Cochlear Implants – A Cultural Threat

This article discusses a common Deaf cultural view of cochlear implants. Not everyone shares these views and this article is for educational purposes only. The company’s name used throughout the article has been omitted.

A cochlear implant is a new mechanism for hearing when a hearing aid is not sufficient. A hearing aid amplifies sound to make it loud enough to hear, while an implant sends sound signals directly to the auditory nerve.

There are many issues involved with the implants and deaf culture. Evidence of issues such as “fixing” deaf children, giving a false sense of hope, and forcing a choice of culture are all found on a cochlear implant manufacturing corporation’s website.

Cochlear implants are a threat, and the website I am going to use as an example, is a prime example of this.

“Fixing” Deaf Children

The corporation’s website exhibits the issue of the implants being used to “fix” deaf children. The mission statement of the corporation states, “Our mission is to improve lives by developing, manufacturing and marketing bionic technologies.”

The cochlear implant is often forced upon a deaf child by hearing parents. This corporation believes they are improving a deaf child’s life by giving them the ability to hear.

A deaf person can have a perfectly happy life being deaf. Who is to say their life is better because of the implant?

The mission statement goes on to say, “We attract technologists and professionals from all over the world who are dedicated to improving the lives of individuals who suffer from neural disorders, such as deafness.”

Again, the corporation states they want to “improve” deaf people’s lives. However, they now state that people are “suffering” from deafness. This use of language framing makes deafness seem like a burden–like it’s something that is weighing down on a deaf person’s shoulders and must be lifted off and must be fixed.

The history of the corporation began with distributing the CLARION cochlear implant whose primary principle was “that deaf patients would hear better with more options in how sound information is delivered to the auditory nerve.”

The primary reason for the implants was always to make deaf people hear. The only reason why anyone would want that is because deafness is seen as a handicap that needs to be fixed.

This is a huge issue in deaf culture. Deaf people believe that deafness is not a handicap, but a culture. Attempts at “fixing” the deaf are seen as offensive and are met with protests. Children should not be “fixed” to be like hearing people, but should be introduced to deaf culture where he or she was born to belong.

False Sense of Hope

The corporation shows on their website the false sense of hope they give prospective patients. The corporation states that the cochlear implant “is the only medical technology able to functionally restore a human sense – Hearing.”

This is not true. The cochlear implant cannot actually restore hearing. A cochlear implant, as stated on the website, “captures sound from the environment,” “processes sound into digital information,” “transmits to the implant over a transmitting antenna,” “converts digital information into electrical signals,” “sends signals down tiny wires to the electrode array in the inner ear,” “delivers electrical signals through tiny contacts, or electrodes, to the hearing nerve,” then “the hearing nerve carries the sound information to the brain, where it is heard.”

An ear does not normally work in that fashion. For that reason, people with these implants cannot hear the actual sounds. The sounds are digital, and the hearing is not normal. The false sense people get about these implants actually bringing back the ability to hear is nonsense. Children cannot actually regain their hearing with a cochlear implant. It is a synthetic sound–it does not fix a broken sense.

There are also biological and technical issues that need to be taken into consideration. The corporation actually states that depending on the age of hearing loss, the age of implantation, the status of the inner ear, and other medical conditions, there is not a guaranteed level of benefit from the cochlear implant. Though these precautions are posted on the website, and each patient is evaluated individually, there is always a chance that the cochlear implant will not work as well as expected.

With a cochlear implant usually being one of the first options given to hearing parents of a deaf child, risks are usually taken and children may be stuck with the implant even though the desired result was not met.

A frequently asked question on the website is “Why do people get a Cochlear Implant?” One of the answers was, “They want to be included instead of left out.”

This is another false sense of hope. Children with the implants are not easily accepted and included. There is still a visible implant on the child’s head which will be an easy target for teasing in mainstreamed schools. The child will more likely be included without a cochlear implant in a deaf school than with a cochlear implant in a hearing one.

Children are cruel and will seek out anything to put another child down. A bionic ear will be an easy target for low self esteem. False hope of a cochlear implant’s success is an issue that needs to be more thought out and assessed. This false hope can lead to a child’s disadvantage.

Forcing a Choice of Culture

A video on the corporation’s website shows that a culture is chosen for many deaf children of hearing parents. In the video, the parents found out that their daughter was deaf at the age of two. “Immediately she was fitted with hearing aids,” and “everyone told [them] initially that it’s a severe impairment but with hearing aids, she should do well.”

