Biography:

Max Stanley Chartrand serves on the advisory committees to the American Tinnitus Association, the Better Hearing Institute, Audiology Online, and is a professional member of the Society of Behavioral Medicine, on the Federal & State Advocacy Committee of the International Hearing Society, and the Advisory Committee for the Arizona Division of Hearing Aid Dispenser Licensing. He is also a professor of Behavioral Medicine and has served on numerous doctoral research committees relative to human health and the hearing sciences. In 1994, he was recipient of the Joel S. Wernick Excellence in Education Award, and has published and lectured extensively throughout the world over the past four decades. At age 3 he became severely hearing impaired and later profoundly deaf. He utilized hearing aid and assistive technology for many years until cochlear implant technology and assistive devices were advanced enough to accommodate his profound deafness. He believes that there has never been a time that communicative options and amplification technologies have been more accessible, more attractive, and more affordable than they are today. His findings are that the market has grown exponentially faster than the industry’s ability to accommodate it. Now, he says, is the most exciting and empowering time to be in the hearing health—the good that can be done is immeasurable and so vital to the well-being of so many hearing loss sufferers and their families.

Abstract:

ABSTRACT Hearing care professionals and hearing aid manufacturers still report untenable levels of remakes, returns for credit, and cases of failure to fit for a variety of reasons. Hearing aid discomfort, own-voice artifacts, and cost/benefit perceptions top the list of reported reasons.1,2, 3,4In the present study, the status of the keratin or corneum stratum in the external auditory canal (EAC) has been found to negatively or positively affect hearing aid adaptation.5,6 These include keratin’s role in preventing oversensitivity in EAC mechanoreceptors (hair follicles, Meissner corpuscles and Pacinian corpuscles) and their subsequent neuroreflexes (Arnold’s Branch, Trigeminal, and Lymphatic Reflex), which affect own-voice perception, insertion and removal, wearing comfort, and coupler adaptation.1,7,8 STUDY PROFILE The Problem • Challenges due to missing or disrupted EAC keratin present obstacles to successful adaptation to wearing hearing aids • Because this is difficult to address adequately at the patient care level, too many new hearing aid users complain of discomfort, own-voice artifacts, and fail to accept their hearing aids • This perpetuates the problem of an unsustainable number of remakes and returns for credit (RFC), too many cases of failure to fit and subsequent delay in obtaining hearing correction Research Question: “How might clinicians identify keratin status and provide counsel relative to effects of hypersensitivity of the EAC neuroreflexes during hearing aid fitting and adaptation process?” Study Design: Bivariate correlational, retrospective file study, 45-day timeline, utilizing best practice standards Participants: 98 new hearing aid users, aged 29-95, 62 males, 36 females, selected randomly from 435 files at a hearing health/occupational therapy practice in Southern Colorado Materials: Patient files, Participant Data Sheet, Rating Scale for Keratin Status & Hearing Aid Adaptation, HIPAA Informed Consent Form, Notice of Privacy Policy, In-house Shipping & Logging Records Ethical Considerations: Observation of all federal, state, and local laws governing dispensing of hearing aids; Participants previously signed Informed Consent forms, HIPAA forms; IRB Review (Northcentral University) Hypotheses: • Ho: Keratin status of the EAC has no positive relationship with successful adaptation to wearing hearing aids. • Ha: Keratin status of the EAC is closely associated with success in physically adapting to wearing hearing aids. Measures Ratings of EAC Keratin Status (Likert-type scale 1-3): • Level 1: Absent/peeled keratin • Level 2: Thin or granulated keratin • Level 3: Moderate, thick keratin (w/ spaced desquamation lines) Ratings for hearing aid adaptation success (Likert-type scale 1-5): • Level 1: Failure to Fit/Complete RFC • Level 2: Exchange or one-sided RFC • Level 3: Remake/problems adapting • Level 4: In-office modifications • Level 5: Adaptation without difficulty

Biography:

