FAQ
(Note: this is from our family's perspective; any medical
questions should be directed toward your healthcare
providers. These questions are based on things we've been
asked on blogs or emails. All of this is written by our
family; none of it comes from a manufacturer or any other
company.)
1. Why did
you choose a cochlear implant for your sons? Why not just
have them use sign language?
We decided that we wanted our children to have the
opportunities that their hearing brothers had; namely, to
reach the educational and occupational levels which they
desired. Typically, the deaf individual reaches about a 4th
grade reading level. Part of this is due to the vast
difference in language structure between ASL (American Sign
Language) and English. Knowing that the cochlear implants
of today offer great hearing, and that our children could
then pursue almost any career as well as speak with their
grandparents, neighbors, friends and other community
members spurred us toward this choice. We have never been
sorry! It is also important to note that the average
hearing parent reaches a preschool level of sign after
years of study, which means that as much as they would like
to, they will never be able to share complex communication
in the way that they can with a shared language. Infants
learn languages quickly; adults do not. The problem lies in
the fact that the majority of the world uses spoken
language; we would not be discussing this if the entire
world had no hearing sense.
2. Doesn't
the cochlear implant hurt the child? Is it painful?
The cochlear implant is not a painful device. While loud
sounds in mapping sessions may frighten in the same way
that loud noises frighten hearing babies, children
sometimes cry in their initial mappings. I have repeatedly
asked my 6 year old if his CI is painful. His answer:
"nope." Implanted adults report the same thing. In fact, if
pain is reported there is something wrong, and the
physician and audiologist should be consulted.
3. I've
heard that the implant is in the brain. Is this
true?
No, absolutely not! The internal device sits in a well in
the bone which the surgeon drills, and the electrode goes
through the round window into the cochlea. The dura
(covering of the brain) is below the device, and the brain
is never touched. The Auditory Brainstem Implant, a newer
device for those with no hearing nerve (or a damaged one)
is implanted in the brain, but it is very new and not yet
FDA approved for children under 12 in the United States.
4. Why do
you call your kids "hearing?" Don't they only hear
environmental noise?
Elliot hears well enough to speak without a trace of
"accent." One cannot replicate clear speech without hearing
clear speech well! He tests in the soundbooth down to about
15 or 20 decibels, which means he hears whispers. Some
implanted kids actually hear better/softer sounds than
their hearing parents, believe it or not! When he removes
his implant, he is completely deaf. With it on, he
functions as hearing. He watches TV and understand the
plot, talks on the phone to various people, and functions
as a hearing person all of his waking moments, aside from
when he's bathing or swimming. He hears entire
conversations with his back turned. He routinely spends
hours playing with the neighbor kids. Many people do not
know that he was born deaf.
5. Haven't
many children died from meningitis caused by the cochlear
implant?
There is a greater risk of meningitis in persons with
cochlear implants. However, some of this risk was due to
past lack of vaccines and also one manufacturers'
"positioner" for their electrode (since removed from the
market). With appropriate parental observation and
vaccination, the risk, while greater, is still low. NO,
there have not been "many" deaths. The June 4, 2007 CDC
website states:
"Worldwide, there are over 90 known reports of people
getting meningitis after getting a cochlear implant. This
is out of approximately 60,000 people who have cochlear
implants."
http://www.cdc.gov/vaccines/vpd-vac/mening/cochlear/dis-cochlear-gen.htm
(These are cases of meningitis, not deaths).
I know of one implanted child who died of meningitis; it is
not yet known if there is a connection between the two. It
IS known that she was not up-to-date on the vaccinations
which can help prevent meningitis. In our opinion, the risk
(while scary) is worth it, considering the risk of living
one's life without hearing in a hearing world. We have seen
firsthand the problems involved with that in other family
members, and it also included bodily harm. Refusing to
implant on this basis alone is a tradeoff we are not
willing to risk, considering employment statistics for deaf
individuals.
6. What if
it fails-- what will you do then?
