Because cochlear implants are a specialty, implant centers are few and sparsely located. Cochlear implant programming, testing and follow-up require frequent visits and substantial time commitments from patients and their families. Many families must travel long distances to reach their clinic appointment, which can be costly and often results in missed time from school and work. And, if a child is unable or unwilling to engage in the programming process, additional appointments would be necessary.
Boys Town National Research Hospital researcher, Michelle Hughes, Ph.D., Director of the Cochlear Implant Research Laboratory, is studying the effectiveness of remote cochlear implant service delivery.
“Our research on remote cochlear implant service delivery will hopefully provide an avenue for increased access to clinical services and better outcomes for all cochlear implant recipients, especially for children who are still developing listening skills,” said Dr. Hughes.
Dr. Hughes and her team are currently conducting three studies that make up the research project, Telepractice for Cochlear Implants. The studies focus on how to effectively deliver a range of cochlear implant services through remote technology for individuals in varying geographical locations.
The first study focuses on validating the use of telepractice for pediatric-specific hearing testing procedures that are used to program the cochlear implant. Remote programming of cochlear implant sound processors for adults has been validated in earlier studies, but test methods for young children are much more challenging. Young children do not understand the concepts of soft and loud, nor do they have the language to tell the audiologist about what they hear through the implant.
Because of this barrier, audiologists use behavioral conditioning methods in a clinic setting that either engage the child with games or reinforce certain behaviors that indicate when they hear a sound. This method requires two clinicians – one who is manipulating the cochlear implant programming software and one who is engaging the child and watching for responses. Recreating the behavioral conditioning for a remote setting adds to the complexity of the task because both clinicians must coordinate communication and timing efforts. Lapses or delays during remote testing may alter results.
Two other studies in this project are examining ways to test speech understanding with the implant in a remote setting and evaluating outcomes of aural rehabilitation conducted in person versus remotely via videoconferencing.
“While we still have more work to do, our recent research shows promising results that we believe will greatly expand access to specialized cochlear implant services,” said Dr. Hughes.
Dr. Hughes’s research team includes Sangsook Choi, Ph.D., Sara Robinson, M.A., CCC-SLP, and Alexis Mills. The Telepractice for Cochlear Implant research project is part of a $212,500 per-year five-year grant funded by the National Institute on Deafness and other Communication Disorders (NIDCD) at the National Institutes of Health (NIH).