Children's Hearing Implant Program

Welcome to the Children’s Hearing Implant Program (CHIP) based at Perth Children’s Hospital (PCH), Western Australia’s premier paediatric tertiary public hospital.

CHIP is the only paediatric hearing implant program in WA. We provide services to children and their families from birth up to 16 years of age.

CHIP combines medical, surgical, and allied health expertise in one integrated program. Our team includes specialists in paediatric ENT, audiology, speech pathology, clinical genetics, and paediatric radiology. We collaborate closely with the Western Australian Newborn Hearing Screening Program and Hearing Australia.

CHIP enables children with hearing loss to reach their full potential in listening and communication through the use of implantable hearing technology. CHIP offers the full suite of implantable hearing devices, including cochlear implants, bone conduction implants, middle ear implants, and auditory brainstem implants, to help children with both bilateral and unilateral hearing loss achieve their full potential in listening and spoken communication.

As the largest and longest-running paediatric implant program in the state, CHIP provides these services at no cost to eligible children under Medicare. We support each child in our program until they reach 16 years of age, at which time we help them transition to an adult implant program.

CHIP feedback

In the CHIP team, we focus on building strong, supportive relationships with our patients and their families, to ensure the highest level of care. We greatly value their feedback, as it helps us continue to enhance our services and support.

Here’s what some of our families have shared:

The team “have been fantastic to deal with and I felt they truly care about getting the best treatment for my son.”
“The experience for my son was an emotional one and I found that the hospital did their absolute best to accommodate his needs and assisted in adjustments accordingly.”
“The Audiologists have been amazing since the diagnosis of my son’s hearing impairment. They go above and beyond in their care and made sure my son’s transition to hearing aids and now to a cochlear implant went smoothly and answered all my questions in depth and in a quick and empathetic manner.”
“I am so grateful for the support we received from the CHIP team. We were treated with patience and care and it really was clear staff cared about our son’s progress.”
“Audiology, Speech and ENT are fantastic.”

Benefits of hearing implant technology

The earliest access to the clearest sound possible is essential for the development of listening and spoken language skills. Research indicates that infants and children who experience hearing loss but gain early access to sound, along with tailored early intervention, can develop speech and language at the same rate as with their hearing peers.

For many children with permanent hearing loss, hearing aids will provide the child with the ability to hear spoken language. However, if hearing aids do not provide clear access to speech, hearing implants, including cochlear implants, can be an excellent option.

CHIP team

The Children’s Hearing Implant Program Team at PCH is uniquely skilled and highly experienced, bringing together a wide array of disciplines to provide a comprehensive and personalised approach for every child.

Our specialised team, including Ear, Nose and Throat (ENT) Doctors, Audiologists and Speech Pathologists, have decades of experience in addressing the unique challenges faced by children with hearing impairment and their families.

Most children participating in the CHIP program, who do not have other complex medical conditions, reach age-appropriate milestones in speech, language, and communication. These children successfully attend mainstream school, fully supported by their achievements in communication.

Ear, Nose and Throat (ENT) Doctor

The ENT specialist plays a crucial role in assessing a child’s medical suitability for a hearing implant and performs the surgical placement of the implant. Following the surgery, the ENT continues to oversee the child’s hearing-related medical needs. This requires specific paediatric ear surgery skills.

Audiologist

An audiologist initially determines whether a child would benefit from a cochlear implant. Post-implant, the audiologist is responsible for programming and regularly adjusting the device, ensuring the child receives optimal access to sound and spoken language through the hearing implant.

Speech pathologist

Prior to surgery, a speech pathologist evaluates how effectively a child uses their current hearing devices for communication. After the child gains access to sound, the speech pathologist engages in targeted habilitation therapy to help the child and their family make the most of this new auditory input, fostering the development of listening and speaking skills.

Why hearing aids are sometimes not enough

Hearing aids are an effective solution for children with mild to moderate hearing loss. Most children with mild to moderate hearing loss who are fitted with hearing aids develop spoken language equivalent to children of the same age.

Hearing aids function by amplifying soft sounds to make them louder. However, there is a limit to how much sound can be amplified before it reaches the cochlea, and excessively amplified sound can become distorted and hard to understand. For children with severe-to-profound hearing loss, this limitation means that hearing aids may not suffice. In such cases, a cochlear implant is often a better option, offering clearer and more comprehensible sound enhancement.

What is a cochlear implant?

A cochlear implant is distinct from a hearing aid in both design and function. It consists of two main components:

an internal part, made up of the receiver-stimulator and the electrode array,
an external processor made up of the sound processor and transmission coil.

To benefit from a cochlear implant, your child needs to have surgery to place the internal component. Afterward, they will need to wear the external processor on the outside of their head. Consistent use of the processor during all waking hours is crucial for achieving the best outcomes.