This is one of the reasons we bilaterally implanted-- so
that our kids won't go without hearing for a period of
time. But even if they both failed, they could be
re-implanted. Re-implantation has been found to be quite
successful. Most likely our children will need to have this
happen several times in their life unless biological cures
are developed. Currently the hair cell regeneration
techniques are a long way off from human trials. But, even
if they had to go without hearing they would have learned
how to speak, which is a very useful thing. Having lived
with a family member who went deaf in adulthood and
lip-read, I can attest to how different their life is than
those who require interpreters to speak.
7. Why didn't you wait until the child could decide for
themselves if they wanted a cochlear implant?
Choosing to wait IS choosing... to disallow a child
successful cochlear implant use. Infants under 2 years of
age have the easiest time acquiring language... the window
of plasticity gradually closes from approximately 3 to 7
years of age. By the time a child can decide for
themselves, it would be too late to learn language with a
cochlear implant. They would only likely really use it for
environmental noise, and would likely find it unusual.
Neural pathways that are taken over by the visual sense
will not easily relinquish their "control" and allow for
audition! We wanted to make things easier for our kids to
learn language. Unlike the children who were orally
educated decades ago, this is not a struggle or something
which requires hours a day and most of childhood. Elliot
"graduated" from AV therapy after 2.5 years of once a week
session (and, there were certainly weeks when we missed for
illness or our wonderful therapist missed for speaking
engagements!) While we have to do a lot of talking on a
daily basis, it is simply an extension of the best way a
child learns language. Actually, parents who have utilized
AV find that their hearing kids benefit, as well, from what
their parents learn about learning to speak, and they often
have a larger vocabulary, sooner, than their peers!
Adults are different; adults who lose their hearing are
also excellent candidates. We are not suggesting that any
hearing impaired individual cannot be a candidate, but it
is easier for children when their brain is the most
plastic. The decision of candidacy is best made by the
individual in conjunction with his or her healthcare
professionals and family members, and with realistic
expectations related to their age, length of time without
hearing, etc.
8. Why
don't you just accept your children as deaf and embrace
them?
We have been asked this a lot (believe it or not). This is
so hard to accept, when you are the parent-- to have your
love and acceptance of your child questioned! We accept all
of our kids, and their idiosyncrasies, their abilities,
etc. We do not believe that human mammals are meant to have
4 senses; we believe they are meant to have 5. Just as we
would medically seek an answer to cancer, missing limbs or
poor eyesight, we want to help our kids experience all 5
senses. We do not agree with those who shun the "medical
model of deafness." We have not been told what to do by the
healthcare professionals; rather, we sought out their help.
We knew what we wanted, and we pursued it. If there was no
cochlear implant, no hearing aids, etc., we would simply do
whatever we had to do, of course. It's difficult to know
what we would do in that circumstance, and since we aren't
living in those shoes we can't say for sure how we would
approach things. But we do know that we are thrilled with
the effectiveness of the cochlear implant as it exists
today. We didn't expect to have a "Gerber baby," but we
knew that it was unfair to disallow hearing when there is a
safe, reliable way to allow them to hear. I doubt people
would ask this question to those who have a blind child,
one with paralysis, or some other disability-- if there is
a way to cure or mitigate the problem, parents will go for
it. Being deaf is NOT akin to having different skin or eye
color, as has been claimed. The world functions as if all
are hearing. Ambulance drivers assume that other drivers
can hear them; teachers usually speak and cannot sign. The
list goes on.
9. What are
the drawbacks to cochlear implants?
Well, it's not exactly the same as normal hearing, though
it is now a very close approximation. My sons do not
currently hear in every single frequency that the ear hears
in (because the CI highlights the speech frequencies). This
means they will not catch all the intricacies of music.
However, there is a new processor coming out soon which
will address some of our desires for them to appreciate
music more fully. Also, of course, they cannot swim or
bathe with them on. Due to static electricity, some
individuals avoid all plastic playground slides, ball pits,
trampolines, etc. (we do not, but this is parental choice).
