EVIDENCE TO DECISION

A good rehabilitation program develops the person’s ability to detect, imitate and associate meaning with the sounds of spoken language. It is thus anticipated that a comprehensive rehabilitation program for a user will outweigh any harms that may be associated with a rehabilitation program.

The balance between benefits, harms and burdens are uncertain due to a lack of evidence identified. The potential harms include misuse of resources.

Rationale

Four studies were identified that met the inclusion criteria for research question seven. However, the interventions were either very broad (i.e. did not describe the actual rehabilitation program in detail) or were investigative (e.g. amphetamine). These studies did not provide adequate or meaningful evidence to form an appropriate recommendation. A review of existing guidelines and identification of lower levels of evidence (e.g. case studies) was therefore undertaken to develop a consensus-based recommendation.

No studies considered lower level of evidence (e.g. case studies) were identified. There were also no clear and consistent guidelines on best practices for rehabilitation after cochlear implantation. Based on available guidelines - more specifically the German Weißbuch1 as it was considered the most comprehensive - the components of rehabilitation that the multidisciplinary cochlear implant team members should consider have been proposed. Until further evidence is available, the specific programme should be tailored to the individual.