Immediately, the answer was to get this little girl to hear again. They wanted to capture any residual hearing she had left. She was already being forced into the hearing world, and at the age of two, she had no choice.

They also used the word “impairment,” already acting like the little girl had a problem that needed to be fixed so she could function in the hearing world.

The video goes on to say that “for months, she struggled” and her parents “learned subsequently that whole technology only provided her with a small benefit.”

The benefit is the functionality in the hearing world. The first sign that something was wrong was that she was struggling. They could have used an alternative method at that point–deaf culture. However, her parents wanted her to be with the hearing, and turned to the cochlear implant.

Her parents said, “We explored every possibility we could think of how we were going to teach our daughter…language.” They went on to say none of the possibilities worked until they found the cochlear implant.

The young girl received her cochlear implant at the age of three and a half. If her parents had tried every possibility, then they tried sign language–it was seen in the video.

However, if the girl was implanted at such an early age, her natural language of American Sign Language was not even possible to fully learn in that amount of time. If she were to learn ASL, then English, she would be fine. But her parents jumped to the cochlear implant, and she had no choice herself. She could have functioned fine in deaf culture, where she was born to be.

Many deaf children of hearing parents are forced into the hearing culture where they were not meant to be. This is an issue that these implants bring up. Hearing aids can be removed, but implants cannot.

What is Right?

What is happening is not the fault of the parents who decide to have their children implanted. It’s the system that hearing parents go through–the information that is given to them. Information is given to them through doctors and scientists–both of whom see deaf people as needing to be “fixed.” They do not offer information about Deaf culture or the fact that deaf children can have a happy and fulfilling life being Deaf–without being told that something is wrong with them.

Cochlear implants raise many issues in the deaf community. Three of which are: “fixing” deaf children, giving a false sense of hope to hearing parents, and forcing a choice of culture upon deaf children.

Evidence of these issues can be found on a cochlear implant manufacturing corporation’s website. I found exactly what I expected to find on this website. I found advertising hype, language of hope and change, and language that would make hearing parents of a deaf child’s minds up before they even knew it.

This website was very informational in how audiologists think in the absence of deaf culture. I learned exactly how a cochlear implant worked, which I have always wondered.

However, I am still wondering about the success statistics. I know that the implants do not work for everyone, but I want to know how many people receive a cochlear implant and have their hearing remain the same or get worse.

I have also heard from several of my professors that the implants tend to die after 15 years, and that medical insurance only covers one implant. When the implant dies, many get an implant in their other ear, spending several thousand dollars. This is not a choice that should be made for a child.

People should have the right to choose which culture they will belong to. The implants cannot be removed and therefore one culture is chosen for a child–one path. They have no choice but to be fixed and shoved into hearing culture while their parents have a hope of success that may never come true.

These issues need to be assessed, and the administers of these implants need to provide both sides of the story as well as all the options.

Check out this fantastic video by JoJa+ that takes a deeper look into Deaf culture and how it relates to society’s need to “cure” deafness:

Again, this article discusses a common Deaf cultural view of cochlear implants. Not everyone shares these views and this article is for educational purposes only.

Articles Submitted by Students

Cochlear Implants and Perspectives from the Deaf Community

by Amy Dragoo | 6 January 2021

Introduction

Cochlear implants are “electronic devices surgically implanted under the skin behind the ear” (National Deaf Center on Postsecondary Outcomes, 2019, Overview section, para. 1). These devices specifically stimulate the auditory nerve within the individuals inner ear to enhance reception and interpretation of sounds and other auditory stimuli (National Deaf Center on Postsecondary Outcomes, 2019). There are four main components of a cochlear implant, which includes a microphone, transmitter, receiver/stimulator, and an electrode array (National Deaf Center on Postsecondary Outcomes, 2019). In order to produce sound, the cochlear implant first transcribes the sound into a digital code, which is then transmitted into the coil of the implant (National Deaf Center on Postsecondary Outcomes, 2019). Once in the coil, these sounds convert into electrical impulses that are sent to the cochlea (National Deaf Center on Postsecondary Outcomes, 2019). Finally, the electrodes in the implant stimulate the auditory nerve and the messages are sent directly to auditory processing parts of the brain to be interpreted (National Deaf Center on Postsecondary Outcomes, 2019). Individuals can receive a cochlear implant at birth or later in life (National Deaf Center on Postsecondary Outcomes, 2019). Overall, the purpose of cochlear implants is to potentially enhance hearing abilities if an individual has been diagnosed as deaf or hard of hearing (National Deaf Center on Postsecondary Outcomes, 2019).