They should always be careful to wear helmets when biking,
skiing or similar sports, and probably avoid serious
contact sports (though some implantees do participate in
them). They have to be careful about MRIs because of the
powerful magnets in the machines (they should call the
manufacturer prior, make sure the machine is appropriate,
etc.-- Med-el brand CIs are the only one which can be kept
in for MRIs; the other two brands require the patient to
have minor surgery).
We have to change batteries... a lot! We have to
"troubleshoot" equipment, change cables sometimes, etc. We
have to wear raincoats, hats or umbrellas in the rain. We
watch out for squirt guns and misters at amusement parks!
:-P Cochlear implantees typically have more difficulty
hearing in very noisy settings, though now with bilaterals
they are much improved. For example, Elliot hears at 98% in
quiet with both CIs on, and 88% in noise (according to
random word tests in the soundbooth, which are actually
harder than a HINT test with sentences). Recently Elliot
tested at 78% with his new ear alone, so we are happy that
after about 1 year, he is able to do quite well with his
new one alone, if there were to be a failure of the older
one. Obviously there are drawbacks compared to natural,
biological hearing, just as there are drawbacks to a hip
replacement or a pacemaker-- but the results are certainly
worth it! Electroconvulsive therapy and
electrocauterization is not allowed in the CI recipient.
Each manufacturer lists the contraindications for implants;
please refer to their literature (our list may not be
comprehensive, and also these may change over time). Some
reports say that deep sea diving may be inadvisable, though
normal shallow water scuba diving may be safe.
There is a misconception that only the profoundly deaf can
benefit and ought to be implanted; actually, they have
found that severe to profoundly hearing impaired children
find school much easier and can hear better with a CI than
with hearing aids, in many circumstances (the CI helps one
hear in all the speech frequencies; hearing aids are only
amplifying sound in the places along the cochlea which
happen to still have hair cells. So kids were often missing
all the high frequencies, and didn't understand plurals,
possessives, etc.) See:
http://www.thecni.org/hearing/research.htm
Also, some people are mistakenly stating that CIs have to
be reimplanted frequently as a child grows-- this is false.
The cochlea is full sized at birth. Reimplantations will
only take place if there is a malfunction. It is quite
possible that Elliot will not need to have another surgery
until adulthood.
10. Why
early implantation?
As we have stated, there is a benefit to implanting when
the infant is most normally going to learn language-- so,
in infancy. However, whether a child can actually get one
at under 12 months will depend on several factors:
willingness/experience of the surgeon, health of the child
(for example, do they have a propensity toward ear
infections?), weight at the time of surgery, insurance
coverage, proof verifiable that they are actually
candidates (ABR or ASSR tests, CT scans, psych evaluations,
etc.). If these things all mesh, a child can be implanted
under the FDA "recommended" age of 12 months. It is just
"off label" use. This decision is best made in conjunction
with your surgeon, but if you want early implantation, BE
PROACTIVE in your search. The PARENT is the final
coordinator for their child and must be the one to pursue
every facet of their care. Not happy with the answers you
get from one surgeon? Get a second opinion! It will never
hurt; the more information, the better. You won't know if
you don't ask. As always, the parent is the best advocate
and coordinator of their child's health. While the staff at
a clinic or in your state's birth to three program may be
helpful, some may not be aware of your knowledge and
desires. Don't rely on them to do all of your advocating!
from Newsweek Special Issue, 1997:
"Research on language has shown now "neuroplastic" an
infant's brain is, and how that plasticity lessens with
age. Patricia Kuhl of the University of Washington studies
the "auditory maps" that infants' brains construct of of
phonemes (the smallest units of sound in a language, such
as "ee" or "l"). At first, neurons in the auditory cortex
are like laborers to whom jobs have not yet been assigned.
But as a newborn hears, say, the patter of English, a
different cluster of neurons in the auditory cortex is
recruited to respond to each phoneme. Each cluster then
fires only when a nerve from the ear carries that
particular sound, such as "pa" or "ma." If one sound is
clearly distinct from another, as "ra" and "la" are in
English, then the neurons whose job it is to hear one will
lie far from those whose job it is to hear the other... By
12 months, an infant's auditory map is formed. He will be
unable to pick out phonemes he has not heard thousands of
times..." -Sharon Begley, "How to Build a Baby's Brain"
11. My
child is older. Is it a lost cause to pursue
implantation?
