 |
| SOURCE |
Cochlear Implant Assessment: Child Profile
Teacher of the Deaf:
Speech and Language Therapist:
Physiotherapist/Occupational Therapist
Main Day-care Provision (please circle):
Please circle as appropriate for the following, giving name and contact telephone number.
1. Does the child have a special support assistant or intervener? Yes / No No. of hours? _____
3. Has an educational psychologist assessed the child? Yes / No
4. Statement of Special Educational Needs (please ring as appropriate)
Not initiated Initiated Completed Review Month: ________________
Vision: | |
Visual field | Binocular co-ordination |
Visual acuity | Colour vision |
Contrast sensitivity | Light-darkness adaptation |
Hearing: | |
Awareness of sound- both environmental and elicited | Imitation of sound |
Response to sound (how is it manifested?) | Identification of sound |
Communication skills: | |
Which method of communication is used with the child? (Please circle) | |
How does the child attempt to get the attention of others? | Does the child initiate interaction or only respond? |
How are needs and wants expressed? | How are emotions expressed? |
Is the child interested in taking part in any form of interaction? | Does the child associate any words, signs or symbols with another person, object or event? |
What form does the interaction take? | Other Comments |
Cognitive skills: | |
Can the child attend to a task? | Can the child classify: sort or match? |
Does the child have awareness of people, objects, events, places? | Does child have symbolic understanding? |
Does the child demonstrate recognition of people, objects & places? | Does the child display imitation: the ability to copy or turn-take? |
Memory: does the child show the ability to predict, store information in the short or longer term? | Curiosity: does child show the ability to explore immediate environment; any awareness of cause and effect or problem solving skills? |
Does child show the ability to anticipate events? | Further comments? |
Socialisation skills: | |
Child’s awareness of self and others | Is interaction with adults and children the same – is there a preference? |
Form in which interaction takes place | Does child display attachments to others? |
Environment: | |
Awareness of different environments? | Does child have preference for particular environment? If so, why? |
Response to change? | |
General development: | |
Sitting unsupported, standing with support etc.) | |
Please add any further information that you feel may be helpful to us in assessing this child.
Thank you for taking the time to fill in this questionnaire
- Meinzen-Derr J, Wiley S, Grether S, Choo DI. Language performance in children with cochlear implants and additional disabilities. Laryngoscope. 2009.
- Hans PS, England R, Prowse S, Young E, Sheehan PZ. UK and Ireland experience of cochlear implants in children with Down Syndrome. Int J Pediatr Otorhinolaryngol. 2009.
- Johnson, Karen C.; DesJardin, Jean L.; Barker, David H.; Quittner, Alexandra L.; Winter, Margaret E. Cochlear Implants and Multiple Disabilities: Two Case Studies. Otology & Neurotology. 29(2):246-250, February 2008.
- Edwards L. Children With Cochlear Implants and Complex Needs: A Review of Outcome Research and Psychological Practice Journal Deaf Stud. Deaf Educ. (2007) 12 (3): 258-268.
- Edwards, Frost and Witham. Developmental delay and outcomes in paediatric cochlear implantation: implications for candidacy. Int J Pediatric Otorhinolarnoglogy 70(9) 1593-600 (2006)
- Holt and Kirk. Speech and Language development in cognitively delayed children with cochlear implants. Ear and Hearing 26, 132-148 (2005)
- Lee, Lustig, Sampson, Chinnici, Niparko. Effects of CMV related deafness on pediatric cochlear implant outcomes Otolaryngology, Head and Neck Surgery 133, 900-905 (2005)
- Wiley S, HahnkeM, Meinzen-Derr, and Choo. Perceived qualitative benefits of cochlear implants in children with multi-handicaps. Int. J of Pediatric Otorhinolaryngology
- Filipo, Bosco, Mancini and Ballantyne. Cochlear implants in special cases: Deafness in the presence of disabilities and/or associated problems. Acta Otolaryngology Suppl. 552, 74-80 (2004)
- Donaldson, Amy Isaacs MA; Heavner, Krista S. MS; Zwolan, Teresa A. PhD Measuring Progress in Children With Autism Spectrum Disorder Who Have Cochlear Implants. Archives of Otolaryngology -- Head & Neck Surgery. 130(5):666-671, May 2004.
Cochlear Implants and Complex Needs
"Deafblindness: where do we come from, where are we, and where are we going" Professor Claes Möller (3 April 2008) click here to view the script
"Audiology Management of deaf children with additional complex needs" Dr Wendy McCracken (22 May 2007) as part of the Phonak Virtual Conference The lecture slides are available here