Pediatric Audiology: Magnus' Journey with Cochlear Implants Case Study

Pediatric Audiology: Magnus' Journey with Cochlear Implants

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Introduction: Pediatric Audiology: Magnus' Journey with Cochlear Implants

The study describes the Audiology based on the cases related to children. The study concentrated on the “Magnus” who is only about 3 years and 5 month’s old child. He had experienced several diagnoses regarding hearing loss. At this age, the baby had suffered a lot but still had not received any aid from the treatments referred. Even the child had got the implantation of two “cochlear” when the child was only 15 months old. Now after the implantation was done, the therapies had gone through the course of life. Slowly he developed listening to the familiar sounds and tries to speak (Rauch et al. 2021). The communication he had developed is based on primarily spoken English. The symptoms that are observed within him are the process of development of the hearing and speaking particles he had started. The study is all about the improvements that had been seen within him. The learning includes the aims of the suggested activities, and the development observed in his language that tries to address. The study also explains the recommendations that are required indulged within the practice. The practices are not only for the child but also for the parents who will be helping the child to develop.

Aims and objectives of the recommended activities

The child “Magnus” had gone through the surgery of implanting two “Cochlear” that will help to hear by producing a sensation of sound. The device is used by those individuals who have hearing problems (Muñoz et al. 2021). This is a type of electronic device that had a special design that helps the person to sense the sounds around

Objectives

• To find out the impact of the “Cochlear implants” after years of using them.
• The therapies involved along with the device.
• To identify the strategies used by the practitioner or the therapist during the treatment of the patients
• To identify the developments that are observed after implementing the techniques and methods.
• To clarify the safety of the device in future use.

Detailed study of case

Activities and Participants

The child requires the maximum time that involves the care of his parents. In this case, the parents had to give more time to their children. Continuous speaking therapies help in the learning progress. Slowly they need to increase the quantity and the quality of the practice that will help them to develop themselves more quickly (Sanchez-Lopez et al. 2020). The professionals who are responsible for performing the activities need to learn the daily life activities of the family that will help the professional to find out the ideas of activities from themselves. The daily life routine helps to understand the background of the family and their habits and the time they provide their children (Parmar et al. 2022). Adult learners are considered as the parents who are also learning new ways of treatment that they apply to their children. And their knowledge of the study differs from that of the child. The activities they involve when they are interacting with their parents in their daily life (Rauch et al. 2021).

The sessions of the therapies always include the parents and the caregivers who are responsible to perform. Especially in the “Auditory Sessions” where 10 auditory verbal sessions take place (Bennett et al. 2020). The key element of the activities involves is the session of interaction where countless number of times in the daily life they are engaging with their parents. The involvement of the parents and the family members is very important and helps the child develop. Support from the family is a requirement that the child highly needs throughout the sessions (Rauch et al. 2021). It is suggested in many of the cases that the child must be kept at his grandmother’s house at daycare, where the child can interact as much as he can.

Materials and toys involved in the Practice

The materials used in the therapy and the developmental process are the toys the child likes the most. One such case was made on one of the children with a similar disorder whose is “Thomas” While treating him the practitioner used a toy car and a few books to make a slope, where the practitioner slide down the car with sounds that matches the action. And she continuously speaks and asks the child to follow her lips (Sanchez-Lopez et al. 2020). Then, the family was also present and did the same as the practitioner. After observing that the action was performed by all, the child spoke up with the same sound. Using the materials that are required in daily life such as bottles, includes the repeated speech of the same word to make the child understand the action and the word to speak for it (Parmar et al. 2022). For example, “I need to open the bottle. I need to open it. Help me, please. Help to open”. In this way using the materials that are required in daily use and performing the task they the child to get familiar with the things around them.

The specific language used in the therapy

The therapy uses “stereotypic phrases” that are applied during the ADI which are referred to as the activities of daily life. This method of therapy helps in the development of the sense in their daily routine of practice (Zafar et al. 2020). This is also a part of verbal language development. The formula applied in the ADL process:

“R = Repetitions per day

N = Number of days activity

performed

P = Potential language repetition

within ADL

X = Exposure to language structure

R × N × P = X”

While performing daily activities the repeated speech used by the parents and families often helps them to understand and learn things more easily (Rauch et al. 2021). Sessions on the spoken language are also taken to improve the strategies slowly to make the child learn.