No! If you are interested, contact an implant team to
determine what tests need to take place. I've seen and/or
heard of children much older than mine who have become
listening, speaking, implanted kids. While it may take more
work in therapy, if the parents are committed-- that's the
most important part. Think back... years ago, the youngest
kids implanted were 3 or older, and many of them are doing
very well! Not EVERY deaf individual is a candidate for an
implant, but the vast majority of deaf babies and
preschoolers could be, and some adults, depending on the
etiology of their deafness. A strong desire to hear and the
drive to participate in therapy to fully utilize the CI
will show your CI team that you are serious.
12. Don't you want your kids to be a part of the Deaf
Culture?
We want our children to be a part of OUR culture. While we
see the value of the sense of community that people have
developed who are part of the Deaf Culture, our entire
family and social network is part of the culture at large
and that of our family. Our kids (both hearing and deaf)
will learn about our religious values, our traditions, etc.
We do not actually believe that there is some inherent
magical genetic component which qualifies our kids for
entry into Deaf Culture. They do have several friends with
cochlear implants, and we have enjoyed things like CI Camp
in the Rockies. We know that there are thousands of kids
just like ours (and we've met many of them personally) so
we are secure in the choices we've made and in giving
information to other parents. We choose to spend our time
accentuating the positive rather than listening to the
small minority of people who are against implantation,
spoken language for deaf children, etc. We have also seen
that there are people who understand both worlds and are
open to modern innovation. Those are the people who know
that, while they didn't perhaps benefit from it, the
cochlear implant is a good thing for kids today. They want
good things for those kids. Those are the people who really
care about others. There are several families I'm
acquainted with who have deaf adult members who use ASL and
who have implanted their children. Their bravery encourages
us all.
13. Doesn't
your child's emphasis on oral language mean that cognitive
development is put on the "back burner?"
No way. We would never have chosen this methodology if that
was going to be the case. Fortunately for deaf children
today, spoken language is totally accessible. They do not
struggle to learn; they learn by sponging up language much
like a hearing child (incidental learning). In the
beginning, when the implant is new, we work on helping them
identify, localize and make sense of sound because it is
new. But by a year or so after implantation there is no
doubt that they hear nearly as well as our hearing kids
(and this is based on objective testing). We can discuss,
categorize and rationalize... we can cover complex
topics... in English. This would never be the case between
us and our deaf children while using sign language; it
would always be a problem between us. Parents who have
never signed and who have children who are taught sign as
their primary language have a communication problem. We are
lucky not to have to deal with that, thanks to the cochlear
implant! Imagine a signing, deaf parent who only used
spoken language with their child. HUH?! Parents are their
children's most important teacher in life, and they need a
shared language with their children.
In fact, much of the "deaf ed." research from decades past
no longer applies in any way to our our kids. There is a
new paradigm, and unless educators undergo a paradigm shift
in their understanding they will get left behind. Perhaps
some educators are unaware of the successes; they may have
met those whose parents didn't care to maintain their
devices, or who were implanted much older, or who didn't
have a language base of any sort-- sign OR oral language.
This is not the gauge to measure kids by; it is the sad
result of a lack of preparedness and understanding of the
device. Anyone who doesn't wear the device all of their
waking hours, or whose parents don't take them for regular
mappings, or who run out of batteries or routinely lose
their device without taking care of it will not find it to
be their "hearing." I've heard of those kids, and all I can
say is that we should not judge the effectiveness of the
device by one family or one child. On the other hand,
involved parents of older implanted kids who worked a
little harder found (in years past) that they were able to
have great results. Many of those kids rarely ever rely on
lipreading, talk on the phone, and even learn foreign
languages (spoken ones)! Altogether, the majority of
today's implantees can have success.
Don't assume that any research revolving around deaf
students applies to implanted students. Make no mistake--
kids with cochlear implants HEAR!
