aline Gomes Bittencourt ◽  
Robinson Koji Tsuji ◽  
Rubens de Brito
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Cochlear Implants ◽  
Free Field ◽  
Effective Procedure ◽  
Speech Processor ◽  
Live Programming

PURPOSE: To verify the effectiveness of remote programming of cochlear implants by stimulation levels and results in the perception of speech and free-field audiometry tests. METHODS: Twelve patients from both genders, aged between 18 and 59 years, users of internal cochlear implant and speech processor of the same model for at least 12 months, were selected. Both the remote programming (RP) and the live programming (LP) were performed on the same day, measuring the minimum (T) and maximum (C) stimulation levels of five electrodes with the interpolation of the remaining ones. Speech perception tests were applied using 65 dBSPL (recorded open context sentences and monosyllables). The patients were submitted to free-field audiometry at 250-8,000 Hz frequencies. The results for the RP and LP were compared. RESULTS: Differences in mean of the T levels for three electrodes and the C levels for one electrode were found. No difference between the results was obtained in the speech perception tests and audiometric thresholds in the RP and LP. CONCLUSION: The RP is a simple and effective procedure for programming cochlear implant devices and, although there were differences in the stimulation levels of some electrodes, it did not interfere in the speech perception outcomes.

Verification of a Proposed Clinical Electroacoustic Test Protocol for Personal Digital Modulation Receivers Coupled to Cochlear Implant Sound Processors

2017 ◽  
Vol 28 (07) ◽  
pp. 625-635
Author(s):  
Erika L. Nair ◽  
Rhonda Sousa ◽  
Shannon Wannagot
Keyword(s):  
American Academy ◽  
Cochlear Implant ◽  
Cochlear Implants ◽  
Hearing Aids ◽  
Clinical Setting ◽  
Cochlear Nucleus ◽  
Behavioral Testing ◽  
Test Protocol ◽  
Digital Modulation ◽  
Sound Processor

AbstractGuidelines established by the AAA currently recommend behavioral testing when fitting frequency modulated (FM) systems to individuals with cochlear implants (CIs). A protocol for completing electroacoustic measures has not yet been validated for personal FM systems or digital modulation (DM) systems coupled to CI sound processors. In response, some professionals have used or altered the AAA electroacoustic verification steps for fitting FM systems to hearing aids when fitting FM systems to CI sound processors. More recently steps were outlined in a proposed protocol.The purpose of this research is to review and compare the electroacoustic test measures outlined in a 2013 article by Schafer and colleagues in the Journal of the American Academy of Audiology titled “A Proposed Electroacoustic Test Protocol for Personal FM Receivers Coupled to Cochlear Implant Sound Processors” to the AAA electroacoustic verification steps for fitting FM systems to hearing aids when fitting DM systems to CI users.Electroacoustic measures were conducted on 71 CI sound processors and Phonak Roger DM systems using a proposed protocol and an adapted AAA protocol. Phonak’s recommended default receiver gain setting was used for each CI sound processor manufacturer and adjusted if necessary to achieve transparency.Electroacoustic measures were conducted on Cochlear and Advanced Bionics (AB) sound processors. In this study, 28 Cochlear Nucleus 5/CP810 sound processors, 26 Cochlear Nucleus 6/CP910 sound processors, and 17 AB Naida CI Q70 sound processors were coupled in various combinations to Phonak Roger DM dedicated receivers (25 Phonak Roger 14 receivers—Cochlear dedicated receiver—and 9 Phonak Roger 17 receivers—AB dedicated receiver) and 20 Phonak Roger Inspiro transmitters.Employing both the AAA and the Schafer et al protocols, electroacoustic measurements were conducted with the Audioscan Verifit in a clinical setting on 71 CI sound processors and Phonak Roger DM systems to determine transparency and verify FM advantage, comparing speech inputs (65 dB SPL) in an effort to achieve equal outputs. If transparency was not achieved at Phonak’s recommended default receiver gain, adjustments were made to the receiver gain. The integrity of the signal was monitored with the appropriate manufacturer’s monitor earphones.Using the AAA hearing aid protocol, 50 of the 71 CI sound processors achieved transparency, and 59 of the 71 CI sound processors achieved transparency when using the proposed protocol at Phonak’s recommended default receiver gain. After the receiver gain was adjusted, 3 of 21 CI sound processors still did not meet transparency using the AAA protocol, and 2 of 12 CI sound processors still did not meet transparency using the Schafer et al proposed protocol.Both protocols were shown to be effective in taking reliable electroacoustic measurements and demonstrate transparency. Both protocols are felt to be clinically feasible and to address the needs of populations that are unable to reliably report regarding the integrity of their personal DM systems.

