Graeme Clark Collection
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ItemComponents of a rehabilitation programme for young children using the multichannel cochlear implant(Whurr, 1996)Rehabilitation with young hearing-impaired children may be defined as a teaching; learning process where the role of the clinician is to facilitate acquisition of listening, speech and language in a normal developmental order. This is often referred to as habilitation. It differs from rehabilitation for adults, which is the process by which lost communication skills are reacquired. It is worth discussing the role of the cochlear implant as a tool in this process. For the adult with acquired hearing loss, the cochlear implant might be expected, in part, to facilitate rehabilitation by restoring the auditory sense. The aim is to facilitate speech reception and provide the adult with a speech feedback loop. For a child receiving the cochlear implant, the aims are more complex. The device needs to provide speech perception abilities to facilitate the development of the entire linguistic system, to develop a range of speech sounds, to enable speech monitoring via auditory feedback and to access shared knowledge of the world. (From Introduction)
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ItemMulti-channel cochlear implants for children: the Melbourne Program( 1991)Although there have been 300 years of deaf education, profoundly-totally deaf children today on average are not able to reach the same level of achievement as their normally hearing peers (Geers & Moog, 1989). This failure of deaf children to develop their true potential is largely due to the difficulty they have in communicating with normally hearing people. During the last 300 years there have been basically two different methods of education used (The New Encyclopaedia Britannica, 1983). Firstly, one which maximises auditory and lip reading cues (auditory/oral), advocated by Juan Pablo Bonet (1620), and one which uses a series of signs to convey meaning (signing), developed by Charles-Michel (1712-89). In addition, there is a method which endeavours to combine both auditory/oral and signing approaches called total communication. In practice, however, children taught by total communication tend to receive speech more predominantly by one or other of these methods.
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ItemRevised selection criteria for the multiple-channel cochlear implant( 1991)The criteria of suitability for a cochlear implant have been extended from total deafness to include some individuals with residual hearing. The aim of the initial hearing evaluation is to define whether the speech discrimination is good enough to justify perseverance with a hearing aid. In adults, usually the pure tone audiogram and speech audiometry are accurate and consistent. In children, however, to achieve accuracy, free field testing must be complemented by repeated aided conditioned responses and objective evoked response audiometry. When a child has residual hearing it is more difficult to assess the potential for habilitation using an aid. For both adults and children, it is necessary to make a selection from a battery of tests on the basis of the subjects experience. This development highlights the need for otologists and audiologists to become familiar with the battery of tests used in evaluating severe deafness (Plant 1984) and to review decisions made about the management of people with severe to total deafness. In suitable people, the aim of treatment with the Cochlear multichannel implant and its multipeak speech processor is a significant score for open set speech discrimination tests using hearing alone. This cannot always be achieved but as long as the evaluation protocol has been used to warn patients before the operation, they will be satisfied with a result where the implant complements lip reading resulting in discrimination of running speech and detection of environmental sounds.