Cochlear implantation in multi-handicapped patients: the merf experience.

Hearing loss is the most common form of sensory impairment in humans. When hearing impairment is present from birth or is acquired in early childhood, it can be devastating for normal development. Early childhood deafness also has implications for cognitive, emotional and social development. In the majority of cases of early childhood hearing impairment, deafness is an isolated disorder. However, in a substantial number of cases, early childhood hearing impairment is not isolated, but forms part of a genetic syndrome with associated handicaps, or is acquired through pre-, perior postnatal causes, possibly with associated deficits. This means that more demands are made on the child's family, the teachers and medical professionals to help these children cope with their rehabilitation, needs and demands. The presence of an additional handicap can pose special problems with regard to surgery, anesthesia or rehabilitation. Cochlear implantation is effective and aids in the effective rehabilitation of other additional handicaps. However, careful patient selection is required and thorough parental counseling regarding expectations must be given. In our Cochlear Implant Clinic a large proportion of implantees are in the paediatric age group. Of these, a few have had multiple disabilities in addition to their deafness. This paper attempts to share our experience in this extremely challenging and specialized field.