State legislation mandating universal newborn hearing screening and subsequent follow-up is leading to the identification of greater numbers of infants with hearing loss. Infants with profound hearing losses represent one of the greatest intervention challenges. Traditional hearing aid technology may provide many of these children with some access to sound; however, the extent to which conventional hearing aids help in hearing the full range of speech sounds is very limited. Cochlear implantation has become a very feasible and effective method of (re)habilitation for these children. Recent approval of one particular cochlear implant by the U.S. Food and Drug Administration (FDA) has expanded the eligibility criteria for implantation to include infants 12 months of age or even younger in cases such as meningitis where cochlear ossification is a concern (Cochlear Corporation, 2001). This allows cochlear implant centers to implant children at increasingly younger ages. As a result, the age of children receiving cochlear implant (re)habilitation services is steadily decreasing. Many professionals, however, have limited experience working with profoundly hearing-impaired infants, both pre- and post-implantation.; This document outlines the progression of speech, language and listening skills in infants and toddlers with cochlear implants. In addition, the benefits of early intervention and implantation, the role of parental involvement in determining outcomes, and appropriate communication techniques for fostering auditory, speech and language skills will be reviewed. Lastly, these principles will be applied to developing an evidence-based overall treatment plan and materials that may be used in activities for encouraging communicative skills in infants and toddlers with profound hearing impairments and cochlear implants.
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