A cochlear implant works by converting speech and other sounds into electrical signals, which are then transmitted from the external processor to the internal implant. These signals are delivered directly to the cochlear nerve through electrical pulses, bypassing the outer and inner ear.

Initially, the sounds your child hears will be quite different from normal hearing. However, with ongoing habilitation and practice at home, the cochlear implant will gradually sound more natural, helping your child to hear and understand language.

An illustration of the inner and outer ear demonstrating where the hearing implant elements are positioned after surgery

The CHIP journey

When your child is referred to the CHIP program for consideration of a cochlear implant, the pathway is carefully structured to ensure the best outcomes.

A typical journey may look like:

A graphic depicting the 4-stages of the CHIP process: Surgery, Switch on, Audiology mapping and Speech pathology habilitation, and 12-month review

Recent CHIP research

The PCH CHIP team is dedicated to advancing cochlear implant technology and outcomes through active research. Our recent studies focus on integrating wireless technology for direct audio streaming, considering speech recognition in noise for SSD implants, enhancing the timing of implantation to optimise language development in children and ensuring safer and more effective outcomes for all recipients. These efforts ensure that we continue to deliver gold-standard, evidence-based care to all recipients.

MacKay CI, Kuthubutheen J, Campbell AJ. An overview of risk factors, management and prevention of cochlear implant infections. Current Opinion in Infectious Diseases. 2024 Jun 1;37(3):220-5.
Garcia-Matte RJ, O'Neil LM, Chase C, Leeming P, Clack R, Rodrigues S, Kuthubutheen J. Long-Term Cochlear Implant Sound Processor Usage in Children with Single-Sided Deafness. Otology & Neurotology. 2024 Apr 1;45(4):392-7.
Tay S, Bowen AC, Blyth CC, Clifford P, Clack R, Ford T, Herbert H, Kuthubutheen J, Mascaro F, O'Mahoney A, Rodrigues S. A quality improvement study: Optimizing pneumococcal vaccination rates in children with cochlear implants. Vaccine. 2022 Jul 30;40(32):4531-7.
Reid A, Bowen AC, Brennan‐Jones CG, Kuthubutheen JB. Congenital cytomegalovirus: the case for targeted infant screening in Australia. Medical Journal of Australia. 2022 Mar 1;216(4).
Davidson L, Foley DA, Clifford P, Blyth CC, Bowen AC, Hazelton B, Kuthubutheen J, McLeod C, Rodrigues S, Tay SM, Campbell AJ. Infectious complications and optimising infection prevention for children with cochlear implants. Journal of Paediatrics and Child Health. 2022 Jun;58(6):1007-12.
Reid A, Firns S, Tao K, Maywood E, Herbert H, Mulders WA, Kuthubutheen J, Brennan‐Jones C. Early detection of hearing loss for infants in Western Australia: Comparison to international benchmarks. Journal of Paediatrics and Child Health. 2022 Mar;58(3):422-6.
Pollaers K, Thompson A, Kuthubutheen J. Cochlear nerve anomalies in paediatric single-sided deafness–prevalence and implications for cochlear implantation strategies. The Journal of Laryngology & Otology. 2020 Nov;134(11):1014-7.
Zhen E, Kuthubutheen J, Misso D, Rodrigues S, Thompson A. 3 Tesla MRI brain scanning under general anaesthesia in a paediatric 3 Tesla-compatible cochlear implant recipient, first reported case: clinical considerations and implications for future practice. International Journal of Pediatric Otorhinolaryngology. 2020 Jun 1;133:110015.
Weng W, Reid A, Thompson A, Kuthubutheen J. Evaluating the success of a newly introduced Feed and Wrap protocol in magnetic resonance imaging scanning of the temporal bone for the evaluation of congenital sensorineural hearing loss. International Journal of Pediatric Otorhinolaryngology. 2020 May 1;132:109910.
Chin O, Dharsono F, Kuthubutheen J, Thompson A. Is CT necessary for imaging paediatric congenital sensorineural hearing loss?. Cochlear implants international. 2020 Mar 3;21(2):75-82.
Kuthubutheen J, Rodrigues S, Herbert H, Clack R, Leeming P, Chase C. Paediatric cochlear implantation outcomes in children under 12 months of age. Journal of Hearing Science. 2018 Jun 1;8(2).

Referrals

For parents, if you would like to know more about our program or would like to know if your child is eligible, please contact us on the email or phone number below.

For professionals, please send the child’s details, Audiology results and any relevant information to:

PCH CHIP Audiology

Phone: 08 6456 0022

Email: PCHChipAudiology@health.wa.gov.au

AND

PCH Audiology

Phone: 08 6456 4036

Email: PCHOutpatients.Audiology@health.wa.gov.au

Or please complete this referral form.