The application process for the 2014 "Hearing Reconstruction Action" cochlear implant donation project has been launched. The National Project Office will provide the application list and approval status on the 15th and 30th of each month respectively to serve hearing-impaired children in China. published online.
Link: Results on May 15: /iframe/2014-05/15/content_4683.htm
Every time the approval status is announced, some people are happy and some are worried, and the review is passed. The children who pass are all similar, and the children who fail have their own reasons. Judging from a batch of review results announced at the end of April 2014, 183 of the 475 children who submitted applications failed to pass the review, accounting for nearly 40% of the total number of applications. There were nearly 20 reasons for failure.
Parents who are not familiar with medical or policy knowledge can't help but feel a little confused when they see the concise sentence "Reason for failure: ***". To this end, Ershu conducted an in-depth analysis of the various reasons why the rescue project failed to pass the review, and tried to discuss with parents in as simple a language as possible what "the *** test results do not meet the project application requirements" exactly means and what to do next. If there is any explanation that is not in place, please leave a message for communication~ (The green text below is the project requirements)
First of all, parents will see the basic application conditions announced by the reviewer before applying:
1. Age: 1-5 years old for "Operation Qi Cong", 1-6 years old for "Colorful Dream";
2. Hearing loss is severe deafness or above, normal development of auditory organs, no postcochlear Lesions;
3. No cerebral palsy, mental, intellectual and behavioral development are normal;
4. No contraindications to surgery;
5. Patient’s Parents have a certain understanding of cochlear implants, a correct understanding of the effects of cochlear implants, and appropriate expectations;
6. The patient's family is relatively financially difficult, but has the ability to ensure that the rescue recipient adheres to long-term rehabilitation training. Able to ensure the daily maintenance costs of cochlear implant products.
Based on the above conditions and a comprehensive evaluation based on age, audiological evaluation, medical evaluation, intelligence test, parent expectations, family economic conditions and support, etc., the 17 reasons for failure discussed below are acceptable. It comes down to the above principles.
Audiology evaluation:
1. The OAE test results do not meet the project requirements
OAE refers to otoacoustic emissions (DPOAE or TEOAE), and the project requires both No reaction was elicited from either side
Otoacoustic emission (OAE) is a kind of acoustic energy. It is a sound wave generated by the vibration in the cochlea and the movement of the tympanic membrane through the ossicular chain of the middle ear. It plays a role in the function of the middle ear. This sound signal can only be detected under normal conditions.
OAE did not elicit a response, indicating that the lesion may be in the auditory hair cells. If the auditory nerve is normal, hearing can be reconstructed through cochlear implants.
If the OAE test results do not meet the project requirements, further medical examination is required to seek other solutions.
2. The ABR test results do not meet the project requirements
ABR is an auditory brainstem response. This objective listening data can be combined with other audiological examinations to identify the nature and severity of hearing loss. with or without retrocochlear lesions. The national project requires that the auditory brainstem response threshold (short sound) is ≥95dB (nHL) on both sides.
There are two situations when the ABR test results do not meet the project requirements: bilateral or one side is less than 95dB (nHL) ), to put it simply, the degree of hearing loss is relatively mild, and hearing aids or cochlear implants can be used to compensate for hearing loss at one's own expense (WHO divides the degree of hearing loss in children into 4 levels: 26~40dB is mild, 41~60dB is moderate degree, 61~80dB is considered severe, and greater than 80dB is considered extremely severe and suitable for cochlear implants)? The data is not elicited, indicating that there may be other diseased parts and are not suitable for cochlear implants, and further examination is required.
Imaging evaluation:
3. MRI test results do not meet the project application requirements
MRI refers to nuclear magnetic resonance, which checks the development of the cochlear nerve. And an important means to determine whether the cochlea has fibrosis. This test result does not meet the project application requirements, indicating that there may be contraindications to cochlear implants and further examination is required.
4. The CT test results do not meet the project application requirements
CT is mainly used to observe the development of the cochlea and internal auditory canal.
The project requires a high-resolution thin-section CT report of the temporal bone, which must describe the development of the inner ear. When filling out the application form, only the CT report form will be provided, and CT images must be brought with you for re-screening.