Use of the TEMPO+ behind-the-ear speech processor and COMBI40+ cochlear implant with very young children

2003 ◽  
Vol 1240 ◽  
pp. 391-397
Author(s):  
L Jamieson ◽  
F Ajayi ◽  
A Costa ◽  
J Martin ◽  
C.H Raine
Keyword(s):  
Young Children ◽  
Cochlear Implant ◽  
Speech Processor ◽  
Very Young Children

Telefitting of Nucleus Cochlear Implants: A Feasibility Study

2021 ◽  
pp. 1-6
Author(s):  
Kenichi Takano ◽  
Aya Kaizaki ◽  
Ayami Kimura ◽  
Kazuaki Nomura ◽  
Norikazu Yamazaki ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Young Children ◽  
Cochlear Implant ◽  
Cochlear Implants ◽  
Feasibility Study ◽  
Effective Means ◽  
Clinical Usefulness ◽  
Face To Face ◽  
Remote Locations ◽  
Subjective Satisfaction

Purpose This study aims to describe the recommended equipment and procedures required for successful telefitting, based on our experience, document and evaluate patient satisfaction with telefitting, and assess its clinical usefulness and address the existing issues. Method Twenty (seven children and 13 adults) individuals who lived far from cochlear implant (CI) centers and who were Nucleus CI users underwent conventional face-to-face fitting and telefitting. We examined the participants' subjective satisfaction and cost and time saved with the telefitting experience. Results The telefitting sessions lasted for an average of 16 min. Majority of the participants responded positively to the telefitting experience. Eighty percent (16/20) of the participants were satisfied with the new procedure, and 85% of them agreed to use telefitting again. Conclusions The results of our feasibility study suggest that telefitting was well received by CI users and is a viable alternative to local MAPping, even in young children with CIs. Although there are some limitations in terms of adaptability, telefitting could be an effective means of delivering CI service to remote locations.

The Effects of Frequency Response on Speech Perception for Cochlear Implant Users

2003 ◽  
Vol 14 (10) ◽  
pp. 582-591 ◽  
Author(s):  
Alexandra Weatherby ◽  
Katherine R. Henshall ◽  
Colette M. McKay
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Cochlear Implants ◽  
High Frequency ◽  
Signal To Noise Ratio ◽  
Low Frequency ◽  
Frequency Range ◽  
Speech Processor ◽  
Minimal Difference ◽  
Better Than

The aim of this study was to investigate the effects on speech perception of manipulating filter gains in a cochlear implant speech processor. Five implantees, who use the CI22 implant and Spectra processor manufactured by Cochlear Ltd, participated. Four experimental maps were created that were identical to their clinical map except for the profile of gains across the filters. Experimental gain profiles had rising or falling gains across the frequency range, or emphasized or de-emphasized the middle frequencies, relative to the clinical map. Perception of CNC (consonant-vowel-consonant) words at 70 dB SPL was significantly better with the clinical map than with all experimental maps, whereas at the lower level (60 dB SPL) there was minimal difference between the maps, with the low-frequency emphasis map giving significantly better scores than the high-frequency emphasis map. Perception of sentences at 70 dB SPL with a signal-to-noise ratio of +10 dB was better with the high-frequency emphasis map than with the low-frequency emphasis map. None of these best-conditions, however, were statistically better than the clinical map. The results highlighted the importance of signal audibility for speech perception with cochlear implants.

scholarly journals Interdisciplinary Approaches to the Study of Listening Effort in Young Children with Cochlear Implants

2021 ◽  
Vol 12 (1) ◽  
pp. 1-9
Author(s):  
Amanda Saksida ◽  
Sara Ghiselli ◽  
Stefano Bembich ◽  
Alessandro Scorpecci ◽  
Sara Giannantonio ◽  
...  
Keyword(s):  
Young Children ◽  
Cochlear Implants ◽  
Language Processing ◽  
Near Infrared ◽  
Systematic Evaluation ◽  
Listening Effort ◽  
Functional Near Infrared Spectroscopy ◽  
Interdisciplinary Approaches ◽  
Potential Benefits ◽  
Hearing Children

Very early bilateral implantation is thought to significantly reduce the attentional effort required to acquire spoken language, and consequently offer a profound improvement in quality of life. Despite the early intervention, however, auditory and communicative outcomes in children with cochlear implants remain poorer than in hearing children. The distorted auditory input via the cochlear implants requires more auditory attention resulting in increased listening effort and fatigue. Listening effort and fatigue may critically affect attention to speech, and in turn language processing, which may help to explain the variation in language and communication abilities. However, measuring attention to speech and listening effort is demanding in infants and very young children. Three objective techniques for measuring listening effort are presented in this paper that may address the challenges of testing very young and/or uncooperative children with cochlear implants: pupillometry, electroencephalography, and functional near-infrared spectroscopy. We review the studies of listening effort that used these techniques in paediatric populations with hearing loss, and discuss potential benefits of the systematic evaluation of listening effort in these populations.

Selecting the Optimal FM System for Children With Cochlear Implants

2008 ◽  
Vol 18 (1) ◽  
pp. 19-24
Author(s):  
Erin C. Schafer
Keyword(s):  
Speech Recognition ◽  
Cochlear Implants ◽  
Empirical Research ◽  
Background Noise ◽  
Signal To Noise Ratio ◽  
Evidence Based ◽  
Signal To Noise ◽  
Speech Processor ◽  
System Input ◽  
Optimal Type

Children who use cochlear implants experience significant difficulty hearing speech in the presence of background noise, such as in the classroom. To address these difficulties, audiologists often recommend frequency-modulated (FM) systems for children with cochlear implants. The purpose of this article is to examine current empirical research in the area of FM systems and cochlear implants. Discussion topics will include selecting the optimal type of FM receiver, benefits of binaural FM-system input, importance of DAI receiver-gain settings, and effects of speech-processor programming on speech recognition. FM systems significantly improve the signal-to-noise ratio at the child's ear through the use of three types of FM receivers: mounted speakers, desktop speakers, or direct-audio input (DAI). This discussion will aid audiologists in making evidence-based recommendations for children using cochlear implants and FM systems.

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