14. Isn't
this all really about you? Making things easier for
you?
Well, life has been made more difficult because our
children have hearing loss; this would stand regardless of
the mode of communication we chose. We are not fluent in
sign, so if we had chosen to utilize it we would have had
to nearly quit caring for our hearing sons, quit work, quit
all activities... and focus on the acquisition of a new
language. We chose another mode, the oral approach, which
meant that we have spent quite a bit of time doing things
like ABR tests, cochlear implant surgeries (and the
accompanying pre and post-op appointments), mapping
sessions with the audiologist, and auditory verbal therapy.
I wouldn't say life is easy once you have a child who is
born with any disability. DISABILITY, you say?! Ugh, the
Deaf Culture advocates would not call it so. We don't call
our boys disabled, either, but the reality is that the
world is made for and made up of hearing individuals. We've
had DC people liken hearing loss to being born a boy vs.
girl. Yeah, right. Biology speaks for itself, we don't need
to say much to refute that. Today's implanted child has a
few years of therapy vs. a lifetime of interpretors,
captioning, etc. Elliot had only two years of AV therapy
before he was caught up or exceeding his peers. Oliver will
probably have less!
We chose to allow our kids to hear like their friends and
family. Yes, in the end it will be easier for ALL of us. It
will also be cheaper and easier for society, because there
will be no unnecessary burden, financially. The CI is a
very cost effective device, saving thousands of dollars of
educational and employment modifications.
15. What is
your opinion of other methods of communication?
First, we believe that parents have the right
to choose how to educate, raise and speak to their
children. No one else has that right. Some deaf culture
advocates who do not even know us have insisted that they
know better, and that we ought not be allowed to speak
orally or have our kids use English as their primary
language. Fortunately, the law is on our side.
There are several options for those who choose other modes
of communication. Parents may have different factors which
affect their decisions; we do not advocate a one size fits
all approach. We have heard of kids who do very well with
Bilingual education, primarily if their parents are deaf
AND the child has a cochlear implant (and thus, has access
to the other language outside the home). We have heard of
successes in families where the hearing parents already
knew ASL, and were able to fluently speak in two languages,
a manual and oral method. We have heard of kids who are
adopted later in life and who have already learned sign,
kids with other impairment who do better with manual and
oral approaches, etc., etc. There are many reasons why a
family might choose to do things differently. BUT, we must
emphasize that our method works well for MOST kids with
prelingual deafness and hearing families-- if they get a
cochlear implant in their infant or preschool years. One
thing to beware of is the fact that many DC advocates do
not actually want children to be bilingual in the sense
that we normally use the term; they want the child to
primarily utilize sign and secondarily, later, to learn to
utilize English. Also, if you read their arguments on deaf
blogs you will see that many of them are strongly opposed
to cochlear implants and only try to placate parents and
not mention that so as to "convince them" of their good
intentions, since they can see that CIs are here to stay.
Watch out! The research regarding Bi/bi education does not
usually come from research of early implanted kids, and the
deaf schools which tout this method usually have abysmal
test scores-- if they report them at all.
Some other methodologies used are TC (Total Communication),
Cued Speech, a purely manual approach (ASL, American Sign
Language), SEE (Signing Exact English), and variations or
mixes of these. Choices in Communication is a book
which explains these in-depth and will answer more
questions; we are not the experts on them. We read this
book when Elliot was a baby. One of the best ways to make a
decision is to visit parents and children in these
different camps, check out classrooms, etc. Seeing it in
action will help you make up your own mind. Also, remember
to keep your final goal in mind. If you would prefer your
child be able to communicate with everyone in their
community, then perhaps an oral approach would fit your
family.
16. Isn't
the CI success rate really hit or miss? Why take the chance
with risky surgery, when your child may not benefit?
