Based on the “Cochlear Implant Clinical Technical Practice Guidelines” issued by the Ministry of Health (No. 473, 2006) (Annex 2), and with reference to the “China Disabled Persons’ Federation Poverty-stricken Deaf Children (Cochlear Implant) Rescue Rehabilitation Program Screening Criteria” (2009-2011), the “Seven Colorful Dreams Action Plan The screening criteria for the “Seven Colorful Dreams Action Plan” deaf children (cochlear implant) rehabilitation assistance project.
These screening criteria are applicable to the initial screening and re-screening of the project.
I. Indications and Contraindications [Indications
(A) Patients with prelingual deafness
(1) Severe or profound sensorineural deafness in both ears; (2) Age in accordance with the conditions stipulated in the “Colorful Dream Action Plan” Cochlear Implant Rehabilitation Assistance Program for Deaf Children, with the best age being 12 months to 5 years; (3) No significant improvement in hearing ability after hearing aid selection; (4) Families have correct understanding and appropriate expectations of cochlear implants. The best age is 12 months – 5 years old; 3.
(2) Patients with postlingual deafness
1.Severe or very severe sensorineural deafness in both ears; 2.The patient’s age is in accordance with the conditions stipulated in the “Colorful Dream Action Plan” Deaf Children (Cochlear Implant) Rehabilitation Assistance Program Implementation Measures; 3.No significant improvement in speech recognition ability after hearing aid fitting; 4.The patient has correct understanding and appropriate expectation of the cochlear implant.
Contraindications
(A) Absolute contraindications
(1) Severe malformation of the inner ear, such as Michel’s malformation or cochlear deficiency; (2) Hearing nerve deficiency; (3) Severe mental illness; (4) Septic inflammation of the middle ear mastoid that has not yet been controlled.
(II) Relative contraindications
1, poor general condition; 2, uncontrollable epilepsy.
Audiological evaluation
(a) Subjective hearing threshold determination: pure tone audiometry is used.
In children, behavioral observation, visual reinforcement and play audiometry can be used.
1.Pediatric behavioral audiometry (behavioral observation, visual reinforcement, play audiometry or pure tone) – bare ear hearing threshold 4kHz ≥85dB HL; 2.Pediatric behavioral audiometry (behavioral observation, visual reinforcement or play audiometry) – assisted hearing threshold 2kHz ≥60dB HL.
(B) objective hearing examination: 40Hz correlation potential and multi-frequency steady-state test can be one of the optional, other audiological examination according to the requirements of the implementation.
1, acoustic conductance – tympanogram (A or C curve), no response to acoustic reflex; 2, auditory brainstem evoked potentials – short sound ≥ 90dB nHL; 3, 40 Hz correlation potential – 0.5kHz, 1kHz are ≥ 80dB nHL; 4, multi-frequency steady-state evoked potentials – 0.5kHz, 1kHz, 2kHz, 4kHz are ≥80dB SPL; 5, otoacoustic emissions: DPOAE is not elicited bilaterally.
（This test is a suprathreshold function test with hearing aids, which is mandatory for the initial screening and optional for the re-screening according to clinical needs.
1.Auditory ability test.
(1) Lin’s six-tone perception test: the number of perceived sounds is not less than one; (2) CAP auditory grading questionnaire and auditory integration questionnaire (MAIS, IT-MAIS): the CAP auditory grading questionnaire is lower than grade 6; the score of auditory integration questionnaire is less than 20; (3) the average scores of rhyme recognition, consonant recognition and bisyllabic word recognition are ≤ 70%, and the open phrase recognition is ≤ 30%.
2.Verbal ability test.
(1) Comprehension ability: the test content is “listening to and understanding pictures”.
(2) Communication ability: the test content is “theme dialogue”.
(3) Questionnaire grading assessment: SIR Speech Intelligibility Questionnaire.
The SIR Speech Intelligibility Questionnaire is used to fill in the test results for applicants who are 4 years old or older and have an average language age of 1 year or older for the comprehension and interaction ability tests.
Item (3) of the auditory ability test and items (1) and (2) of the speech intelligibility test were used in the word list of “Standards and Methods for Assessment of Auditory Ability in Children with Hearing Impairment Standards and Methods for Assessment of Speech Intelligibility” (Sun Xibin, ed.).
Third, imaging assessment of high-resolution temporal bone CT showed normal bilateral cochlea and internal auditory canal structures. MRI can be added in combination with the clinic to show normal cochlear structures and no auditory nerve abnormalities. There is no organic/progressive lesion in the brain.
This test is mandatory for the initial screening, and the need for additional tests will be determined by the results of the initial screening and clinical observation.
(a) Hirsh-Nay learning ability test score (for 3-17 years old) >84.
(ii) Graves’ Mental Development Test score (for applicants under 3 years of age or who cannot cooperate in completing the HINET test) > 86.
(C) Autism and autism tests.
1. Kirsch Autism Behavior Scale score <10 (suitable for 2 years old and above); 2. Rutter Child Behavior Questionnaire score <9 (suitable for 7-16 years old).
V. Other 1. For difficult cases with non-contraindication to surgery, the parents can submit a written application to the provincial project office, and the provincial project office will organize a local expert committee to review or report to the project office of China Rehabilitation Research Center for Deaf Children to organize an expert consultation.
2.For the surgery of difficult cases, if the local designated hospital lacks surgical experience, (1) the parents can choose another designated surgery hospital by themselves; (2) they can also apply to the China Rehabilitation Research Center for Deaf Children project office to arrange the surgery hospital or expert guidance.
3. This standard applies to the “Seven Colorful Dreams Action Plan” deaf children (cochlear implant) rehabilitation assistance program, and is interpreted by the project office of China Rehabilitation Research Center for Deaf Children.