Strategies that meet the objectives

Auditory Verbal Strategies

Different studies show that “Auditory verbal strategy” is extremely helpful to treat hearing loss patient. In this process, proper coaching is been given to parents and the young baby also. This process is extremely helpful to boost the hearing and the learning process of the baby. In this process, lip-reading is used to provide information to the child. No visual support provides in this method (Putcha et al. 2019). A baby tries to understand the emotion or the expressions of the parents by reading the movement of lips. There are such activities if applied come up with new ideas and outcomes (Chandrasekhar et al. 2019). The factors that are affecting the outcome of these hearing disorders within children are “the Universal Newborn Hearing Screening and advances in hearing technology”. The strategies include in the study are when the child is at the age of 3 to 4 weeks of the post-birth period the necessary treatment undergoes (Jiang et al. 2021). Until all the procedures get complete the result of the Auditory Test cannot be identified. The methodology of the “Auditory Verbal Strategies” is telling some things before showing. In this process, a coach tries to give some instructions to the child before showing anything. The process is focused on the auditory learning of the child. The equipment that is required to implement within the child’s body must be checked regularly whether it is working perfectly or not. The batteries must be cleaned and checked every time. The implantation of the cochlear that is applied in the child must be checked by the wiring system whether it is working perfectly or not.

There are four different steps in “Auditory Verbal Strategies,” and they are:

• In the first step, the child is taught to be aware of the sound.
• Then the coach instructs the child to pay attention to a particular sound.
• Then a response is given to the sound according to the condition.
• The baby analyzes the sound and understands the meaning (Pisoni et al. 2019)

The outcome of the strategy

The application of the strategies at an early stage helps in the development of the child in learning and hearing. It fully depends on the environmental stimulation that is received by the child that gives a very meaningful input to the child (Tuttle et al 2020). This strategy helps a child to develop proper auditory learning in the early stage of growth.

Auditory sandwich

In this method, audio is sent to the child and then visual support is given. Then the video support is removed from the audio. In the visual support, different types of sign and symbols are used. It is also known as the “listening sandwich,” which includes the working of the eyes and direct measures (Chandrasekhar et al. 2019). The strategies involved in the study describe the useful application of hearing aids like cochlear implants. [Refer to Appendix 1]. In “Auditory sandwich” techniques, the total strategy are divided into many parts, which have been discussed below.

• At the time of using auditory sandwich techniques, an audio recording of the targeted words has been given.
• Then the same audio input will provide the visual presentation. In the visual presentation, different types of pictures, signs and symbols are used.
• Then the visual supports are removed.
• At last, the baby tries to get the meanings of the audio (Lou, 2021)

The outcome of the strategy

The strategies that are included in this study help to build up trust in their hearing, that is dependent on the input of auditory. This strategy improves both audio and visual concepts. As an example, If a mother is saying, “Brush your teeth,” and then the mother gives proper visual support to the baby to understand the command,. After this, the boy itself is saying, “Brush your teeth” and observing the vibration of the lip and the expression as well. It can come out properly when given a wait time to get adopted in the child's way of practicing. This helps in the development of skills related to visual aids.

The development within the child could be observed

Hearing and understanding (at the age of 3 to 4 years)

The child tries to respond when someone calls from some other room or place.

Understand the words that denote colours such as red, blue and green.

Word understanding with the help of shapes such as circles and squares.

Word understanding helps in building up relation understanding that involves brothers, aunts and grandmothers or any other family member.

Talking (at the age of 3 to 4 years)

The development of questioning involves the use of what, who and where (Chandrasekhar et al. 2019).

Tries to talk in the pattern of rhythm. For example cat-hat

The application of the pronouns that involve he, she, and it etc.

The understanding of the difference between singular and plural words

Make mistakes in adding 2 to 4 words together

Explain the incident or what happens by trying to add a few more words.

Critical Evaluation

The study discussed the various methods and strategies that help the child to develop the practices within itself where the equal participation of the family and the parents are required (Graydon et al. 2019). The strategies if implemented at an early age of the child will give positive outcomes of the implications. At the age of 3 and onwards they tend to adopt various other activities that help them to interact with their parents and families (Chiopris et al. 2020). The study also discussed the strategies of speech that must be used during the practice. The techniques and the methods applied by the practitioners or the family must be careful in inputting as that will develop the child’s audition.

Reflection

The study had a greater impact on my learning as it generated a sense of humanity for the children and the people who cannot hear. The difficulties they had to face in their lives regarding hearing loss. The improvement in technology had saved those people from ruining their life and thinking negatively. I must thank the technological innovations that are helping people to overcome their difficulties.

In the first stage of the study, I could not understand every concept related to it. The learnings and the concept I found a little bit difficult. But shifting my viewpoint from the perspective of a scholar to a practitioner of a real-life helped me a lot in the study. Critical thinking I started building up in myself as I could find it easy to interpret in terms of a practitioner. Books cannot be always the helpful guide unless the experience takes place in life. That I understood very well.

The adoption within a child that grows up and starts to learn by themselves as a tree that requires guidance from the very first by giving water but gradually learns to withstand the environment on its own.