Cochlear Implants and the Deaf Community

The use of cochlear implants in the Deaf community is largely controversial (Cooper, 2019). Individuals who identify with the Deaf community believe that the use of a cochlear implant does not necessarily “cure” the state of being deaf (Cooper, 2019). Additionally, many Deaf individuals feel that parents should not choose for their child to receive a cochlear implant as infants do not have a say or choice in the matter (Cooper, 2019). While the idea of using a cochlear implant may be appealing and beneficial for a child, it could potentially be determinantal to the child’s sensory processing system (Cooper, 2019). According to Cooper (2019), the brain requires time to rewire and process the new auditory information being received and interpreted. At initial installation, a child or adult may feel overwhelmed by the overstimulation of background noise, static sounds, and other auditory stimuli in his or her environment (Cooper, 2019). Once the cochlear implant is inserted, it may take months or years before the individual starts receiving and interpreting auditory information accurately (Cooper, 2019).

Unfortunately, the use of a cochlear implant does not fully restore the function of hearing, which raises a concern for the Deaf community (Cooper, 2019). Commonly, parents who are hearing will request for their child to utilize a cochlear implant and will not teach their child American Sign Language (ASL) (Cooper, 2019). Children who are deaf or hard of hearing may be deprived of the use of ASL during the first two years of life, which is a critical period for language acquisition and development (National Association of the Deaf [NAD], 2021). This could potentially affect the child’s development and result in cognitive and language delays (Cooper, 2019; NAD, 2021). Based on these factors, children who are deprived of a visual language early in life may negatively affect their learning, quality of life, and well-being later in life (NAD, 2021).

Conclusion

While the use of cochlear implants may be beneficial for some individuals, the Deaf community views them as controversial (Cooper, 2019). These reasons include that the use of a cochlear implant does not “cure” deafness, a child does not have the choice to receive an implant, and that a cochlear implant could be more damaging to the individual’s sensory processing system (Cooper, 2019). Finally, individuals in the Deaf community feel that parents who are hearing may not expose their child to ASL early in life (NAD, 2021). While some individuals may view the condition of being deaf or hard of hearing as a disability, the Deaf community views it as a respectful celebration (Cooper, 2019). Overall, the Deaf community highly values their language, cultural identity, history, and sense of community, and strives to provide optimal opportunities for individuals who are deaf, Deaf, or hard of hearing to live meaningful lives (Cooper, 2019; NAD, 2021).

References

Cooper, A. (2019). Hear me out: Hearing each other for the first time: The implications of cochlear implant activation. Missouri Medicine, 116(6), 469-471. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6913847/

National Association of the Deaf. (2021). Position statement on early cognitive and language development and education of deaf and hard of hearing children. https://www.nad.org/about-us/position-statements/position-statement-on-early-cognitive-and-language-development-and-education-of-deaf-and-hard-of-hearing-children/

National Deaf Center on Postsecondary Outcomes. (2019). Cochlear implants: An introduction [PDF document]. https://www.nationaldeafcenter.org/sites/default/files/Cochlear%20Implants_%20An%20Introduction.pdf

My Review of “My Deaf Son Fought Speech. Sign Language Let Him Bloom.”

by Kaylee Perry | May 16, 2018

The article I chose was “My Deaf Son Fought Speech. Sign Language Let Him Bloom.” by Elizabeth Engelman of the New York Times. The whole article related to her son who was born profoundly deaf. Elizabeth, being a hearing mother, immediately went to see if he was able to get the Cochlear implant surgery. He was able, and that was the first thing she did. Micah, her son was miserable. He tried constantly to rip the cochlear implants out of his head and cried screams of terror when they turned them on. Elizabeth did not know what to do. The audiologist told her that American Sign Language would hold her son back and just become a crutch he did not need. Speech therapy was not going well either and Elizabeth did not know where to turn. Finally, Elizabeth said that is enough. She finally started taking American Sign Language classes at a local community college and started teaching her son the language. He picked it up very well and instantly took his cochlear implants off his head. Elizabeth explains that the first word he learned was “flower” and she distinctly remembers him signing it to her. Elizabeth recalls the first time Micah signed a real story to her. She states, “The first time he told me a story, he was 6. We were eating greasy burgers and fries in a diner’s pleather booth, and he told me about a dream from the night before. Our mouths were full, chewing, lips sealed, but his story continued with rapid-fire signs.” The progress from seeing him scream and cry because of an implant, to seeing him sign fast paced, happy and full was amazing.

