Programming of the cochlear implant, or what is commonly called a "Mapping", refers to the setting of the electrical stimulation limits necessary for the cochlear implant user to "hear" soft and comfortably loud sound. Since the Cochlear Implant can only process sounds in a very narrow range (6-15 dB), it must be able to compress the natural range of sounds (normal speech is usually between 40-60 dB) into this small band.
Due to the this small range of sound that a cochlear implant is limited to, CI users are more sensitive to loudness changes. Therefore, "stimulation levels" must be set so the sounds processed by the cochlear implant should not cause discomfort to the CI user. These stimulation levels correspond to psychophysical (i.e. sensory responses to outside stimuli) measurements known as Threshold (T) and Comfort (C or M) Levels. During the mapping process, the "T" and "C" levels of each individual electrode on the cochlear implant's internal electrode array (the spiral located inside the inner ear or "cochlea") are adjusted in order for the user to hear the wide range of sounds that one is typically exposed to (soft to loud).
Programming
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Each MAP is individual to its user and is constantly changing. Over time, MAPs may become weak, softer, or less clear. This may be the result of tissue growth, or the user becoming used to their MAP and 'adapts' to it, finding that over time, it may no longer be a loud enough signal. Re-programming the device will compensate for the changes that may occur due to adaptation.
Threshold (T-levels) measurements may be obtained in several ways, depending the age or functioning level of the patient. For children over age six, a hand raising method is used to determine T-Levels (similar to a hearing test). For children under three, a different method is used, where the child is trained to look at a moving toy in response to sound. The stimulation is then reduced until the lowest level that the child is able to detect the sound. Typically, two audiologists are used; one training the child and one manipulating the computer controls.
For children between the ages of three and six, play audiometery is used. The child is trained to place a block in a box in response to electrical stimulation. The stimulation is reduced to the lowest detectable level.
Comfort level measurements may also be obtained in several ways, depending the age or functioning level of the patient. For children over 5, a loudness scaling chart or verbal response is used to determine Comfort Levels. For children under age five, the comfort levels may have to be estimated, using the threshold levels or other objective measures as a reference.
The mapping report provides printed out information on map parameters, threshold and comfort level settings. Parents' understanding of this report is not necessary in the child's progress with the device. It is merely a print-out of the settings created during the mapping session. It should be used only be used as a reference for the mapping audiologist.
What may be helpful to the parent is a report of what is in each program slot. The parents should be given instructions as to when or whether to change programs; which program may be designated for an FM System; which may be a back-up program or an old program; which may be a noise program, etc.
When a mapping is performed efficiently, the user will have hearing within a normal to near-normal hearing range. Parents may use the mapping sessions to discuss progress at home, school, and in therapy. Questions and problem issues may also be addressed. The mapping audiologist will give recommendations on if and when to change programs as well as when a follow-up appointment should be made.
Mapping the Cochlear Implant - A Parent's Guide to Understanding a Cochlear Implant Programming
Read a full description of a mapping by clicking here: Mapping a Child's Cochlear Implant
Aaron Parnes are parents of a 5 year old cochlear implant user. They have been involved in studying and writing about issues and matters related to deaf children and how they can successfully be taught to hear and speak with the right preparation. They are the owners of Hearing Pocket, which develops products that provide an easier way to wear the cochlear implant. Their website also contains articles full of great tips and useful information for other parents of young hearing-impaired children with cochlear implants. Go to hearingpocket.com
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