Making the Cochlear Connection in Class Educational audiologists and speech-language pathologists can use a range of strategies to help students with cochlear implants better access instruction. School Matters
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School Matters  |   July 01, 2017
Making the Cochlear Connection in Class
Author Notes
  • Kelly Nichols Starr, MA, CCC-SLP, works in the audiology department at the Michigan Medicine Cochlear Implant Program at the University of Michigan in Anne Arbor. kellnich@med.umich.edu
    Kelly Nichols Starr, MA, CCC-SLP, works in the audiology department at the Michigan Medicine Cochlear Implant Program at the University of Michigan in Anne Arbor. kellnich@med.umich.edu×
Article Information
Hearing Aids, Cochlear Implants & Assistive Technology / School Matters
School Matters   |   July 01, 2017
Making the Cochlear Connection in Class
The ASHA Leader, July 2017, Vol. 22, 38-39. doi:10.1044/leader.SCM.22072017.38
The ASHA Leader, July 2017, Vol. 22, 38-39. doi:10.1044/leader.SCM.22072017.38
Today, many children with cochlear implants (CIs) reach age-equivalent listening and spoken language when compared to typical hearing peers. This achievement often results in successful placement in mainstream classrooms. Recent medical and technological advances in the treatment of hearing loss, combined with improvements in early identification, contribute to this improvement in spoken-language outcomes for these children.
However, as wearable components of hearing technology get smaller and more stylish and spoken language improves, identifying students who use CIs becomes more challenging. Without such identification, teachers may misinterpret a child’s difficulty with listening in the classroom as poor behavior or poor attention.
Students with CIs still need accommodations and strategies in classrooms, even if they demonstrate “speech and language within the average range.” Here are several accommodations and strategies with a listening and spoken-language focus to support children with CIs.

Students with CIs still need accommodations and strategies in classrooms, even if they demonstrate “speech and language within the average range.”

Implement a cue to listen. Most classrooms are a source of constant noise. Using a “cue to listen” strategy alerts the child with a CI to pay attention because the teacher will start presenting instructions. Examples of such cues include calling the student by name or flashing the lights, which alerts the entire class to listen.
Comprehension check. Children are excellent at pretending they understand what they just heard. They frequently nod in agreement or respond “yes” when asked if they understand. Avoid yes/no questions—such as “Do you understand?”—and instead inquire about the information by posing open-ended questions, such as “What should we work on next?” or “What did I say?”
Get closer, not louder. Improving proximity to the microphone of the speech processor will maximize the auditory signal the student receives. Increasing vocal volume, however, can cause words to become distorted. Ideally, the student should sit close to the teacher. This allows a child with CIs to access auditory and visual cues.
Acoustic highlighting. Background noise and reverberation make a listening environment more challenging for children with CIs. Improve audibility by reducing background noise and by providing seating away from such noise sources as open windows and loud hallways. Asking educators to use a singsong voice and a slightly slower rate of production generates a clearer speech sound for the student.
Repetitions. Have students with CIs practice asking teachers to repeat directions. This helps them feel more confident about asking others to repeat speech they’ve missed.
Pre-teach vocabulary. Work with classroom teachers to obtain vocabulary lists prior to introduction in the classroom so students can review words at home and with the speech-language pathologist. This exposure allows the student to hear new words and concepts in a quiet environment before they are presented in the noisy classroom, which helps ensure an accurate acoustic representation for each word. This technique also enables the child to follow along in class with confidence and ease.

Ironically, a child’s learning environment might present one of their most acoustically challenging settings.

Use written visual aids. Visual aids, such as written instructions, confirm what the teacher presented verbally. This works well with homework assignments as well as classroom tasks.
Promote self-advocacy. Review students’ listening accommodations with them regularly to make sure they understand them—and are using them correctly. Teaching students with CIs to actively and independently promote their needs—such as sitting close to the teacher and using an FM/DM microphone as available—goes a long way toward their success in school and beyond. Help your students accurately describe the parts of the CI processor so they can help troubleshoot if equipment breaks down. Acquiring these skills at a young age instills the importance of knowing and using them early in a student’s life.
Ironically, a child’s learning environment might present one of their most acoustically challenging settings. Providing access to clear sound significantly improves comprehension and learning for children with CIs.
2 Comments
July 9, 2017
Karen Maitland
Accommodations and Strategies
This article offers great ideas for accommodations and strategies. Too often our students with cochlear implants are overlooked in the classroom. This will be helpful to share with classroom teachers and paraprofessionals as the new school year begins.
July 16, 2017
Monica Faherty
Great article!
Excellent ideas in this article. I especially like having the student practice asking the teacher for clarification.
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July 2017
Volume 22, Issue 7