This article definitely relates to Deaf culture. Going from a mom not knowing anything about ASL, and being told by an audiologist that it would just be a crutch, to watching her son transform to a happy kid, excited about his new language is amazing. I think it is so important that people do their research before just resorting to a Cochlear implant. This article would be a very good read for a parent who is hearing who also has a deaf child. When they are not sure what to do all they would have to do is read this article and truly see what the best option is for their child. This would also be a good read for Deaf communities to show people that may not have any experience with Deaf culture. This is a very helpful article that gives great insight into what happens when people may be ignorant ton a certain topic. I feel that this article has been very helpful and it was great to learn that this is something that actually happens to many deaf children unfortunately. They are not able to make the choice of what they want and people seem to forget that. I only hope that this article was able to open the eyes of many hearing parents who may be blind to the fact of what is really the best option for their children.

Works Cited

Engelman, Elizabeth. NY Times. “My Deaf Son Fought Speech. Sign Language Let Him Bloom”. 26, May 2017. https://www.nytimes.com/2017/05/26/well/family/my-deaf-son-fought-speech-sign-language-let-him-bloom.html

Cochlear Implants

by Kayla Hite | August 7, 2020

A cochlear implant is a small electronic device that electronically stimulates the cochlear nerve (nerve for hearing) (Johns Hopkins Medicine).  Cochlear implants are a controversial topic within the Deaf community, as these implants have many pro and cons.  It is important to full understand cochlear implants, in its entirety, before determining if this is the right decision.

There is an external and internal part to a cochlear implant. The external part sits behind the ear, processes the sound and transmits it to the internal part of the implant.  The internal part of the implant is placed under the skin behind the ear.  A thin wire and small electrodes lead to the cochlea nerve in the inner ear.  The wire then sends signals to the nerve, which in turn, sends sound information to the brain.  Normal hearing is not restored through cochlear implants; however, hearing experience can improve with an increased awareness of sounds, leading to better communication in the environment (Johns Hopkins).

There are several beneficial reasons for getting a cochlear implant.  The pros include, but are not limited to: reduced social isolation, misunderstandings, and dropped conversations (Hearing Solution).  In addition, a cochlear implant will “provide for the ability to hear and detect the presence of sound. Most patients will hear speech and environmental sound and see an improvement in lipreading skills. Many patients will see improvements beyond the minimum, including some understanding of speech without visual cues, and even the ability to use the telephone” (OHSU).

While cochlear implants have several benefits, there are also consequences of these implants.  Cochlear implants cannot fully restore hearing, and there are no guarantees to the level of improvement after the implants.  In addition, this is a surgical procedure, and can be expensive, especially for those without health insurance.  Cochlear implants also require ongoing maintenance, including battery maintenance, and may need to be removed for high contact sports and activities (Hearing Solution).  It is also important to remember it is possible that cochlear implants may not help some individuals at all, and it is also possible you may lose the rest of your natural hearing where the implant is placed (Johns Hopkins).

There are also many risks associated with cochlear implant surgery.  These risks can include: bleeding, swelling, infection, tinnitus, dizziness, numbness, changes in taste, dry mouth, injury to the facial nerve, leakage of spinal fluid, and risk of general anesthesia.  It is not uncommon for cochlear implants to be later removed due to infection (Johns Hopkins).  In addition, age at the time of surgery, experience with hearing and language prior to surgery, and consistent rehabilitation therapy and a language-rich home environment should also be considered essential when considering cochlear implants and their effectiveness in one’s life (Johns Hopkins).

In conclusion, cochlear implants are a controversial topic, especially between members of the Deaf community.  Members feel as though cochlear implants “do not provide recipients with “clear and unambiguous access” to linguistic input in the same way that sign language does. For young children learning their primary language, “reliance on only spoken language input via cochlear implants may result in linguistic deprivation if sign language is excluded from [their] environment (Cooper).  Although this is a belief among some; others feel as though any improvement to hearing is a positive.  Therefore, it is highly essential to consider all factors when determining if cochlear implants are the right decision for each individual.