This is a very common myth among Deaf Culture advocates;
fortunately it is mainly a myth which has stayed in that
insular community. It is not true. In the early days, they
were not sure who would benefit. Clearly, the older the
person, or really, the person who has gone longer without
auditory stimulation, will be less likely they will be able
to change those pathways and use them for audition. A good
example is what happens after a stroke; the legs learn to
walk with a limp in certain individuals, and even if the
original cause is "fixed," their body has developed a
certain gait which will remain forever. This is why therapy
must begin quickly after a stroke. In a similar way,
deafness that has gone on for a long time will likely
create changes that are irreversible. So, when some older
adults or kids with prelingual deafness were implanted in
the early years, they may have not gained the benefit that
can be had today by those who are better candidates. IF a
child is young and IF they are determined by CT scans, ABR
tests, psychological testing and hearing aid trials to be
able to benefit, they will benefit. Today, surgeons are
very cautious because in the past, people with unrealistic
expectations of what a CI could do would blame anyone and
everyone if they couldn't talk on the phone or enjoy
hearing lots of sound. When our sons were implanted, our
surgeons always emphasized the steps to determining
candidacy and were firm about the risks and limitations.
When we talk about success we are really talking about two
(or more) things-- actual working quality of the device (is
it functioning as it was supposed to, according to
manufacturing and engineering), and the success that a
child has with a cochlear implant (so, their ability to
detect sound, use sound, speak, etc.) These include a lot
of variables. Many times, the success of the child's
speaking depends on the parents. If they do not require
wearing the device (after all, one has to hear to reap the
benefits of hearing), help habilitate the child to sound,
troubleshoot the parts (is there a cable broken? do
batteries need changed?) and encourage spoken language,
then the child is less likely to succeed. Sometimes those
parents blame the device when it was really other factors.
Most parents who actually pursue the device are vigilant
about these issues. If a person does not include speaking
in their goals, that will be self fulfilling.
Today's devices are typically extremely well made. As an
example, the Medel.com website (manufacturer of Med-el
cochlear implants, which my boys have) states this (in
September 2007):
"Since the first implantation of the PULSARCI100 in March
of 2004, not a single implant has failed due to loss of
hermeticity or electronic defects. The same holds true for
the modified C40+ implant* in use since May 2002.
Experience over the last 4 years shows an accident related
failure rate of the hermetic housing of 0.14% per year.
This value is in the range of the US wide rate of accident
related traumatic brain injury **
0.1% … children between 0 and 4 years
2.87%… for adults "
So, you are no more likely to experience damage to your CI
than you are to experience traumatic brain injury. Yes, if
a baseball hits your head at the site of your device, it
may become damaged. Without it, your head would also be
damaged, so this is not the fault of the CI. Once you
recovered your device would likely need to be removed and a
new device implanted. The device, according to their
statistics has 99.7% reliability when you remove accident
related problems from the calculation. My son's first
device, the older Combi, has a 82.37% cumulative survival
after 114 months (!) when you disregard accident/trauma. It
goes to 74.6% if you include all accidents, surgical
incidents, etc. This is still quite high at 114 months
(10.5 year). Most professionals believe that the devices
are manufactured to last somewhere around 15 or 20 years.
At that time, patients will probably experience a failure
and be reimplanted.
How risky is CI surgery? Well, it is considered outpatient
in adults, usually. It is not a terribly risky surgery; no
surgeon worth his salt would mess around with doing them if
they were. Obviously, since deafness is not life
threatening, the surgery must be proven to be safe and
effective in order to justify it. It has been shown in over
100,000 people to be very safe. The risks are related more
to how a person reacts to anesthesia, blood loss, etc. Our
surgeon spoke of canceling surgeries after being in the OR
because he determined that there was an ear infection
present, or some other problem which made him feel it was
unsafe. No doctor will perform life threatening surgery on
an infant in order to provide hearing. Once a child reaches
6 months of age (approximately) their bodies are better
able to handle surgery and anesthesia. For some reason
those who are anti-CI never got the message that the
surgeries keep happening and people are happy with their
devices. Worried about facial nerve damage? Surgeons use a
facial nerve monitor to detect if they are nearing the
nerve. Their is very little chance that it will be damaged.
