Troubleshooting Cochlear Implant | Processor Will Not Turn On

By Eric Sherman

Have you ever placed a fully charged battery into your cochlear implant processor only to find out it doesn’t power up? 

Dirt on battery terminal

In a blog story, AAA Batteries For Cochlear Implant Processors, I wrote about how rechargeable batteries can lose their capability to store a charge above 750 milliamps (mAh). When this happens the processor tends to turn on and then shut down or may not power on at all.  Well there may be another issue with the battery that can fool you into thinking your processor has gone bad.

Over time, the processor’s battery terminals can become dirty.  When this happens, the dirt forms a barrier between the battery and the processor’s battery terminals preventing your processor from turning on.

This happened to my son’s processor.  After a weekend of totally refreshing the rechargeable batteries, one of his processors didn’t power on.  I knew the batteries were good because they all tested above 900 mAh and they worked in the other processor.  Plus, my son had recently seen his audiologist for a mapping session and all his equipment checked out.  I thought I was going to have to buy a new processor because his is out of warranty.

Materials to Clean AB Neptune Processor

My son is bilaterally implanted and wears Advanced Bionics Neptune processors on a daily basis.  The Neptune processors are very durable, so it is hard to imagine that it would die from everyday use.

When examining the processor, I noticed what looked like a scuff mark on the brass battery terminal.  I grabbed a Q-tip and 91% isopropyl alcohol and cleaned the terminals in the processor.  The scuff mark came right off.  After making sure everything looked clean, I popped in a fully charged battery and the processor powered right up and has been working ever since. 

Practicing good maintenance on your hearing devices will help them last and stay in good working order. Make sure you follow your manufacturer’s instructions on maintenance and troubleshoot before you start looking at replacing your device. It might just save you time and a lot of money.

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Back-to-School with Cochlear Implants – What You Need to Know

By Eric Sherman

School is back in session. Is your child prepared?  I’m sure you’ve already purchased items such as, backpack, pencils, paper, pens, etc., but what about your child’s cochlear implant(s)?  If you are like our family and sending your child off to school with cochlear implants, there are things you should know to help your child succeed in the classroom.  

Cochlear implants have been around for more than 30 years, but it is amazing how few schools or teachers are aware of this wonderful technology.  In our experience, most teachers and schools have never worked with a student who has cochlear implants, and we are in the second largest school district in the country. 

The population of school aged children receiving cochlear implants is growing. Unfortunately, parents have to make sure teachers and schools are educated about their child’s cochlear implants and hearing needs.  If you child is entering a public school in the U.S. with a cochlear implant, you should have an IEP or a 504 plan agreement in place.  These are legal documents under the Individual Disability Education Act (IDEA) to insure your child receives the necessary support in the classroom.  

The Individualized Educational Program (IEP) or a 504 plan is developed to ensure that a child with a disability receives specialized instruction, related services, and accommodations that will ensure their academic success and access to the learning environment.  Similar laws or rights may exist in other countries.

Classroom seating arrangement is important

to the success of a DHH student.

When appropriate accommodations are provided children with cochlear implants do very well in mainstream classrooms or in a special education programs.  We have found that the following steps are helpful to our child’s success in the classroom: 

• Pack a bag in your child’s backpack with extra accessories (i.e. sound cord, audio jacks, etc.), batteries and troubleshooting instructions with your contact info. 
• Make sure the school has appropriate assistive listening equipment in place, per IEP or 504 plan, at the start of school year.  This is generally an FM system that can directly connect to your child’s processor(s).
• Meet with teachers during the first week of school and explain how the cochlear implant works, troubleshooting, etc. If your child is old enough or has the ability to advocate for themselves, great!  If not, you’ll still want to discuss the following:

o     Optimal seating for hearing needs in the classroom

o    How to change batteries, sound cords and headpieces, different programs on processor

o    Breaks if needed.  The sounds of a noisy classroom can be overwhelming for some children and small breaks can be helpful.

o     Possible behaviors that might occur if the processors aren’t working properly

o     Speaking naturally, in a clear voice, not talking to fast or shouting

o     Making sure child is following along with instruction

o     Repeating questions and answers during class discussions

o    When using audio & video equipment making sure it can connect to assistive listening equipment

o  Explaining to the teacher the importance of using the assistive listening equipment (i.e. FM system, Roger Pen, etc.)

Every child entering school has different hearing needs and it’s good to look for resources that will best support your child.   We found Advanced Bionics Tools for Schools had a pretty comprehensive list of materials. They have communication logs, tips for teachers, assessment tools, as well as other information that could be helpful in addressing your child’s needs.

If your child participates in school sports, extra-curricular activities, or just plays on the playground, make sure you have an accessory that secures and helps protect the processors.    Our son uses the specialty shirt Ci Wear to secure his devices.

It’s important to be involved and collaborate in your child’s education.  Nobody knows your child’s hearing needs better than you do.  The more the school knows the greater success your child will have in the classroom. 

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Overstimulation May Be Why Your Child Won’t Wear Cochlear Implant processors

By Eric Sherman

Recently I shared why my child refused to wear his CochlearImplant(s). Unfortunately, the recommendation from others, including hearing health professionals, was just do your best to keep your child’s processor on.

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:

1. The audiologist's past experiences with other patients
   
   
2. Updated information regarding the child's progress (from parents, therapists and teachers)
   
   
3. Audiometric test measures
   
   
4. Observations of the child during programming
   
   
5. Objective measurements (NRT/NRI, ESRT)
   
   
6. 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

Troubleshooting Neptune Processor Water Leak | Battery Compartment

By Eric Sherman

My son uses an Advanced Bionics Neptune sound processors daily.  We have a white battery cap for the left side, and red battery cap for the right.  This was the easiest way for us to know which processor was programmed for which side of the head. 

We found over time water leaked into the battery compartment, and the battery would begin to rust.  This was very concerning to us.  We thought how could the seal start breaking down so quickly?  What we discovered was the battery cap was cracked.  

We found the cap had developed a micro crack on the end.  You could only see it when you pulled outward on the sides of the cap (pictured). The crack most likely developed over time from daily use, and from attaching the processor clip. 

We decided to replace the daily use caps with new caps dedicated just for swimming. We picked a different color not to mix up the caps.  Ever since we started changing caps for swimming, we have not had any problems with water leaks.

If you find water getting into your battery compartment, check for small cracks and make sure the gasket around the processor is free of debris.  Also, consider using different caps when swimming if you use the Neptune processor for everyday use.  

Please read our story Troubleshooting Cochlear Implant | Processor Will Not Turn On if you find rust in battery compartment after water use.

#CiWear is a shirt designed for cochlear implant (CI) processors and other listening devices. Use as a rash guard, swim shirt or an exercise apparel.