Works Cited

Cooper, Amelia. “Hear Me Out: Hearing Each Other for the First Time: The Implications of Cochlear Implant Activation.” Missouri medicine vol. 116,6 (2019): 469-471.

John Hopkins Medicine.  “Cochlear Implant Surgery.”

OHSU.  “Cochlear Implant Benefits.”  Ear, Nose Throat.

The Hearing Solution. “Cochlear Implants Pros and Cons: Need to know.”

Cochlear Implants

by Emily Carr | September 2, 2020

I was born with congenital nystagmus and oculocutaneous albinism, resulting in a moderate visual impairment in both eyes.  I went to public school but met with a vision teacher once a week, had enlarged textbooks when necessary, and always sat in the front row of class, although that did not always guarantee I could see what I was supposed to be learning.  For as long as I can remember, I always wished there was some surgery that could fix the condition I was born with so that I could see what everyone else could see from such far distances, read a book without wearing very thick glasses, and most importantly to me, drive a car.  Based on my experiences in life my with visual impairment, I always thought that if I had been born deaf instead of legally blind, I would have wanted my parents to help me receive a cochlear implant.  I never imagined there would be such a divide on the issue between the hearing and Deaf community, and that the decision to receive a cochlear implant might not be as straightforward as I thought.

According to the United States Food and Drug Administration (FDA), a cochlear implant is “an implanted electronic hearing device, designed to produce useful hearing sensations to a person with severe to profound nerve deafness by electrically stimulating nerves inside the inner ear” (Cochlear Implants: Different Hearing).  The implant typically consists of two main parts: the externally worn microphone, sound processor, and transmitter system, and the implanted receiver and electrode system.  Although research with cochlear implants began in the 1950’s, the first single channel cochlear implant was introduced in 1972, and a multi-channel cochlear implant system was developed in 1984.  Cochlear implants were approved for adults in 1984 and for children in 1990, and there are currently three FDA approved cochlear implant systems available in the United States (Cochlear Implants).

Children and adults can both receive cochlear implants if they meet the requirements to receive one.  As of 2000, the FDA had approved the use of cochlear implants in eligible children beginning at 12 months of age; however, the company Cochlear Limited obtained U.S. FDA approval in March of 2020 to lower the age of implantation from 12 months to 9 months (Cochlear Receives).  The idea behind early implantation of cochlear implants in children is that they tend to hear and speak better than those who receive implants at an older age since they are exposed to sounds during an optimal period to develop speech and language skills (Cochlear Implants: Different Hearing).

Although approval of cochlear implants for adults came first, there has always been less debate about this issue.  Late-deafened adults who choose to receive a cochlear implant already have language, and it is believed that since they are older, they are capable of making the decision for themselves.  However, for the past 30 years, the debate about whether it is acceptable for a deaf child to receive a cochlear implant remains strong.  In 1991, the National Association of the Deaf deplored the approval by the FDA of cochlear implants in children saying it was “unsound scientifically, procedurally, and ethically” (Spencer).  Although the NAD changed their position in 2000, stating, “technology has been evolving and is now playing an important role in leveling the playing field for deaf and hard of hearing people” (NAD’s Position), there is still a strong divide among the hearing and Deaf community about the use of cochlear implants in children.

The main reason the Deaf community is opposed to the implantation of cochlear implants in children is they feel it is a threat to Deaf culture.  Culture, as defined by sign language scholar Carol Padden, is “a set of learned behaviors of a group of people that share a language, values, rules for behavior, and traditions” (Jay 42).  Deaf culture was first recognized in 1965 and consists of all these things, with American Sign Language being regarded as the highest asset (Jay 43).  The Deaf community sees cochlear implants as a threat to their culture as they fear fewer children will learn ASL.  Since at least 90% of deaf children are born to hearing parents, the implant appears to be an attractive option since some of the benefits include the ability to hear sounds and understand speech, making communication with children easier.  There would be “little to no need for visual aids” if implanted at a young age (Praderio), as children would spend their time working with speech and language therapists learning how to process and interpret sound, as well as speak.  The NAD asserts that “the right to a natural, visual language is a human right of all deaf and hard of hearing children” and encourages the use of ASL from birth for language acquisition in children who receive an implant as part of a bilingual, bimodal environment (Position Statement).  However, despite this position, it is still difficult for the Deaf community to accept something that could jeopardize their entire culture, and the loss of ASL learners due to cochlear implants is still at the forefront of the debate against allowing children to receive them.

