How Do I Know if the Cochlear Implant

How Do I Know if the Cochlear Implant is Working?

Gail S. Murray, Ph. D. , CCC-A Associate Professor, CWRU Director, Audiology Services Clinical Director, Cochlear Implant Program UH Case Medical Center Rainbow Babies & Children’s Hospital August 5, 2009 Gail. murray@uhhospitals. org

Introduction • Cochlear Implant Manufacturers – Cochlear Americas (Nucleus) – Advanced Bionics (AB) • Also known as Clarion – Med-EL

Introduction • Each manufacturer supports multiple sound processor models. • Each manufacturer has “current” sound processor technology that is back-ward compatible with “older” implant technology. • Each sound processor requires slightly different troubleshooting procedures.

Troubleshooting made easy. . . Identical Main Modules Different Controllers

Recommendations for Schools • At least one person at school become familiar with the student’s sound processor. • Learn the model name of your student’s sound processor. • Learn the components or parts of the sound processor by name. • Practice preventative maintenance

Troubleshooting Toolbox • Be prepared to troubleshoot • Work with the parents & audiologist to have the following on hand: – Appropriate back-up batteries – Appropriate battery holder/rack – Monitor Headphones – Signal Check – Back-up transmitting cables – Lapel or Auxiliary Microphone

Nucleus Freedom Standard BTE Sound Processor • Sound Processing Module • Microphone(s) • Transmitting Coil/Cable Coil • Coil & Magnet • Controller • Batteries or Rechargeable Battery Module

Nucleus Freedom Body Worn Sound Processor • Sound Processing Module • Microphone(s) • Transmitting Cable/Coil • Coil & Magnet • Controller Shoe & Cable • Batteries or Rechargeable Battery Module

Nucleus Esprit 3 G Sound Processor • Microphone(s) • Transmitting Cable/Coil (missing in slide) • Coil & Magnet • (missing in slide) • Controls • Battery module

Advanced Bionics Harmony BTE Sound Processor and Components • Sound Processing Module & Controller • Microphone & Ear Hook • Transmitting Cable/ Coil • Coil & Magnet • Rechargeable Battery Module

Advanced Bionics Harmony BTE Sound Processor and Components There are two other models of BTE processors Auria Platinum/CII BTE

MED-EL Ear-level Speech Processors • Tempo+/OPUS 1 – Program/volume switches – Sensitivity dial • OPUS 2 – Switch free design – Fine. Tuner™

MED-EL Tempo+ BTE Sound Processor • Sound Processing Module & Controller • Microphone(s) • Transmitting Coil & Magnet • Transmitting Cable • Ear Hook • Battery Module

MED-EL Opus BTE Sound Processor • Sound Processing Module & Microphone(s) • Coil & Magnet • Transmitting Cable • Earhook • Battery Module • Connecting piece

Basic Troubleshooting Concepts • Establish a two-way communication & notification method with the student’s parent. • Incorporate an action plan for daily equipment checks into the student’s IEP

Basic Troubleshooting Concepts • Establish reliable speech-base feedback tools to use for daily listening check. – – Ling 6 sounds test (aa, oo, ee, sh, ss, mm) Closed set spondees (baseball, airplane) Closed set words (colors, familiar names) Open set words/sentences (What did you eat for breakfast; Who drove you to school).

Ling 6 Sound Check

Cochlear Implant Accessories – to have on hand • • Monitor Headphones Lapel or Auxiliary Microphone Signal Check or System Sensor Battery Charging System Earhooks (T-Mic, Direct Connect, etc) Audio or Interface Cables User Manual (CD)

Nucleus Freedom BTE Accessories • Monitor Headphone • Lapel or Auxiliary Microphone • Signal Check/System Sensor • Battery Charging System • Earhooks (T-Mic, Direct Connect, etc) • Audio or Interface Cables • User Manual (CD)

Sprint Body Worn Accessories • Monitor Headphone • Lapel or Auxiliary Microphone • Signal Check/System Sensor • Battery Charging System • Audio or Interface Cables • User Manual (CD)

