Hearing aid trial in multi-handicapped child (General Considerations)

Children with developmental disabilities are a heterogeneous group. Cochlear implant (CI) candidacy must be determined on a case-by-case basis. In syndromic or handicapped child, it is particularly difficult. In many cases, this is based primarily on the results of objective and behavioral audiometric tests combined with the results of the questionnaires and surveys. The restrictive responsive capacity of mentally handicapped child makes it difficult to confirm the existence of residual hearing by means of audiometry. Besides, mentally retarded children lack the cognitive or linguistic skills to participate in speech recognition testing. Objective audiometric test are valuable but aided and unaided behavioral thresholds after a certain amount of hearing aid use are more important. CI candidacy may be determined primarily on the basis of aided speech detection thresholds after an appropriate hearing aid trial. Anticipated expectations for child outcomes are discussed candidly with families during this pre-implantation evaluation.