Somia Tawfik is a Professor of Audiology at Ain Shams University, Cairo, Egypt. She graduated from the Faculty of Medicine at Ain Shams University in 1978 and received her Master’s (1982) and Doctorate (1986) degrees at the same university. She has many publications in the area of Central auditory evaluation & development of Arabic material for central auditory testing in adults & children and shared in development of an Arabic computer-based material for remediation of children with central auditory processing disorders. She has good clinical experience in evaluating and remediating patients with different hearing disorders, especially children with auditory neuropathy. She had been the Director of the audiology unit, Ain Shams University for twelve years (1998-2010) and got two grants and organized many local and international conferences. Presently, she is a member of the International Association of Physicians in Audiology, the Egyptian Audio-Vestibular Medicine Association and the Egyptian Society of Oto-rhino-laryngology. She is reviewer of the Egyptian Journal of Ear, Nose and Throat and Allied Sciences and Journal of the American Academy of Audiology. Her present research focuses on new horizons in central auditory testing such as speech-evoked potentials in children with central auditory processing disorders and language disorders. She also shares in research on hearing aids, vestibular testing and rehabilitation of hearing-impaired children and central auditory testing in elderly.

Abstract:

A comprehensive program for remediation of auditory processing disorders was developed in Arabic language in order to suit Arabic-speaking children. Arabic computer-based auditory training program (CBAT) was developed by a multidisciplinary team of audiology, phoniatrics, acoustic engineering, and software programming. The program proved to be an efficient approach for remediation of auditory processing disorders. It offered several advantages including multi-sensory stimulation in an engaging format, generous feedback and reinforcement that facilitates intensive training with a highly interesting and attractive theme for children. Application of the program on children with auditory processing disorders particularly those with language and learning problems as well as on children with (C)APD combined with other perceptual disorders & neuro-psychiatric disorders showed promising outcome. Evaluation of the outcome showed beneficial improvement subjectively and objectively. Arabic CBAT program is a new horizon for management of auditory processing disorders.

Biography:

Allan T P Ho is an Associate Professor in the Department of Surgery, Faculty of Medicine at the University of Alberta. He is an Otologist, cochlear implant and lateral skull base Surgeon in the Division of Otolaryngology Head and Neck Surgery. He serves on several local, national and international scientific committees. He chairs the Canadian Otology subspecialty group of the Canadian Society of Otolaryngology. He is the Director of the Edmonton Ear Clinic. He graduated from the University of Newcastle-upon-Tyne, United Kingdom. He obtained fellowship training in otology, neurotology and skull base surgery in Halifax, Nova Scotia.

Abstract:

Objectives 1. To update the audience on the latest developments in hearing loss management with surgical implant technology 2. To discuss the evolution of bone conduction hearing devices 3. To explore the clinical rationale behind choice of surgical hearing implantable devices including active and passive middle ear implants and cochlear implantation. In the last 5 years the surgical implant world has seen an explosion of innovation for patients with mixed hearing loss, conductive hearing loss and single sided deafness. This includes percutaneous bone conduction devices (Cochlear BAHA, Oticon Ponto), transcutaneous bone conduction devices (Sophono, BAHA Attract), active transcutaneous bone conduction devices (MedEl Bonebridge, Oticon BCI) and also devices with their actuator coupled directly to the cochlea (MedEl Vibrant soundbridge, Codacs). The extensive choices of internal implantable devices and external processors make the rationale for the choice of treatment more complex and challenging. With regard to these new devices, safety, stability, complexity of surgery, risks of surgery and the economic considerations will be explored.

Biography:

Luciana Macedo de Resende is a Speech-Therapist and Audiologist. Graduation and Post Graduation Professor at Federal University of Minas Gerais (UFMG), Brasil, Doctor in Human Communication Disorders. She develops research with biomedical engineering research group at UFMG as well as part of the research group CTBG/UFMG (Congenital Toxoplasmosis Brazilian Group).

Abstract:

Aim: The present study aimed to describe the performance of patients referenced to auditory processing assessment and associate findings to age, gender, complaints and also correlate behavioral and electrophysiological findings.

Methods: Cross-sectional descriptive study. Patients referenced to the audiology service for auditory processing assessment were included in the study. All patients underwent tonal audiometry, tympanometry, acoustic reflexes, behavioral and electrophysiological measures. Selected behavioral procedures included dichotic tests, monaural low redundancy tests, temporal processing tests and binaural interactions tests. Auditory brainstem response (ABR), middle latency responses (MLR) and P300 were the electrophysiological measures. Chi square and Fisher’s exact test were used at statistical analysis to associate categorical variables, followed by Kappa’s to observe the degree of associations. T test and Mann-Whitney were also used. Variables distribution was assessed with Kolmogorov-Smirnov and a p-value of 5% was adopted.