The CT test results do not meet the project application requirements. It may be due to incomplete development of the cochlea or internal auditory canal, making it unsuitable for cochlear implantation.
Pediatric behavioral audiometry:
5. The results of the naked-ear hearing test do not meet the project requirements
The project requires naked-ear hearing loss of 2kHz and 4kHz in both ears ≥ 85dB (HL), if it does not meet the project requirements, it means that the hearing loss in the naked ear is <85dB. You can choose to use a hearing aid or cochlear implant at your own expense to compensate for hearing loss.
6. The hearing aid threshold test result does not meet the project requirements
The project requires the hearing aid threshold to be 4kHz ≥60dB (HL) in both ears. If the hearing aid threshold test result does not meet the project requirements, it means Using hearing aids to compensate for hearing will have better results
7. Failure to wear hearing aids does not meet the project application requirements
The project requires applicants to wear hearing aids for at least ≥3 months; re-screening is required Wear hearing aids, otherwise designated hospitals will not allow re-screening.
Trying on hearing aids before cochlear implantation can stimulate the development of the auditory nerve, help deaf children understand sounds, establish preliminary listening habits, and make corresponding action responses to sound stimulation through training, which provides a basis for postoperative artificial hearing aids. It lays a good foundation for the startup of the cochlea and the smooth progress of the modulation procedure. It also helps children after surgery to understand sounds and re-establish language concepts.
This non-compliance with the project application requirements is easy to solve. You can apply again after wearing the hearing aid for three months. The Hearing Impaired Children Service Network also has a free hearing aid loan service, application link
/ borrowhearingaid/introborrow.php
Auditory and speech ability assessment:
8. The auditory and speech ability test results do not meet the project application requirements
9. Do not meet the requirements of 3 years old ( Including) The above auditory speech rehabilitation training, closed speech test maximum recognition rate standard
Two items 8 and 9 are closely related, let’s talk about them together.
The assessment of auditory speech ability is divided into two aspects---auditory ability test and speech ability test.
Auditory ability tests include (1) Lin's six-tone detection (2) Auditory Integration Questionnaire-Parent Questionnaire (IT-MAIS) (3) Final recognition (4) Initial consonant recognition (5) Disyllabic word recognition . If you are too young to cooperate, you can only do the first two items.
Projects usually require that the maximum recognition rate of closed speech tests is ≤70%, the maximum recognition rate of open speech tests is ≤50%, and the average maximum speech recognition rate of the auditory ability assessment of applicants aged 3 and above is ≥ 20% is recommended.
The verbal ability test includes 1) Grammatical ability (imitation of sentence length) 2) Comprehension ability (looking at pictures and talking) 3) Communication ability (topic dialogue) National requirements The language ability assessment of applicants over 3 years old is average Recommended only if the language age is 1 year old or above (including 1 year old).
There are two situations when the auditory speech ability test results or the maximum recognition rate of the speech test do not meet the project requirements. One is that the auditory speech ability has greatly improved after wearing the hearing aid, and you can continue to use the hearing aid or have a cochlear implant at your own expense. Second, if the foundation of auditory and speech abilities is too poor, you can continue to undergo hearing and speech rehabilitation to improve and then apply again.
10. The results of the Auditory Integration Questionnaire do not meet the project application requirements
The Auditory Integration Questionnaire is a 10-question question asked to parents in the form of an interview to understand the use of hearing aids by deaf children. situation, confidence in hearing, and the deaf child's ability to associate sounds with their meaning. The project requires test results <20 points. Failure to meet the application requirements means that the hearing aid equipment currently in use can play a certain compensatory role, and you can continue to use hearing aids or implant cochlear implants at your own expense.
Mental, intelligence, and behavioral assessment:
11. The results of the Xi-Nei learning ability test do not meet the project application requirements
The Xi-Nei test is for 3- The intelligence test of 17-year-old deaf-mute children is tested through activities that do not require language, such as stringing beads, remembering colors, and arranging square logs. The project requires a score of the internal learning ability test (suitable for those aged 3 and above) > 84
Failure to meet the project application requirements means that the child's intellectual development may be slightly slower than that of his peers. Parents should pay attention to using games, art activities and other methods to promote the all-round development of their children in addition to hearing and language rehabilitation training.