Freedom Sound Processor Help Messages

Freedom Sound Processor Help Messages • H 1 = Battery flat – Check for proper battery insertion – Change batteries; change battery holder • H 2 = Battery low – Change batteries • H 3 = Coil error – Check for proper coil insertion & placement – Check for cable damage – Change coil

Freedom Sound Processor Help Messages • H 4 = Sound/stimulation error – – – Turn processor “Off”, “On” Check/change microphone protector cover Check/change coil Check sensitivity & volume settings > 0 Use the lapel microphone to sound processor check microphone – Contact parent &/or student’s cochlear implant center

Freedom Sound Processor Help Messages • H 5 = MAP corrupt – Try alternate program – Contact student’s cochlear implant center • H 6 = RF interference – Contact student’s cochlear implant center

Harmony Sound Processor Help Messages

Harmony BTE 3 Color Help Messages • Red: – A communication error with implant – Processor/ear is mismatched – Headpiece off or loss of communication • Green: – Microphone is working – Program slot is empty • Orange: – Battery is low – Battery needs to be changed/dead – Battery charge status

MED-EL: Verifying normal equipment function • The red LED will illuminate 4 -5 seconds when the processor is first activated (brief flashes for Opus 2) • This uploads the map, & performs a diagnostic check. • LED light continues to blink only when communicating a problem.

LED Indicator in MED-EL Processors • • Processor status Program errors Low battery Flashing patterns can be deactivated by the CI audiologist

MED-EL TEMPO+/OPUS 1

Fine. Tuner Tips • Not needed during the day unless: – Child has need of the telecoil feature – Child needs to make a program or volume change • If processor batteries are changed, it reverts to the same settings previously in use – One exception: Telecoil on reverts to mic on

Basic Troubleshooting Concepts • Check for power – Processor turned on & in proper program – Check for visible signal light or LCD display – Replace batteries

Power Options • Ask parents to provide disposable battery pack option

Basic Troubleshooting Concepts • Check for visible defects – Frayed cables – Cracked casing or controller – Loose connections • Cables, component parts, batteries

Basic Troubleshooting Concepts • Check Transmitting Coil & Cables – Steps: 1. Confirm that cable(s) is plugged in correctly. 2. Hold the signal check over the transmitting coil when power is on.

Basic Troubleshooting Concepts • Check Transmitting Coil & Cables – Steps: 3. Red light should illuminate. 4. Replace transmitting coil one at a time; apply signal check after each component change. 5. Check microphone if no transmission. MED-EL signal check: Nucleus:

Basic Troubleshooting Concepts Advanced Bionics

Basic Troubleshooting Concepts Advanced Bionics

Microphone Check

Basic Troubleshooting Concepts • Microphone Check Steps: – Turn off sound processor – Attach monitor headphones – Turn sound processor on – Perform listening check • Use Ling sounds & running speech • Own voice should be clear & static free • Move cables around & listen for static or intermittency – Apply Aux mic & compare sound

Use of Auxiliary Microphone • When the student’s headset or sound processor microphone produces no sound or sound of poor quality, the Aux/Lapel microphone may be used until a replacement microphone is available • Attach the lapel mic outside the student’s shirt, near the chin, and away from objects that may produce sound interference (e. g. jewelry).

Don’t forget about the internal device • When all else fails – refer the student back to the implant center &/or surgeon

Other Learning Tools • Join the hands-on demonstration at today’s Break-Out Sessions. • Accompany your student to the CI Center for a mapping session. • Attend the Greater Cleveland Cochlear Implant Support Group Meetings – 3 per year.

Help by Phone. . . • Cochlear Americas 800 -523 -5798 • Advanced Bionics 800 -678 -2575 • MED-EL 888 -633 -3524 Ask for Customer Service, or for the “Audiologist on call” • The student’s Cochlear Implant Audiologist

Help on the Web. . . • http: //www. cochlearamericas. com/PDFs/T eachers. Guide. Chpt 6. pdf • http: //www. bionicear. com/tfs_ – Interactive Troubleshooting guide on-line • http: //www. medel. com/ENG/INT/60_Conta ct_and_support/020_download_center. asp

All questions will be honored answered at the end of the morning proceedings. Please write your questions on a provided note card.