After surgery, the cochlear implant is usually turned on about 2-4 weeks after surgery. Cochlear implant programming in children is a process. Children may be seen for programming eight or more times in the first year activation after activation, and then 1-2 times in each subsequent year. These appointments are necessary because changes in hearing continue to occur over time. Children get better at programming as they get older. Technology changes and equipment must be replaced, and regular programming ensures the integrity of the entire cochlear implant system, from the external components to the internal implant itself. These evaluations help us identify any potential issues early and address them to avoid long-term effects on the child's speech and language development. When we turn it on, you can start talking. So it's super soft and I think he's okay. Cameron. Cameron. Hey big boy. Hi Cameron. Are you reading a book? Cameron. Hi. How are you today? Are you being a big boy in here for the first time? Yeah. You is mama's big boy, aren't you? Hi Cameron. Hi big boy. Yeah. I can hear, I can hear. Hi. Wow. Cameron. Cameron. Hey, over here. Cameron. Hi. Wow. Good boy. Hi. How are you today? Is this all new? Where is dada? Dada. Hi. There's dada. Cameron. Cameron. Cameron. Say hi Alora. Hi Alora. Hi Alora. Yeah. You're such a big boy. You make me want to cry. Yeah. Hi. In addition to programming, we complete regular performance evaluations. These assessments help us validate our programming. We initially use the same tests that we evaluated the child with preoperatively, and those are followed up by harder tests as the child ages and develops spoken speech and language The evaluations monitor both the child's performance with the implant and the integrity of the implant system, and they also provide pivotal information for planning and managing auditory rehabilitation. For instance, if we've confirmed that all equipment is working correctly, and the child still fails to make appropriate progress with their language, we may consider referring on for additional evaluations such as neuropsychology or developmental pediatrics. We use rechargeable batteries. We use rechargeable batteries. My strawberry jelly is sweeter than yours. My strawberry jelly is sweeter than yours. Earth is the third planet from the sun. Earth is the third planet from the sun. I like to read books for fun. I like to read books for fun. How long have you been waiting? How long have you been waiting? My dad got a speeding ticket. My dad got a speeding ticket. We know that the effects of hearing loss can be minimized via early identification, early cochlear implantation, and an appropriate habilitation plan, which usually includes weekly auditory-verbal therapy after device activation. Children who receive a cochlear implant at a young age have the potential to close the gap between themselves and children with normal hearing. If implanted early, children with cochlear implants often attain speech and language and academic skills similar to those of children with normal hearing. So what's the rush? We used to think that cochlear implantation by the age of three, then by the age of 18 months, would result in good outcomes. We now recommend cochlear implantation as close to or under 12 months of age, and the reason for this is that optimal brain development is at stake. We know that there's a critical window for language learning, for spoken language, from birth to three years, and this is the time when the neuroplasticity of the brain is the greatest. Stimulation of the auditory cortex at this early age is important because it actually influences the organization of the brain's auditory pathways. If the brain is not stimulated auditorily in the early stages of life, these pathways will not be as strong or they may be taken over by other brain functions altogether. Cochlear implant outcomes suggest that children with cochlear implants clearly outperform children with similar hearing losses who continue to use hearing aids. We know that the younger the child receives their implant, the better they will develop speech recognition, and speech and language abilities. As we see children implanted at younger and younger ages, we believe even greater results will be facilitated. Children should be referred for a cochlear implant evaluation as soon as a severe to profound hearing loss is diagnosed. At our clinic, we see children as early as one month of age to fit their hearing aids and introduce them to the idea of cochlear implants as the gold standard of care for their child's hearing loss. A child should be referred when they fail to meet appropriate speech and language milestones with the use of hearing aids. This doesn't guarantee that they will receive a cochlear implant, but it does ensure that they receive the thorough evaluation needed to determine if they might benefit from a cochlear implant, and if not, to facilitate the appropriate referrals to determine why appropriate progress hasn't been made with their hearing aids. A child should also be referred when a parent expresses concern regarding their child's progress with their hearing aids. In summary, many changes have taken place with cochlear implants over time. The test materials we use are harder, the presentation levels we present tests at has changed, and the patient characteristics differ. As a result, candidacy is often determined on a case-by-case basis, and professional judgment plays a strong role in candidacy decisions. Early implantation at or before 12 months of age is critical for developing age-appropriate spoken speech and language, and optimizing outcomes. I'm going to let a little friend of ours from our cochlear implant program end our video for us. So I thank you for watching. Hi, my name is Will. I got my cochlear implants when I was one. I like to play with toys and I like to play with star wars action figures. Thanks for watching.
