Four to six weeks after cochlear implantation, the speech processor is fitted and the auditory and speech training started. This takes place either at the German Hearing Center (Deutsches HörZentrum Hannover, DHZ) or at the ‘Wilhelm Hirte’ Cochlear Implant Center (CIC), whose director is Dr. Barbarar Eßer-Leyding. During the postoperative hospital stay following CI surgery at MHH’s Department of Otorhinolaryngology, the headset of the speech processor is attached to the child’s head and the device activated for the first time. During this fitting process, the children (accompanied by one of their parents) stay at the Department of Otorhinolaryngology, at the CIC or at a hotel nearby.
In child-friendly conditions, fitting is carried out first, followed by the step-by-step activation of the electrode. Because in most cases the children have had no previous hearing experience, it is important to adopt a cautious approach in order to avoid overstimulation, but to still achieve sufficient stimulation of the auditory nerve so that the children are able to hear something. The children gain their first experience with hearing in a systematic process, and this experience is gradually extended over time. Meeting other children and talking to other parents will help parents of an implanted child to compare notes on their experience, support one another and use this to intensify their child’s auditory and speech training. Visits to Hannover are usually scheduled for a whole week or half a week each. The appointments are staggered at first; later on there are wider intervals between the individual sessions.
The educational approach adopted in Hannover is based on our extensive, in-depth experience with cochlear implantation since 1984 and the specific knowledge we have gained of the rehabilitation of adult CI recipients. Given that cochlear implants are highly complex systems, this is especially important. It is only the experience gained with cochlear implantation in adults that enables us to optimally use the systems in children and to ensure good maturation of the auditory pathway. We apply the principles of Auditory-Verbal Therapy (AVT), which are instilled at the DHZ and can be continued to be used by the children’s local therapists.
To ensure successful rehabilitation, standardised tests are carried out at regular intervals. This is in the child’s best interest, and enables us to evaluate the strengths and weaknesses in the child’s performance and to improve it using a targeted approach. In addition to regular ENT check-ups, which can only be carried out at the DHZ, we can organise and coordinate medical examinations by other specialists (based at MHH or external), if necessary. This helps to identify and manage potential complications in good time.
Therapy targets are set step by step and reviewed at the child’s next visit to Hannover. A child’s weaker areas can be specifically addressed and worked on. Collaboration with parents is crucial in this process, because they are the most important therapists in their child’s life and must continue with the intensive rehabilitation process at home.
There is another partner of equally great importance, namely the local educational facilities near the family’s home. This includes early-intervention institutions, educational institutions for the deaf and publicly funded social educational centres. Measures started prior to the child’s implantation must be continued and intensified with the aid of the CI. Because these institutions usually work with children over a period of several years, they play a significant role in the overall approach to cochlear implantation rehabilitation in children.
Interactive learning programmes:
- Music RehAB
- The Listening Room (English)