Results: Patients’ main complaint was learning disability and behavioral results which indicated maximum disorders in auditory temporal processing aspects and dichotic listening. Correlation was observed between behavioral and electrophysiological measures, particularlyauditory closure and MLRs, temporal ordering and MLR and P300, dichotic listening and P300, binaural interaction and acoustic reflexes.

Discussion: Individuals with learning disabilities may present maturational delay in cortical structures related to auditory abilities assessed with behavioral and electrophysiological measures. Both measures are relevant in diagnosing auditory processing disorders and directing auditory intervention plans.

Conclusion: Most patients referred to auditory processing assessment presented some learning complaint. Difficulties in temporal processing and dichotic listening tasks were the most prevalent. Electrophysiological measures helped diagnosis become more precise with correlation in many auditory aspects.

Biography:

Mark Williams is a Chief Audiologist at the The Tinnitus Clinic Ltd. He is a senior clinician specialising in the provision of tinnitus and hyperacusis management options for adults. He has a specific interest in tinnitus psychoacoustic measurement along with researching the efficacy of neuromodualtion therapies for the treatment of subjective percepts. He has both led and contributed to a number of clinic based observational studies. He currently leads a multidisciplinary clinical team for The Tinnitus Clinic Ltd. He has previously led a team of audiologists for the NHS and have been a clinical tutor/examiner for MSc and BSc Audiology students at University College London (UCL). He originally studied at UCL and obtained an honors degree in Molecular Biology, a Masters Degree in Audiological Science and a Post Graduate Diploma in Audiology Clinical Competency. He is registered as a Hearing Aid Dispenser with the Health Professions Council (HPC) and as a Clinical Audiologist with the Registration Council for Clinical Physiologists (RCCP).

Abstract:

Objective: To describe the quantitative treatment outcomes of patients undergoing acoustic coordinated reset (CR) neuromodulation at a single independent audiology practice over a 22- to 26-week period as part of an open label, non-randomized, non-controlled observational study.

Methods: Sixty-six patients with subjective tonal tinnitus were treated with acoustic CR neuromodulation with a retrospective review of patient records being performed in order to identify changes of visual analog scale (VAS, n = 66) and in the score of the tinnitus handicap questionnaire (THQ, n = 51). Patients had their tinnitus severity recorded prior to the initiation of therapy using the tinnitus handicap inventory in order to categorize patients into slight up to catastrophic impact categories. THQ and VAS for tinnitus loudness/annoyance were obtained at the patient’s initial visit, at 10–14 and 22–26 weeks.

Results: Visual analogue scale scores were significantly improved, demonstrating a 25.8% mean reduction in tinnitus loudness and a 32% mean reduction in tinnitus annoyance with a clinically significant reduction in percept loudness and annoyance being recorded in 59.1 and 72.7% of the patient group. THQ scores were significantly improved by 19.4% after 22–26 weeks of therapy compared to baseline.

Conclusion: Acoustic CR neuromodulation therapy appears to be a practical and promising treatment for subjective tonal tinnitus.

Biography:

K Ramdoo is working as an Ear, Nose and Throat Research Registrar in North West London Hospital Trust. Having completed his core surgical training in London, he has pursued his interest in research and is currently undertaking an MD at UCL alongside his clinical duties. His particular area of interest is screening for hearing loss and detection at an early stage and well as product development to enable this. He has written a number of research papers on the topic and presented both nationally and internationally.

Abstract:

Objective: The ageing population has led to increasing numbers (approximately 330,000) of older people residing in care homes across England; estimates suggest 75% of them could have a hearing loss. This study aims to illustrate the current prevalence of undiagnosed hearing loss in a typical elderly care home and evaluate the feasibility of opportunistic screening of hearing loss in the community.

Method: Subjects over the age of 65 years were recruited from three Nursing homes. A validated subjective bed-side hearing screen (whisper test) was performed to identify individuals with hearing impairment. Subjects who failed or self-reported hearing difficulties were offered gold standard audiological assessment, pure tone audiometry.

Results: Hearing screening was performed on 56 patients, 20 (36%) of those self-reported hearing loss, 22 (39%) failed the screening whisper test. All (n=42) were referred for audiological assessment, of whom 5 declined and 11 were unable to engage in audiometric assessment. 62% had aidable hearing loss and were referred for hearing aids. This identified a screen: aid ratio of 2:1.