Another reason the Deaf community does not support cochlear implants, particularly in children, is they feel it is the hearing world’s way of “fixing” or “curing” them “since hearing people think deafness is limiting” (Aronson, Sound and Fury).  The term deafness with a lowercase d refers to the medical condition in which a person has auditory hearing loss, whereas Deafness with an uppercase D is the identity of those within the Deaf community and culture.  In the movie “Sound and Fury,” Nita Artinian, the mother of three deaf children, one of whom wanted a cochlear implant, was worried an implant would change her daughter’s identity, and that she would be missing out on Deaf life.  Peter Artinian, the husband of Nita who was also deaf himself, commented that even if there were a pill to cure deafness, he would not take it because “In my heart, I know this is who I am… I want to be Deaf.” (Aronson, Sound and Fury).  Nita and Peter ultimately agreed that a cochlear implant was not right for their children at that time.  The NAD “recognizes the rights of parents to make informed choices for their deaf and hard of hearing children” but it asserts “cochlear implantation is a technology that is to be used as a tool for some forms of communication, not a cure for deafness” (NAD’s Position).  This viewpoint drives home the point that although parents can choose to let their child have a cochlear implant, it does not take away their Deafness and it is important for them to understand who they truly are as a member of the Deaf community and culture.

Although the debate about cochlear implants has improved since they were first approved by the FDA in 1984, it does not seem there will ever be complete agreement about whether people, particularly children, should receive them.  Medically there are many benefits and risks to getting them, but the more important benefits and risks involve the welfare and identity of the person receiving the implant.  It is not an easy decision to be made, especially by a parent of a child, but hopefully there will continue to be more acceptance and understanding by both the Deaf and hearing community as time and technology progresses.

Works Cited

“Cochlear Receives FDA Approval to Lower the Age of Pediatric Cochlear Implantation to 9 Months.” Cochlear, 18 Mar. 2020, www.cochlear.com/ca/en/corporate/media-center/media-releases/2020/fda-ped-9-months. Web. 27 Aug 2020.

“Cochlear Implants: A Different Kind of ‘Hearing’.” U.S. Food and Drug Administration, 10 Nov. 2017, www.fda.gov/consumers/consumer-updates/cochlear-implants-different-kind-hearing.  Web. 27 Aug 2020.

“Cochlear Implants.” American Speech-Language-Hearing Association, 2004, www.asha.org/policy/TR2004-00041/.  Web. 27 Aug 2020.

Jay, Michelle.  Don’t Just “Sign” – Communicate!  A Student’s Guide to ASL and the Deaf Community. Judea Media. 2011.

“Position Statement on Early Cognitive and Language Development and Education of Deaf and Hard of Hearing Children.” National Association of the Deaf, 18 June 2014, www.nad.org/about-us/position-statements/position-statement-on-early-cognitive-and-language-development-and-education-of-deaf-and-hard-of-hearing-children/.  Web. 27 Aug 2020.

Praderio, Caroline. “Why Some People Turned down a ‘Medical Miracle’ and Decided to Stay Deaf.” Insider, 7 June 2018, www.insider.com/why-deaf-people-turn-down-cochlear-implants-2016-12.  Web. 27 Aug 2020.

Sound and Fury. Dir. Josh Aronson. Artistic License.  2000.  Documentary.

Spencer, Linda J, et al. “Outcomes and Achievement of Students Who Grew up with Access to Cochlear Implants.” The Laryngoscope, U.S. National Library of Medicine, Sept. 2004, www.ncbi.nlm.nih.gov/pmc/articles/PMC3210741/.  Web. 27 Aug 2020.

“What Is the NAD’s Position Regarding Cochlear Implants?” National Association of the Deaf, 2020, www.nad.org/about-us/faq/.  Web. 27 Aug 2020.

Cochlear Implants and the Controversy Surrounding Them

by Anonymous | March 31, 2020

The scope of the subject of cochlear implants is far too vast.  This is a very short history of cochlear implants, the makeup of the implants, the reactions of some of the Deaf community to use of the implants, and how that reaction has or has not changed.