Conclusion

The study is based on the hearing disorder that occurs within a child during birth. The processes that are improved in recent days help those children to hear. The study included the techniques and the involvement of the required participants in the practice of the sessions and the materials required in the session. The application of the materials and things that are included in the daily life practice of work. The strategies put forward by the study involves the positive outcome of the application of the study. The learning outcomes involve helpful feedback from the explained strategies.

References

Journals

Bennett, R.J., Meyer, C.J., Ryan, B., Barr, C., Laird, E. and Eikelboom, R.H., 2020. Knowledge, beliefs, and practices of Australian audiologists in addressing the mental health needs of adults with hearing loss.American Journal of Audiology,29(2), pp.129-142.

Chandrasekhar, S.S., Tsai Do, B.S., Schwartz, S.R., Bontempo, L.J., Faucett, E.A., Finestone, S.A., Hollingsworth, D.B., Kelley, D.M., Kmucha, S.T., Moonis, G. and Poling, G.L., 2019. Clinical practice guideline: sudden hearing loss (update).Otolaryngology–Head and Neck Surgery,161(1_suppl), pp.S1-S45.

Chiopris, G., Veronese, P., Cusenza, F., Procaccianti, M., Perrone, S., Daccò, V., Colombo, C. and Esposito, S., 2020. Congenital cytomegalovirus infection: update on diagnosis and treatment.Microorganisms,8(10), p.1516.

Graydon, K., Waterworth, C., Miller, H. and Gunasekera, H., 2019. Global burden of hearing impairment and ear disease.The Journal of Laryngology & Otology,133(1), pp.18-25.

Jiang, F., Alimu, D., Qin, W.Z. and Kupper, H., 2021. Long-term functional outcomes of hearing and speech rehabilitation efficacy among paediatric cochlear implant recipients in Shandong, China.Disability and rehabilitation,43(20), pp.2860-2865.

Lou, Z., 2021. The effect of external auditory canal packing duration on healing after endoscopic cartilage myringoplasty.Ear, Nose & Throat Journal,100(9), pp.656-661.

Muñoz, K., Nagaraj, N.K. and Nichols, N., 2021. Applied tele-audiology research in clinical practice during the past decade: a scoping review.International Journal of Audiology,60(sup1), pp.S4-S12.

Parmar, B.J., Mehta, K., Vickers, D.A. and Bizley, J.K., 2022. Experienced hearing aid users’ perspectives of assessment and communication within audiology: a qualitative study using digital methods.International Journal of Audiology,61(11), pp.956-964.

Pisoni, A., Mattavelli, G., Casarotti, A., Comi, A., Riva, M., Bello, L. and Papagno, C., 2019. The neural correlates of auditory-verbal short-term memory: a voxel-based lesion-symptom mapping study on 103 patients after glioma removal.Brain Structure and Function,224, pp.2199-2211.

Putcha, D., Brickhouse, M., Wolk, D.A., Dickerson, B.C. and Alzheimer's Disease Neuroimaging Initiative, 2019. Fractionating the Rey Auditory Verbal Learning Test: Distinct roles of large-scale cortical networks in prodromal Alzheimer's disease.Neuropsychologia,129, pp.83-92.

Rauch, A.K., Arndt, S., Aschendorff, A., Beck, R., Speck, I., Ketterer, M.C., Jakob, T.F. and Hassepass, F., 2021. Long-term results of cochlear implantation in children with congenital single-sided deafness.European Archives of Oto-Rhino-Laryngology,278, pp.3245-3255.

Sanchez-Lopez, R., Fereczkowski, M., Neher, T., Santurette, S. and Dau, T., 2020. Robust data-driven auditory profiling towards precision audiology.Trends in hearing,24, p.2331216520973539.

Tuttle, C.S., Waaijer, M.E., Slee?Valentijn, M.S., Stijnen, T., Westendorp, R. and Maier, A.B., 2020. Cellular senescence and chronological age in various human tissues: a systematic review and meta?analysis.Aging Cell,19(2), p.e13083.

van der Straaten, T.F., Netten, A.P., Boermans, P.P.B., Briaire, J.J., Scholing, E., Koot, R.W., Malessy, M.J., van der Mey, A.G., Verbist, B.M. and Frijns, J.H., 2019. Pediatric auditory brainstem implant users compared with cochlear implant users with additional disabilities.Otology & Neurotology,40(7), pp.936-945.

Zafar, S., Lai, Y., Sexton, C. and Siddiqi, A., 2020. Virtual Reality as a novel educational tool in pre?clinical paediatric dentistry training: Students’ perceptions.International journal of paediatric dentistry,30(6), pp.791-797.