12. The results of the Grayface Intelligence Test do not meet the project application requirements
The Grayface Mental Development Test is suitable for applicants under 3 years old or who cannot cooperate to complete the Hi-Ne test. The six dimensions of movement, personal and social, hearing and language, hand-eye coordination, operation and reasoning are used to evaluate the mental development level of infants and young children, and the project requires a score of >86.
13. The score results of the Conner ADHD Evaluation Scale do not meet the project application requirements
According to the applicant’s age and degree of cooperation, the applicant will be selected from the Klinefelter Autism Behavior Scale and the Conner ADHD Evaluation Scale. For one, the project requires a Conner ADHD Rating Scale score of <10 and a Klinefelter Autism Behavior Scale score of <10. Failure to meet the requirements indicates that there may be ADHD or autism tendencies and further examination or treatment is required.
14. The score result of the Rutter Child Behavior Questionnaire does not meet the project application requirements
The project requires that the Rutter Child Behavior Questionnaire score is <9. If it does not meet the project application requirements, parents need to pay attention to the physical and mental health of their children. For health problems, you can go to the hospital for further examination or correction.
Others:
15. The application age does not meet the project application requirements
The required age range of "Qidi Action" is 1-5 years old, and the "Colorful Dream" project The required age range is 1-6 years old, and you can choose appropriate projects to apply.
Colorful Dream’s latest preferential policy is: Those under 7 years old who have received long-term rehabilitation training, and those under 3 years old can be given priority; those who are older than 7 years old, have entered ordinary schools after rehabilitation, and have persisted in training for a long time Those who wear hearing aids and have speech ability, but whose hearing aid effect is minimal may also consider cochlear implantation if they pass the application for review and approval.
Parents who do not meet the project application requirements insist on wearing hearing aids and rehabilitation training, while seeking other rescue opportunities or raising funds to implant cochlear implants at their own expense.
16. The annual per capita income of the family is too low, and the family may not be able to afford the long-term cost of spare parts replacement and rehabilitation.
Different assistance projects have different subsidy amounts for expenses other than cochlear products. Families need to have certain human and financial resources to support related expenses, such as transportation and accommodation fees to and from other places, pre-operative and postoperative examination fees, hospitalization fees, postoperative machine adjustment fees, rehabilitation training fees, and cochlear equipment maintenance fees, etc.;
For example, information provided by a provincial Disabled Persons' Federation shows that recipients of the "Qi Chong Action" can receive cochlear implants worth 200,000 yuan for free, and are required to pay a surgical fee (not exceeding 10,000 yuan). Post-rehabilitation training fee (14,000 yuan), project supporting funds (6,000 yuan) and other related expenses.
17. One-year compulsory hearing and language rehabilitation training is not arranged
There are very few cases where the application is not approved due to this reason. In order to ensure the rehabilitation effect after cochlear implantation, the national project will require families to be able to cooperate and ensure that recipients receive at least one year of rehabilitation training in designated rehabilitation institutions, and provide rehabilitation subsidies (directly allocated to rehabilitation institutions). Parents in the project You can see this clause on the application form, just make sure to check "Agree".
In short, when you see that the application result is "failed", instead of being frustrated, it is better to carefully analyze the reasons for failure and actively seek corresponding solutions. For example, certain conditions that do not meet the requirements can be achieved through hard work and can be used. Apply again after meeting the conditions. If you are suitable for cochlear implantation but do not meet the conditions for assistance, you can learn about other assistance programs (such as Love's Decibel) or consider paying for it yourself. Medical insurance and New Rural Cooperative Medical Insurance in various places have different reimbursement policies for cochlear implant surgeries. In March and June each year, each Cochlear implant manufacturers may also have discounts of varying degrees. For details, please refer to the Ear Tree related articles. As long as parents don't give up, their children will always get closer and closer to the audio world.
From the Ear Tree website: /tech/show/192