By Eric Sherman
Forcing a child to wear a cochlear implant that they clearly don’t
want to wear is not the correct approach. Refusing to wear CI processor(s) is
generally a symptom of a problem that a child can’t necessarily express. Their
behavior becomes the only way to communicate the issue.
Pediatric Audiologist Joan Hewitt, Au.D., who specializes in
cochlear implants says, “Our brains crave hearing. Children should want
to have their CIs on all the time. If a child resists putting the CIs on
in the morning, cries or winces when they are put on, or fails to replace the
headpiece when it falls off, there is a strong possibility that the CIs are
providing too much stimulation. Some children appear shy or withdrawn
because the stimulation is so great that interacting is painful. Others
respond to over stimulation by being loud and aggressive.”
In the article, "Overstimulation in Children with Cochlear
Implants," Berger et al (2011) found symptoms which indicated children
were overstimulated by their cochlear implants. They included: reluctance or refusal
to wear the device, overly loud voices, poor articulation, short attention span
or agitated behavior, and no improvement in symptoms despite appropriate
therapy. When the researchers reduced the stimulation levels, they found
very rapid improvement in voice quality and vocal loudness and gradual
improvement in articulation. Finally, they found "surprising effects
on the children's behavior" such that the parents reported a marked
improvement in attention and reduction in agitation.
If you find that your child is refusing to wear
their cochlear implants, an overstimulating map could be the problem. You should discuss the issue in detail with
your child’s audiologist.
Jennifer Mertes, AuD, CCC-A, and Jill Chinnici, MA,
CCC-A wrote in their article,
“Cochlear Implants —
Considerations in Programming for the Pediatric Population,” (2006)
AudiologyOnline, that children are not little adults. To address their CI needs, they require an experienced clinician. Most children
are unable to provide accurate feedback while the audiologist programs their cochlear
implant and therefore, the clinician must take many things into account:
- The audiologist's past
experiences with other patients
- Updated information regarding
the child's progress (from parents, therapists and teachers)
- Audiometric test measures
- Observations of the child
during programming
- Objective measurements
(NRT/NRI, ESRT)
- If age appropriate, the
clinician will train the child to participate in programming (Conditioned
Play Audiometry (CPA), loudness growth task.
Many of the decisions made during programming appointments come
from the clinician's knowledge and experience, rather than the child's
behavioral responses.
If your child continues to refuse to wear their processors after a
remapping, take into consideration your audiologist’s experience and mapping
approach and seek a second opinion.
When we sought out a second opinion with a new audiologist who
specializes in pediatrics, she found our child’s map was overstimulating. Once
she remapped our son's cochlear implants using a different approach, he didn't have a problem wearing his processors again.
More about the author
Eric Sherman is the inventor and founder of Ci Wear, the patented specialty shirt designed to secure and protect cochlear implant processors. Ideal for sports and water activities. No need for added accessories or clipping processors to collar. Shirts are manufactured in the USA and are available in youth and adult sizes at CIWear.com
#cochlearimplants, #audiology, #parenting #mapping