Why are MAPpings Needed Forever?

Why are MAPpings Needed Forever?

MAPping ImageCochlear implants are an amazing technology. Tiny electrodes implanted inside the ear (cochlea) can stimulate the auditory nerve causing the brain of a people with significant hearing loss, to hear the sounds around them, including speech.

At initial activation, the audiologist programs the speech processor so that an individual has access to sound across the frequency range. While different audiologists do things differently, the end result is a program (MAP) that allows the person access to the sounds of speech. After leaving the audiologist, the new implantee can now hear sounds going on around him/her. In the initial stages it is typical to go back frequently for MAPpings. Each clinic has different procedures and each person is unique, so one size does not fit all. Even, after the initial period (around the first year), people with cochlear implants must go back for MAPpings. For some CI Centers, the recommendation is every three months for life, while others recommend annually. Why is there a need for regular MAPings?

The way I like to explain this to the families I work with is the following….

For whatever reason, the brain acclimates to the sound. This is more often in the first years of implantation than later, but it does still happen. And every brain is different making it difficult to determine a specific timing for when a MAP change will be needed.

In order to better explain the idea that the brain adjusts to the sound, I use the analogy of a cake baking. Imagine yourself backing a cake at home. You put it into the oven and it starts to cook. The delicious smell emanates through you kitchen and you entire house. It smells so good, but after a while, you no longer smell it. However, even hours later, when someone else enters the house, he/she might ask what you made that smells so good. At this point, you don’t even smell it anymore, you didn’t even realize the smell was still present. You have acclimated to the smell. Even though the smell is still there, you brain does not recognize it any longer.

This is the same for the person with a cochlear implant. Even though the sound is still present, the brain no longer recognizes the sound, so a tweak of the MAP is needed to allow access to the sound again. Adults may be able to recognize this change themselves, but for children, we needs to monitor to determine when they are in need of a MAPping.

How do you know if your child needs a MAPping?

  • Is your child saying “What?” more frequently?
  • Is your child no longer detecting or identifying one of the Ling Six Sounds?
  • Is your child’s speech sounding different (slushier, articulation errors that weren’t there before)?

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