Conclusion: This pilot highlights a high incidence of undiagnosed hearing loss in elderly patient residents in a typical Care home. The results suggest consideration should be given for a screening program to help address this unmet need as part of a portable toolkit utilizing our Audiology team in the community. The team involved is currently developing this patented toolkit.

Biography:

Sudhira Ratnayake, MBBS, MRCSEd, DO-HNS (RCS Eng), MSc, is a Consultant Audiovestibular Physician at The Royal Wolverhampton NHS Trust and is the Team Leader for the local Newborn Hearing Screening Programme. He completed specialist medical training in Audiovestibular Medicine in London, UK, and has a Masters degree in Audiovestibular Medicine from University College London. His research interests are in the causes of hearing and balance disorders. His MSc thesis on aetiology of unilateral deafness in newborns has been cited in UK national guidelines. He has been involved in teaching junior doctors, medical students and Audiology students for over 10 years.

Abstract:

Deafness is the commonest congenital sensory impairment in humans. About 1-2 babies per 1000 births have severe to profound deafness and the prevalence rises with age. Causes of permanent deafness are varied. Approximately 50% is genetic in origin and the rest are environmental reasons. Of the genetic reasons, about 15% is syndromic and 85% is non-syndromic. Non-syndromic causes can be autosomal dominant, autosomal recessive, x-linked or mitochondrial mutations. Most of the syndromes can cause disorders in other body systems. e.g. vision and vestibular disorders in Usher Type 1, renal disease in Alport Syndrome. There are numerous environmental causes. Congenital cytomegalovirus (CMV) is the commonest congenital infection and can present with late-onset or progressive deafness. Symptomatic congenital CMV, if diagnosed early, can be treated with anti-viral medication to prevent the progression. Infections such as measles, mumps and rubella are becoming rare due to immunization. Meningitis needs urgent auditory and vestibular assessments to establish amplification and cochlear implantation. Ototoxic and vestibulotoxic medication can cause sudden or progressive auditory and balance difficulties. Head injuries can cause sudden deafness. There are several reasons why it is important to establish the cause of deafness. It can be the initial presentation of a much wider health problem. The aetiology can indicate the prognosis of deafness to help plan future care. Parents and young people may wish for genetic counseling. Cochlear implant outcomes may relate with the aetiology of deafness as some causes have associated learning and neurological disabilities. Aetiology is also important for epidemiological studies.

Biography:

Abstract:

Introduction: Intratympanic medication might alter cochlear NO-production resulting in damage or protection, respectively. In this study, the quantitative distribution patterns of gentamicin and doxycycline were determined after intratympanic application in the guinea pig animal model.

Materials & Methods: Gentamicin or doxycycline were injected into both middle ears of male animals (n = 24 and n = 3, respectively). The cochleae were removed 1, 2 and 7 days after gentamicin injection or 1, 6 and 24 h after doxycycline application, transferred into fixative and embedded in paraffin. The cellular staining reactions by specific antibodies against gentamicin and doxycycline were quantified computer-assisted on sections for seven different cochlear regions.

Results: Gentamicin was identified in all experimental groups in numerous regions of the cochlea but with quantitative cell-specific differences. An intense accumulation was observed within the spiral ligament, organ of Corti, nerve fibers, interdental cells and fibrocytes in the limbus-area. A low gentamicin accumulation was seen in spiral ganglion cells and no accumulation in the striavascularis. Statistic analysis revealed fixed effects of cell type and an interaction between treatment and cell type, but no effects of cochlea turn and of treatment. Analysis over time identified a reduction of gentamicin within the spiral ligament and nerve fibers. Doxycycline was preferentially located in the striavascularis and in hair cells.

Conclusion: In respect to the route of infiltration, a contribution of the vessel systems is discussed. The identified accumulation of gentamicin in those cochlea regions which are responsible for potassium recycling might result in a local NO-increase leading finally to cochlear damage. The specific accumulation of doxycycline in the striavascularis and hair cells might prevent an NO up-regulation in stress situations in these areas. Knowledge of cell specific accumulation of different pharmaceutical products offers a promising approach for human medication.

Biography:

Abstract:

Background: Dyslexia has been used to refer to the specific learning problem of reading. The temporal auditory processing deficit theory suggests that one causal deficit of dyslexia is an impaired ability to process sounds.

