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Oxford University Hospitals NHS Foundation Trust

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Cochlear Implant assessment process

Your first visit to the Auditory Implant Programme is an opportunity for you to find out more about Cochlear Implants and for us to find out about you or your child.

You will have already received a questionnaire with your appointment letter. This will give us some information about you or your child and the other professionals involved.

We will explain the assessment process, how a Cochlear Implant works, and the rehabilitation process (how you learn to listen with the Cochlear Implant). We will also show you what a Cochlear Implant looks like and give you the opportunity to ask questions.

You will see a number of people including an audiologist, a speech and language therapist and the programme co-ordinator.

The first assessment appointment will take between two and three hours. The assessment process differs slightly for children and adults.

Paediatric initial assessment

We will start by taking a full history of your child's deafness and other relevant factors. If your child is taking any medication, or has a medical or developmental condition, it is important for us to know about this.

Audiology

We will carry out some audiological (hearing) tests. These will include the standard tests your child will have had before, and possibly some more detailed objective testing they may not have had. We will explain these tests before they are carried out.

We will need to assess their hearing, both with and without their hearing aids.

Please ensure that their hearing aids are working properly and that their earmoulds fit well.

Speech and Language Therapy

The Speech and Language Therapist will assess your child's communication ability with speech, language and listening tests suited to your child's age. You may be asked to complete some questionnaires.

All the testing will be adapted to suit your child's age and developmental stage.

We hope to find out as much as possible about your child's communication in the assessment. We will discuss your expectations for a Cochlear Implant and what you hope to achieve.

If you would like to meet families with children with Cochlear Implants, or adults with implants, we will try to arrange for you to meet someone / parents of a child who has a Cochlear Implant.

Adult initial assessment

We are happy to meet you and any family members or friends you would like to bring to the assessment.

We will start off by taking a full history of your deafness and other relevant factors. If you are taking any medication or have a medical condition it is important for us to know about this.

Audiology

We will carry out some audiological (hearing) tests. These will include the standard tests you will have had before, and possibly some more detailed objective testing you may not have had. We will explain these tests before they are carried out.

We will need to assess your hearing, both with and without your hearing aids.

Please ensure that your hearing aids are working properly and that your earmoulds fit well.

Speech and Language Therapy

The Speech and Language Therapist will assess your communication ability with speech, language and listening tests and by completing some questionnaires with you.

We will discuss your expectations for a Cochlear Implant and what you hope to achieve.

If you would like to meet someone with a Cochlear Implant we will try to arrange for you to meet someone in a similar situation to yourself.

What happens next?

If the initial results indicate that a Cochlear Implant may be appropriate for you or your child and you decide you would like to proceed, we may refer you or your child for scans to be carried out.

There could be a CT scan, a detailed X-ray, which looks at your inner ear and shows if the cochlea is suitable for electrode insertion, and an MRI scan, which looks at the soft tissue in your head and specifically the nerve of hearing.

If your child is young and unlikely to lie still for the scans, these may need to be done under a general anaesthetic. This appointment will be sent to you from the X-ray department, for another day. It will not be carried out on the same day as the rest of your assessment.

When we have all the test results, we will have a team meeting to discuss whether we feel cochlear implantation would be appropriate and beneficial for you or your child.

We may need to bring you back for further testing, or recommend referring you or your child for opinions from other professionals. We will write to you and keep you informed at all stages.

We will then send you another appointment to meet the surgeon so that the final decision regarding implantation can be discussed, and any further questions answered.

At this point the surgeon will discuss whether one or both ears will be implanted. Funding at a national level is only available for one Cochlear Implant for most adults. For children, funding is available for both sides, and is generally recommended. If a unilateral Cochlear Implant (on one side) is decided upon, the surgeon will discuss with you which ear will be the best to implant.

On that day we may be able to give you a date for the surgery, or at least give you an indication of when it may be. We will also be able to discuss the different Cochlear Implant devices available, and give you an opportunity to look at the devices. Unless there is a clinical reason why one device should be used, the choice of device and colours is up to you.

What if cochlear implantation is not suitable?

If, after the assessment process, cochlear implantation is not thought to be likely to benefit you or your child, we will write to you and let you know the reasons why. We will also arrange to meet you again and discuss the outcome if you wish.

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