Development and validation of the Nottingham Auditory Milestones (NAMES) profile for deaf children under 2 years old, using cochlear implants

Abstract

Objectives: Clinicians face considerable challenges in setting appropriate auditory goals for babies and young children who receive cochlear implants. This paper describes the rationale, organization, implementation, and validation of the Nottingham Auditory Milestones profile that was developed to address these challenges.Methods: The use of the profile has been fully integrated into the postoperative pathway at the Nottingham Auditory Implant Programme since 2009. Data are presented on a cohort of 30 children who received bilateral cochlear implants under the age of 2 years and who have no other diagnosed difficulties. The data were used to validate the profile’s structure and characterize the expected development trajectory for this population of children.Results: The analysis of routine data from the children confirmed that the profile’s structure reflected the typical order and rate at which skills emerged and were acquired over the first 3 years following cochlear implantation. The distribution of profile scores across five assessment time-points established a developmental trajectory for typically developing children. Three case studies describe the use of the profile to set consistent expectations for progress for a wide range of children.Discussion: The development trajectory established using the profile provides a mechanism to identify children not making the expected progress, in order to support the need for a review of approach or a differential diagnosis.Conclusion: The Nottingham Auditory Milestones profile is an accessible and practical tool for identifying, monitoring, and appraising the auditory achievements of deaf babies and young children in the first 3 years following cochlear implantation.