General Questions for the Implant Team

· Who are the members of the implant team? (Should include: surgeon, audiologist, speech pathologist, psychologist, educator/educational liaison)

· How many different makes of cochlear implants are available through their program?
 
· How many children have they implanted with each device?

· Are all the devices currently FDA-approved, or are some currently in FDA clinical trials?

· What are the advantages and disadvantages of selecting a device in clinical trials?

· How adaptable is each of the available cochlear implants to improvements in technology? (i.e. newer processing strategies, smaller component parts, etc.)

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The Pre-Evaluation

· Does your team recommend a hearing aid trial to commencing the cochlear implant evaluation?

· Does your center contact your child's teacher before the pre-evaluation?

· What evaluation procedures are required before implantation? (i.e. audiological tests: behavioral and electrophysiological, speech/language assessment, cognitive evaluation, otological evaluation, CT scan, educational assessment)

· Does the behavioral audiological assessment include speech perception testing?
 
· Does the psychological or audiological evaluation include an assessment of parental expectations of benefit from the cochlear implant?

· If you and your child utilize total communication, is at least one member of the team able to communicate in sign language with your child?

· What is the audiologist's personal experience with cochlear implants? How many years has he/she worked with implants?

· How many workshops/training courses on cochlear implants has the audiologist attended?

· How many within the last two years?

· Is the audiologist certified by one or more of the implant companies to rehabilitate cochlear implant recipients?


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Surgery
 
· How many cochlear implant operations has the surgeon performed on children?

· Which devices has the surgeon implanted in children?

· What preparation for surgery does the center provide? (i.e. tour of hospital)

· What physical restrictions are placed on the child in the weeks immediately post surgery?

· What special precautions need to be taken when playing contact sports with a cochlear implant?

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The Mapping Process

· Which implants does the audiologist have the most experience with?

· How many adults/children has he/she mapped?

· How many children between the ages 12 months to 4 years has she/he mapped?

· What objective procedures are utilized in mapping the very young child?

· What behavioral procedures are utilized in mapping the very young child?

· What procedures does the audiologist take to avoid possible overstimulation of the child at initial stimulation?

· What techniques does the audiologist use to validate mapping?

· What experience has the audiologist with coupling assistive devices to the cochlear implant?

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Equipment

· Does the center have a stock of spare processors, replacement microphones, coils, cords, etc.?

· How easy is it to obtain replacement parts for each implant? (i.e. What is the center's policy on scheduling emergency appointments?)

· What is the repair warranty and loss/damage policy on each implant?

· How often should you expect to have to replace cords, batteries, and other component parts?

· What equipment costs and/or follow-up costs are not covered by insurance?

· How easy is it to upgrade the external equipment when new components become available?
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Rehabiltation/Educational Follow-Up

· How many days does your center schedule for initial stimulation of the device? (2 to 3 sessions is usual)

· How often are follow-up visits scheduled? (i.e. at one month, three months, six months, one year, eighteen months, two years, annually?)
 
· What follow-up tests are conducted to document progress with the cochlear implant? (i.e. speech/language evaluation, speech perception tests, etc.)

· How many follow-up visits are covered by insurance?  

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Rehabiltation/Educational Follow-Up

· What liaison with the schools does your center provide?

· What rehabilitation therapy is offered on site at the center?
 
· Does your child's school/teacher support the decision to implant?

· Has your child's teacher worked with other children with implants?

· Does the speech therapist at school have experience in auditory habilitation?

· Will your child's school support time off for teachers to receive the specialized instruction and training necessary in working with children with cochlear implants?

· Is your school willing to provide inservice training about cochlear implants to teachers?

· What level of auditory training and speech/language rehabilitation is your school able to provide post implantation?

· What level of support are you, the parent/family/caregiver able to provide post implantation?

· Are you able and willing to reinforce educational goals and recommendations at home?

(For the OLDER CHILD...)

· Have you discussed the cochlear implant with your child? Is he/she motivated to receive an implant?

· Are you and your child aware of the debate over cochlear implantation among the deaf community?

· Have you and/or your child talked with other cochlear implant recipients and their families?

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• PRE-EVALUATION
• SURGERY
• THE MAPPING PROCESS
• EQUIPMENT
• FOLLOW-UP TESTING
• REHABILITATION/EDUCATIONAL FOLLOW-UP