17. How do
you know for sure that your kids were deaf? They were
implanted so young, surely the hearing aid trial might not
have been enough to show how well they could have done with
them.
It is correct that hearing aids, by themselves, will not
give a full picture of hearing loss in the brief time we
used them (4-6 months for the boys). What is not known is
that the testing can tell EXACTLY what the decibel loss is.
ABR testing, the most common, tells the amount of hearing
up to 90 db, which is the "profoundly deaf" range. The
newer ASSR test can predict hearing all the way to 120 db.,
which is so profoundly deaf that hearing aids are virtually
useless.
Almost all deaf individuals have some residual hearing.
However, my boys did not have enough to benefit from aids.
That is not to say that Elliot might not have heard a small
amount of very loud environmental noise (which assisted in
his learning to alert to sound) but it was not enough to
hear in ANY of the speech frequencies. Oliver had no
residual hearing to 120 db, and Elliot to 90 (possibly
more, but only the ABR was available then).
I've heard people question the validity of the newborn
screen. It is only a screening test, but let me explain how
it works. It does not require any response whatsoever from
the infant. Electrodes taped to their head while they are
sleeping will record brain activity while clicks are
administered via headphones. There is no pain involved, and
almost every state in the union now requires newborn
screening for hearing loss. (Unfortunately, the follow up
is often lacking). So, it is quantifiable, and the
subsequent ABR test (which is a more extensive version of
the screen) will be able to tell definitively if there is
loss. It does NOT require ANY responses from the newborn.
It does not require a soundbooth test or any verification
from the subject.
Recently, there was an "announcement" by one foreign
researcher that a certain number of kids will regain their
hearing and shouldn't be implanted young. This "news"
article, unfortunately, was very wrong (and, his study
flawed). There are some premies whose hearing isn't
developed and may mature, and there are kids with auditory
neuropathy who can hear at times and not at others.
However, the OAE test is the flawed one and can result in
some incorrect test results. The ABR is clear and
definitive, and administered correctly (we had more than
one taken, also) it can be very clear if the child has
hearing loss. A healthy, full term child who has an ABR and
is show to have hearing loss to 90 or more db is
unequivocally DEAF, and will not regain their hearing.
No matter how long we would have gone with hearing aid
trials, our kids would have struggled with speech. Since
audition and speech are two major goals for our kids, we
knew that the cochlear implant offered the answer. No aided
kid with even severe or moderate hearing loss hears as well
as our kids do with implants! Anyone who tries to tell you
otherwise... may not know what clear hearing really is, or
why it is desirable. Yes, some individuals use hearing aids
with some success, but they do not hear nearly as closely
to natural hearing as the cochlear implant. Hearing aids
function completely different, amplifying sounds for the
remaining hair cells-- which may not exist in certain
frequencies. The electrode of a cochlear implant stimulates
along the length of the cochlea, providing hearing
throughout the range of frequencies, especially those for
speech. It replicates the action of the missing hair cells.
18. What
about babysigns? Can't hurt, right? Isn't there research
showing it to be helpful?
There are 1 or 2 studies (small) regarding babysigns. They
were NOT studying children who were profoundly deaf. In a
nutshell, hearing babies are hearing the entire time that
the few dozen signs are being used, so perhaps it does not
delay their language development, though it might delay
expressive somewhat. Unfortunately, these studies are being
utilized to criticize parents who have not used sign with
their deaf infants. There is no literature to suggest that
deaf infants born to hearing parents will benefit from use
of sign language prior to implantation or after
implantation. In fact, there is plenty of research which
suggests that rewiring the brain in this way (visually) may
make it permanently more difficult to learn to speak and
use English grammar well. Since most deaf infants are born
to hearing parents, it is important that their children
learn a complex language very early, which is impossible
for them to do in ASL.