Objectives: To study auditory temporal processing in children with dyslexia using two electrophysiological tests.

Subjects & Methods: 80 children were participated in this study. They were divided into control group formed of 30 children and study group formed of 50 children. All participants had normal hearing sensitivity, normal middle ear function with average intelligent. All children were examined using speech auditory brainstem response and cortical auditory evoked potentials with /da/ speech stimulus at intensity 90 dBnHL.

Results: It showed that there was significant statistical difference between control and study group in both electrophysiological tests. Prolonged latency and reduced amplitude were recorded in children with dyslexia in S-ABR as well as in cortical auditory evoked potentials.

Conclusions: Children with dyslexia have deficit in auditory temporal processing and encoding of auditory information. Electrophysiological tests are sensitive in cases of dyslexia, so they were considered good diagnostic tests in such cases.

Biography:

Shalaby A, MD is a Professor of Audiology at Ain Shams University. He/She is a Member of International Auditory Physician Association (IAPA). He/She is a Member of Egyptian Otorhino-laryngology Society, and a Member of Egyptian Audio-Vestibular Medical Society. He/She is a Certified Trainer of KAMPS method of Auditory Integration Training (AIT), and a Reviewer of EJENTAS Journal. He/She is specialized in diagnosis & management of hearing & balance disorders. His/Her main domains are evaluation & management of children with learning disabilities, central auditory processing disorders (CAPD), attention deficit hyperactive disorder (ADHD), Autistic spectrum disorder.

Abstract:

This study included 2 groups: a study group of 60 children with mild to moderate sensorineural hearing loss (SNHL); and a control group of 30 normal hearing children. The children's age ranged from 6-12 years.

Objective & Methods: To study temporal auditory processing abilities in SNHL children using behavioural [Auditory fusion test (AFT); Duration pattern test (DPT); Pitch pattern sequence test (PPST); time compressed sentence test (TCST)] and electrophysiological measure [Mismatch negativity (MMN)]. And to study whether there is a correlation, if any, between results of behavioural tests and MMN in assessment of temporal auditory processing.

Results: The SNHL subgroups showed statistically significant lower scores in AFT, TCST, DPT and PPST as well as longer MMN latency than their controls. Age had significant effecton temporal auditory processing tests results and on MMN parameters but gender and aetiology of SNHL had no effect. There was no statistically significant correlation between results of behavioural tests and MMN in normal as well as SNHL children.

Conclusion: Sensorineural hearing loss affects temporal auditory processing abilities reflected on both behavioural & electrophysiological test results. Age showed maturational effect on behavioural tests in all subjects, but this effect was not reflected on the MMN results of the controls, despite of the significant effect of SNHL on MMN parameters. There was no correlation between behavioural & electrophysiological test results.

Biography:

Dr. Khabti Almuhanna.MD is KSU fellowship, Consultant Otorhinolaryngology, subspecialty Otology and Cochlear Implant at Prince Sultan Military Medical City, Riyadh KSA.

Abstract:

Otosclerosis has been derived from a Greek word meaning ear hardening. Clinical judgment was the only way to diagnosis this disease. Confirmation of the diagnosis preoperatively is needed in order to explain to the patient the procedure and the outcome. Multiple–frequency tympanometry (MFT) is a non–invasive, quick, and inexpensive method for examining the middle-ear function that found to be with value in differentiating otosclerotic from normal middle ears that caused re-searchers to evaluate its sensitivity to detecting otosclerosis. Resonant frequency had been found to be higher in otosclerotic middle ears than normal. We conducted multiple – frequency tympanometry measurements in three groups. First group otosclerotic ears (25 subjects) before stapes surgery, second group normal ears control group (24 subjects) and the third group the FMT was conducted after stapes surgery (10 subjects). Mean middle-ear resonant frequency for the otosclerotic group was found to be 1190 Hz and mean middle – ear resonant frequency of the control group was 934.6 Hz (p<0.001) and post-operative group where as 800Hz. The present findings confirm the advantage of the resonant frequency tympanometry in detecting middle – ear status and mechanics in patients with otosclerosis. As a conclusion, multiple–frequency tympanometry is sensitive in detecting the otosclerosis and we recommend it to be part of diagnostic toll before stapes surgery. However, further studies are necessary in order to brace this proposal.

