Laurie S. Eisenberg, PhD
This July, House Ear Institute (HEI), Los Angeles, celebrates the 30th Anniversary of the first pediatric cochlear implant. HEI received FDA approval for a clinical trial in July 1980 to implant three patients under the age of 18 with the single-channel cochlear implant. The single-channel device had been developed at HEI by William House, MD, in the 1960s and successfully implanted in adults.
William House, MD, fits a processor on young patient.
The success of HEI’s clinical trial led to implantation of the same single-channel device in the first preschool-aged child the following year. Soon after, other centers in the United States initiated FDA pediatric clinical trials under the guidance of HEI in partnership with 3M Company.
Cochlear implants are surgically implanted electronic devices that also include externally worn components. The implants provide sound information for people who are unable to hear conversational-level speech through the use of even the most powerful hearing aids.
"Today, pediatric cochlear implantation has become standard clinical practice across the globe," said Laurie S. Eisenberg, PhD, co-director of the Children’s Auditory Research and Education (CARE) Center at HEI. "This is a remarkable outcome when one considers that 30 years ago the implant technology was crude and the idea of implanting children was abhorrent to many in the scientific and clinical communities."
Evelyn Root listens with her new implant while her mom, Jennifer Root, looks on. Evelyn received her first implant when she was a little over a year old, and had surgery to have a second implant in the other ear in 2009. She now has bilateral cochlear implants.
"Although there are many reasons why cochlear implants have become as successful as they are in helping deaf people with profound hearing loss to hear sound, it is the courage and commitment of a small group of clinicians and parents of deaf children who were instrumental in the eventual success of this technology for children," said Eisenberg, who was an audiologist on the first pediatric cochlear implant team in 1980.
Since the summer of 1980, HEI and House Clinic surgeons have implanted approximately 600 children. In the early 1990s, typically 12 children per year were implanted. In 2009, House Clinic surgeons performed 74 cochlear implants on children, with 44 of those implants on children under 5 years old.
In the late 1980’s, HEI became the first center in the United States to implant a young child with a multichannel device. The multichannel cochlear implant was FDA-approved for pediatric use in 1990. With the development of multichannel cochlear implants, recipients have been able to realize even greater benefits from this technology.
The FDA approved implanting children at 12 months old in 2000. HEI researchers participated in a national study led by Johns Hopkins University. Findings from this study were published in April 2010, showing the earlier a child with hearing loss is implanted, the more successful the spoken language development outcome is for a child.
Rob Rainey has been a patient of the House Clinic since he was 3 years old. He received his cochlear implant in 1983 when he was about 10. Rainey now has a PhD and works at House Ear Institute as a postdoctoral scientist.
To further improve auditory and oral communication results for children, the growing trend across the country is for bilateral cochlear implants.
"Since the benefits of bilateral hearing have been proven, we are increasingly implanting 1-year-olds with bilateral cochlear implants," said William Luxford, MD, House Clinic associate. "In addition, we are seeing more children we implanted as toddlers who are now coming back as teenagers to get a second implant."
House Clinic surgeons have trained colleagues around the world to perform the cochlear implant surgery. The cochlear implant has proved to be one of the most significant advances for people with hearing loss. According to 2009 data from the National Institutes of Health, a total of 25,500 children in the United States have received cochlear implants.
The success of HEI’s pediatric implant program can be attributed to the CARE Center’s multidisciplinary approach involving audiologists, speech-language pathologists, and psychologists. In addition, the implant team includes an educational liaison who bridges the gap between the CARE Center, the school, and the families trying to find the best educational environment for their children.
One-year-old Mark Root, has the processors for his bilateral cochlear implants put on by his mom, Jennifer Root, and audiologist, Jamie Glater. Mark had surgery for bilateral cochlear implants in October 2009; the same day his sisters had surgery for their second implant.
"A cochlear implant provides a child with access to sound and the surgery is the first step," said Melinda Gillinger, HEI educational liaison and mother of a cochlear implant recipient. "I work with families, school districts, regional centers, and the implant center to bring everyone together to create an educational or follow-up plan to meet the needs of the child and the family."
Gillinger provides parent support, teacher education, and training at schools throughout Central and Southern California. Parents of cochlear implant recipients from other hospitals or centers that do not have an educational liaison have contacted Gillinger for assistance. HEI has created a multidisciplinary model with the educational liaison all centers performing cochlear implant surgeries should provide to their patients and families.
"The key factor for a child with a cochlear implant to be successful is the family," said Gillinger. "We cannot simply provide a child with a cochlear implant without helping the parents to understand their new roles as teacher, language facilitator, and advocate."
Click here to view a video clip posted by HEI on YouTube.
HEI is a nonprofit organization that aims to advance hearing science through research and education to improve quality of life. HEI scientists investigate the cellular and molecular causes of hearing loss and related auditory disorders and neurological processes pertaining to the human auditory system and the brain. Its researchers also explore technology advancements to improve auditory implants, diagnostic techniques, and rehabilitation tools. The Institute shares its knowledge with the scientific and medical communities and the general public through its education and outreach programs.
All photos courtesy of House Ear Institute.