from Newsweek magazine Special Issue, 1997:
At 20 months, children of chatty mothers averaged 131 more
words than children of less talkative mothers; at 2 years,
the gap had more than doubled, to 295 words. "The critical
factor is the number of times the child
HEARS (emphasis mine) different words,"
says Huttenlocher. The effect holds for the complexity of
sentence structure, too, she finds. Mothers who used
COMPLEX sentences (those with dependent
clauses, such as "when..." or "because...") 40 percent of
the time had toddlers who did so 35 percent of the time;
mothers who used such sentences in only 10 percent of their
utterances had children who did so only 5 percent of the
time." -Sharon Begley, from "How to Build a Baby's Brain'
Remember, deaf children are born with the same capabilities
and abilities for language and complex thought as any other
child, but their development can be hampered IF they do not
get complex language. This is the reason that, for many
years, a small number of deaf children who were born into
ASL using families outperformed the majority of deaf kids
who were born to hearing families. The hearing families
could choose to do one of two things-- either use sign
language (poorly-- most could not use complex sentences) or
use speech when it was more difficult for the child.
Today's family does not have the same difficulty if their
child's hearing loss is detected early. Take a look around
at deaf blogs to see how difficult English language still
is for older, deaf adults.
Once again, it goes back to your goals. If you goal is a
fluent signing adult, sign. If your goal is a speaking and
listening adult, talk.
"Before anything
else, preparation is the key to success." Alexander Graham
Bell
STATS on DEAFNESS
Source: Compiled from fact sheets produced by the National
Institute on Deafness and Other Communication Disorders
(NIDCD).
*Hearing loss is greater in men.
*Approximately 28 million Americans have a hearing
impairment.
*Hearing loss affects approximately 17 in 1,000 children
under age 18. Incidence increases with age: Approximately
314 in 1,000 people over age 65 have hearing loss and 40 to
50 percent of people 75 and older have a hearing loss.
*About 2 to
3 out of every 1,000 children in the United States are born
deaf or hard-of-hearing. 9 out of every 10 children who are
born deaf are born to parents who can hear.
*Ten million Americans have suffered
irreversible noise induced hearing loss, and 30 million
more are exposed to dangerous noise levels each day.
*Only 1 out of 5 people who could benefit from a hearing
aid actually wears one.
*Three out of 4 children experience ear infection (otitis
media) by the time they are 3 years old.
*Approximately 3 to 6 percent of all deaf children and
perhaps another 3 to 6 percent of hard-of-hearing children
have Usher syndrome. In developed countries such as the
United States, about 4 babies in every 100,000 births have
Usher syndrome.
(Usher syndrome causes vision impairment as well as hearing
impairment; hearing with a cochlear implant is thus a great
advance for this subset of the deaf)
*****
How many cochlear implants are implanted
worldwide?
The numbers are hard to find. The University of Michigan
reported 100,000 worldwide last winter (2007). However,
Cochlear Corporation, the largest of the 3 manufacturers
reported:
"...global sales of Cochlear's implants jumped by 24 per
cent on last year, with 15,947 units sold." They also
predict that only 10 % of the potential market is being
treated.
http://www.theage.com.au/news/Business/Cochlear-records-25-profit-growth/2007/08/14/1186857472537.html
While not all of those units may be implanted in people, it
shows that a substantial jump might be made each year if
you add up the implantees from all the companies. Studies
also mention that 3% of those are bilateral implantees, but
that number is growing rapidly. (Litovsky)
*****
In 1991, 24% of deaf college graduates reported NO income,
and deaf graduates of secondary schools have more than
twice the number of unemployed than the national average.
(IRS data)
In 1986, the average reading comprehension scores of the
deaf leveled off at about 3rd grade equivalency, about the
same as in 1974. (Schildroth and Karchmer)
Deaf children who have heard from 3-6 years of age earn 5%
more than those born deaf. (Schein and Delk)
Prior to universal newborn screening (mandated by most
states, now), the average age of detection of hearing loss
was 24 months, and for minority populations, as high as 48
months. (Elssmann, Matkin and Sabo, 1987)
Manually communicating deaf earn 30% less than the general
population. (Schein and Delk, 1974)
In 2007, authorities in Scotland stated that 40% of deaf
individuals suffer from depression. (The vast majority of
those are not implanted.)
