Technology Plays Important Role: Cochlear Implants 

The Nova Scotia Cochlear Implant Program is a joint program between HSNS, Nova Scotia Health, and the IWK. Hearing and Speech Nova Scotia offers pre-implant assessments to determine candidacy, post-operative activation of the cochlear implants, post-implant follow-up, as well as speech-language consultation. NSH Department of Otolaryngology performs the surgeries in Halifax. To date, the program has completed almost 900 surgeries. 

A cochlear implant is an electronic device that is designed to provide hearing to those with severe to profound deafness. Part of the device is surgically implanted into the inner ear and the other part is worn externally. A cochlear implant does not restore a person’s hearing to normal or cure deafness. The implant stimulates the auditory nerve directly, bypassing the damaged part of the cochlea. Many working nerve fibers remain in the hearing nerve even in cases of profound deafness and the implant can restore activity to this nerve and the hearing pathway. 

The youngest age approved for cochlear implants by Health Canada is presently six months. Children who are six to 24 months of age with a profound hearing loss in both ears and who do not benefit from conventional hearing aids are potential candidates for an implant. Children who are 24 months and older with a severe to profound hearing loss in both ears, and who have limited or no benefit from conventional hearing aids, are also potential candidates for cochlear implantation. Other factors that can determine candidacy are the cause of the hearing loss, the child’s educational placement, and the family’s commitment to the rehabilitative process. 

Candidates for cochlear implantation includes persons over the age of 18 years who have a severe to profound hearing loss in both ears, and limited or no benefit from conventional hearing aids. Other factors that determine candidacy are the cause of the hearing loss, how long the person has been deaf, the method of communication used (spoken or sign language), and demonstrated commitment to the rehabilitative process.  

Rehabilitation following the activation of the cochlear implant is very important. For many adults who have not benefited from amplification for many years, there is a period of learning to re-adjust to auditory stimulation from the cochlear implant. This process can take up to a year for the adult to realize the full benefit of the cochlear implant. Patience and commitment are critical to this rehabilitative process. 

Unlike adults who have lost their hearing after they have developed their speech and language skills, children with profound hearing losses have no auditory memories to draw upon to understand spoken communication. Rehabilitation for these children is often a lifelong process that takes the child through all stages of language acquisition learning, from attaching meaning first to a vocalization, syllable, then to words, phrases and sentences, and ultimately to conversation. For children, there is often improvement seen over a period of three or more years of rehabilitation. 

The Cochlear Implant Speech-Language Pathologist helps the client learn to identify and associate meaning to the new sounds that are heard. If broader support is needed, referrals can be made to community based provincial health services, school boards, or upon request, to private SLPs. For children, the Atlantic Provinces Special Education Authority (APSEA) also provides rehabilitative support. Most important to the overall success of rehabilitation is the support and involvement of parents, family members, the child’s social circle, and community. 

Because of the rapid advancements in technology, the companies that produce cochlear implant devices may decide to stop making a certain model and render it “obsolete.” This means they will no longer repair models that break down. The companies provide clients with one year’s notice to prepare for the change, but this change comes with a cost. In Nova Scotia, cochlear implant recipients have been fortunate over past years because the Nova Scotia Government has provided funding to replace obsolete devices. This year the Department of Health and Wellness provided financial support of $900,000 to cover replacement costs of obsolete cochlear implants for Nova Scotians, like Gina.  

Gina MacPhail has been wearing a cochlear implant for approximately 15 years and feels fortunate to live in Nova Scotia. “What an amazing experience to be able to hear music in the malls,” she said. “My most recent replacement was provided to me free of cost – a major help. I’ve always had a wonderful team to help me through this process. I feel I’m a walking, talking, hearing miracle!”