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April 29, 1999

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Cochlear Implant Increases Access To Mainstream Education

Reduces need for special education support after two years

Researchers at Johns Hopkins report that profoundly deaf children receiving a cochlear implant are more apt to be fully mainstreamed in school and use fewer school support services than similarly deaf children without an implant.

Results of the Hopkins-funded study, believed to be the first in the United States to examine the use of special education aid such as speech therapy, interpreters and tutoring in students with a cochlear implant, is published in the May 1 issue of Archives of Otolaryngology--Head and Neck Surgery. Specifically, the study showed children who received the implant plus one year of intense auditory and language development training were fully mainstreamed faster, at younger ages and at higher rates than a comparison group without implants. They also were less dependent on special education services after an average of two years. The study additionally placed the cost savings of educating a child receiving an implant at age 3 at $30,000-$100,000 over the course of primary and secondary school education.

"The cochlear implant also appears to give children a significant educational advantage," says Howard W. Francis, M.D., assistant professor of otolaryngology--head and neck surgery at Hopkins and lead author of the study. "It offers the possibility for the development of verbal language, which increases the chance of English literacy, and better educational and vocational opportunities."

Francis and his colleagues reviewed the progress of 35 school-age (K-8) children with profound hearing loss. Prior to implantation, 22 attended special education classes full-time in public schools, five attended the Maryland School for the Deaf and eight were in special preschool classes. All received a multi-channel cochlear implant at the Listening Center at Hopkins and underwent one year of comprehensive auditory training and speech rehabilitation.

Following implantation and rehabilitative therapy, the Hopkins team found that during the first two years there was very little change in the children's education status. After two years there was a significant trend toward full-time mainstream placement; after four years, 75 percent of the children were in mainstream classes full-time, relying on an average of only one hour of special education support.

Francis says he'll now focus on how a child's age at the time of diagnosis of hearing loss and age of intervention impact his or her development and educational independence. Other studies will compare the type of intervention (lip reading vs. sign language) used.

"Our first priority is the development of verbal language regardless of the type of intervention," he says. "It appears that the cochlear implant enhances the achievement of this goal."

Francis cautions that their results may not be duplicated everywhere. "These results depend on the kind of rehabilitative training the child receives," he says. "The children in this study have undergone intense, comprehensive rehabilitation here. Many programs differ in their approach to rehab."

The cochlear implant is an electronic assistive listening device surgically implanted within the inner ear to stimulate hearing. Candidates for the cochlear implant have a severe to profound hearing loss (cannot discriminate sound in words and language) and do not benefit from high-powered hearing aids. Cochlear implants have been found to be among the most cost- effective medical procedures, ranking above other medical interventions like coronary artery bypass surgery and cardiac transplantation.

The study's other authors were Mary E. Koch, M.A.; J. Robert Wyatt, M.D., M.B.A.; and John K. Niparko, M.D., all of the Listening Center at Johns Hopkins.

Relevant Web sites:

The Listening Center at Johns Hopkins -- http://www.med.jhu.edu/listen/
The Johns Hopkins Department of Otolaryngology/Head and Neck Surgery -- http://www.med.jhu.edu/otolar
The Johns Hopkins Research and Training Center for Hearing and Balance -- http://www.bme.jhu.edu/labs/chb

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