Biography:

Zheng-min Xu has completed his PhD from Ghent University and Postdoctoral studies from same University, in Belgium. He is the directors of Shanghai Pediatric Hearing Center and ENT Department, Children`s Hospital of Fudan University, in Shanghai. He has published more than 40 papers in reputed journals and has been serving as an Editorial Board Member of China ENT journals etc.

Abstract:

The Chirp-Stimulus generates an optimized synchronous excitation of neurons in all regions of the basilar membrane. The stimulus structure allows modification to excite predefined regions in the cochlear. However, the chirp-ABRs have been investigated in few studies involving young children with varying degrees of hearing loss. Only some researchers reported that in this study a variety of tools were used to analyze the synchronicity of ABRs evoked by chirp- and click-stimuli at 40 dB HL in 32 normal hearing subjects aged 18 to 55 years. In our recent study, we investigate the relationship chirp-ABR and behavioral visual reinforcement audiometric (VRA) hearing thresholds in a group of infants with varying degrees of sensorineural hearing loss. In particular, we examine how accurately the prediction formulae (which were based on Chirp-ABR/VRA threshold correlation data) estimated hearing threshold in order to find out if it is possible to be used as the clinical application with regard to diagnostic audiology in young children. This study demonstrates the effective implementation of chirp-ABR predicted frequency-specific thresholds, especially of low- middle-frequency. The use of a chirp-ABR testing could be higher sensitivity and accuracy than that of auditory steady-state evoked response (ASSR) for measuring frequency-specific thresholds in young children.

Biography:

Assoc. Prof. Ayşe Sanem SAHLI, PhD. She earned ‘Master of Science degree’ at Hacettepe University, Institute of Health Sciences, Department of Otorhinolaryngology, Educational Audiology Program in 2005 and ‘Doctorate degree’ in the same program in 2010 and she received “Assoc Prof” title in field of Audiology in 2012. Between 2008–2010, she has worked with Warren Estabrooks who is a Global Ambassador of the Alexander Graham Bell Association for the Deaf and Hard of Hearing and professional trainer and she has earned certificate of Auditory-Verbal Therapy and Trainers of trainers. In 2009, during four months, she has been Albert Ludwig University, Freiburg University Hospital, Department of Otolaryngology and Freiburg Cochlear Implant Center as a fellow and visiting researcher. She carried out studies on cochlear implantation, programing (fitting), auditory re/habilitation and music therapy in Hearing and Speech Training Center Turkish and German patients and performed doctorate thesis on multiple intelligences and learning preferences of Turkish children with cochlear implant in Germany. She has been carrying out music therapy programs of hearing and speech disorder with childrens and their parents still. She has been working in Cochlear Implant Assosication Supervisory Board since 2006 and Hacettepe Disability Research and Application Center, Education Unit actively since 2010. She has been in organizations of many Audiology meetings and congresses and educational meetings for parents, teachers and society in different regions of Turkey. Dr.Sahlı, has been working as ‘editorial consultant/ scientific reviewer’ in journals and she has many scientific articles in international and national journals. She has attended many international and national congress/symposium as speaker or listener and currently, she has been continuing her vocational and academic studies as staff in Hacettepe University Vocational School of Health Services Hearing and Speech Training Center since 2004. Workspace: : Hearing loss, delayed speech, educational assessment in children with hearing and speech disorders and cochlear implant, assessment of speech and language, educational follows, auditory re/habilitation, auditory-verbal therapy, music therapy, family counselling.

Abstract:

Congenital hearing loss is a important public health problem. 1-3 infants are born with congenital bilateral sensor ineural hearing loss in Turkey. Several factors including degree, type and configuration of hearing loss, interact to determine the impact of hearing loss on auditory perception, speech, language and communication skills. National Newborn Hearing Screening Program (NNHSP) are very important for early hearing detection and early intervention services. Newborn Hearing Screening Program has begun firstly in 2003 in Turkey. For a effective new born hearing screening program, all new borns should have access to hearing screeening before 1 month of age, confirm the presence of hearing loss before 3 months of age and receive intervention services before 6 months of age. Early intervention services include hearing technologies (hearing aid, cochlear implant) and auditory verbaltherapy (auditory habilitation). Early intervention programs should be family centered and all infants should be assessed and monitored for auditory, language and speech development.