Pediatric Habilitation Following Cochlear Implantation

This document defines appropriate speech/language habilitation services for children following cochlear implantation. It provides a rationale based upon state-of-the-art research and clinical findings. Speech-language habilitation for children after cochlear implantation falls under the definition of "habilitative services” crafted in 2010 by the National Association of Insurance Commissioners. It defines habilitation, in part, as:

"Health care services that help a person keep, learn, or improve skills and functioning for daily living. Examples include therapy for a child who isn’t walking or talking at the expected age."

Read the entire paper HERE.

iHear Teletherapy Program Offers Opportunity for Children with Cochlear Implants

Teletherapy has been an option offered for hearing (re)habilitation has been offered by clinics and schools for a number of years. It is particularly helpful for children given the frequency recommended for young children who are deaf and hard of hearing. Its importance was underscored during the COVID-19 pandemic when access to in-person therapy services was severely limited. ACI Alliance successfully advocated for continued insurance coverage of telehealth and is happy to highlight one example of a teletherapy program at St. Joseph Institute for the Deaf, the iHear program.

St. Joseph Institute for the Deaf, with two locations in St Louis, MO and Indianapolis, IN, offers the iHear teletherapy program to support children and their families in listening and spoken language. Based on years of Early Intervention services in the home, educators theorized the delivery model could be internet-based and just as effective as in person. Early pilots of the program confirmed it was convenient for families and very effective for children. A decade after it was first started, iHear teletherapy has provided more than 20,000 sessions worldwide to children ages 0-18 years old with hearing loss.

Within rural communities or even communities of limited support, iHear is a terrific option to closely monitor and develop a child’s listening skills after cochlear implantation.

What is the iHear Program?

This virtual program provides Listening and Spoken Language (LSL) services to a family anywhere in the world. A computer, internet connection, and a highly trained specialist help children progress in both auditory and language skills to reach their educational, social, and personal goals and support families as they become empowered advocates for their child.

Funding for these sessions includes State Early Intervention funds, local school district contracts, and private pay sources. Therapists work directly with school districts and State Early Intervention programs to maximize the local resources and ensure a smooth transition to the child’s home district. Parents can request iHear as part of an Individualized Education Plan (IEP) or Individual Family Service Plan (IFSP). Additionally, some families select private pay to ensure transition when the family is ready for the next step.

iHear has the capacity to serve children locally and internationally, meeting the child and the family wherever they are. An iHear therapist is a consistent provider when a child is transitioning into a new educational program, the family is relocating, or to provide flexible service delivery during the day to support daycare teachers. iHear is mobile and therapy can continue during vacation and summer sporting events while the family keeps their typical schedule.

What does iHear teletherapy provide?

The services for younger children are designed to offer flexible formats to accommodate family’s needs.  “Our services are based on a triadic approach of therapist-parent-child.  This model fully encompasses the parents, siblings, extended family, even the family dog,” says iHear Executive Director, Michelle Graham, MS, CED, LSLS Cert AVEd.  “We know from doing this work for decades the importance of family involvement.  By empowerment through a coaching model, we have witnessed infants acquire incredible listening and language”. Sessions consist of 45-50 min of services with all participants as active members of the visit.  For parents, the focus is technique and skill building so they can help their child develop listening and language.  For children, the therapist observes their behavior and reactions to determine typical development, listening to their environment, and any delays. 

Following cochlear implantation, a therapist will work with the family and teachers providing specific auditory training and monitoring progression of listening skills. Therapists share progress documentation with the audiologist and cochlear implant team, providing valuable information and feedback the team can consider when mapping and programming.

Does the iHear program work for children enrolled in school?

More than 40% of participants are children 6-18 years old who are mainstreamed in traditional school. iHear collaborates with existing classroom teachers and staff and works to coach the teaching professionals alongside the student to assist in their understanding of the student’s educational needs and foster carryover of skills into the classroom helping them access their academic material.  iHear Director Michelle Graham notes specifics about this population given their unique characteristics. “This age group is one of our fastest growing populations with the most pressing needs” she says. “Because their auditory and language gaps are compounded by the increasing complexity of curricula, teletherapy like iHear can be a strong reinforcement for quality listening and spoken language skill development in the educational setting.”

For more information on this remote therapy program, www.sjid.org/ihear.

Hearing First Resources for Families Hearing First has many resource for families with hearing loss. They believe that there’s a proven path you can take for your child to learn to listen and talk. Through early detection, appropriate hearing devices, and prompt Listening and Spoken Language (LSL) intervention, children are excelling at the same rate as their hearing peers. With LSL, your child can learn to listen and talk in your family's home language, go to their local school, play music or sports, go to college, and work in the job of their dreams. Read more here.