Cochlear implants were “invented” several times.  The original was developed in 1957 by André Djourno and Charles Eyriès as a single-channel implant.  William House invented a cochlear implant in 1961 and in 1964 Blair Simmons and Robert J. White implanted a single-channel electrode in a patient at Stanford University. However, because the single-channel devices would not allow differentiation between frequencies well enough, they were considered not to be really useful.  The cochlear implant of today is a multi-channel device and was first implanted in a person in December 1977.  This device was one developed by a team led by Ingeborg Hochmair in Australia.  The first cochlear implants approved by the FDA were in the mid-1980s.

The implant has two main parts. There is an external portion that is put behind the ear and an internal portion surgically implanted under the skin. There is a microphone to pick up sounds from the environment, a speech processor to handle those sounds, a transmitter and receiver to convert sounds into electric impulses, and an electrode array that sends those impulses to the auditory nerve.

The decision to have or not to have cochlear implant is not to be made lightly.  It is very expensive and insurance may not cover the costs.  The audiology visits and rehabilitation are a life long process–every three to six months during the first year for programming.  And, like any other kind of surgery, there may be complications–device malfunction, facial nerve weakness, ringing in the ear, and meningitis are all possibilities. These complications are rare.  In a small minority of people, they may not help with hearing at all.

A lot of people think, a cochlear implant will give a deaf person normal hearing.  This is not so.  What it does is give a “useful representation” of what’s going on in the area around him or her to help him or her understand speech. An implant in a young child who is deaf or has severe hearing loss exposes that child to sounds to help develop skills in speech and language. Parents who have a deaf child must decide whether to raise that child by teaching oral language or non-oral language (such as ASL).  The child raised on non-oral can develop close relationships in the Deaf community but it would be difficult for that child to communicate with people who do not know sign language.  Cochlear implants do benefit some children.  Most children who have an implant are mainstreamed in school.

“Research has shown that when these children receive a cochlear implant followed by intensive therapy before they are 18 months old, they are better able to hear, comprehend sound and music, and speak than their peers who receive implants when they are older. Studies have also shown that eligible children who receive a cochlear implant before 18 months of age develop language skills at a rate comparable to children with normal hearing, and many succeed in mainstream classrooms.”  (Denworth from Time Magazine Online. “Science Gave My Son the Gift of Sound.)

There is evidence that Deaf children who sign well do better academically.  However, it is also argued that with an implant and all the therapy needed that there is so much emphasis on that that it takes away from the child’s identity and even may lead to poor self-image as “disabled”.  That child should have a healthy self-concept as a proud Deaf person.  Of note, children that have cochlear implants are usually educated orally and do not have access to sign language.  In fact, they are often isolated from other deaf children.

Most of the resistance to cochlear implants is from the Deaf community, which considers itself to have their own language and culture.  They do not consider that deafness needs to be “cured.”  Especially those whose first language is a sign language.  The Deaf community does not see themselves as having a need for a “fix” for their non-existent deficiency.  “For some in the Deaf community, cochlear implants are an affront to their culture, which, as they view it, is a minority threatened by the hearing majority.”  (“The Cochlear Implant Controversy, Issues And Debates”. NEW YORK: CBS News. September 4, 2001.)

An argument used in opposition to this is that the implants are a way deaf people can access the “hearing world” and still maintain their Deaf identity.  In 2011 Irene Leigh (a retired from the psychology department of Gallaudet University) editored a book with Raylene Paludneviciene in which they expressed the idea that the Deaf community was beginning to better view recipients of cochlear implants and helping them to still enjoy a Deaf identity.  As a culture, deaf people do not generally support cochlear implants in children because they do not have a choice about it like adults do. “Scientists suggest that the best guarantee of good language outcomes for Deaf children is to establish Sign Language as a secure first language before a cochlear implant program (CIP) is considered.” (Campbell, R; MacSweeney, M; Woll, B (2014).  “Cochlear implantation (CI) for prelingual deafness: the relevance of studies of brain organization and the role of first language acquisition in considering outcome success”. Front Hum Neurosci. 8: 834. doi:10.3389/fnhum.2014.00834. PMC 4201085. PMID 25368567.)

I have an acquaintance that has a cochlear implant in each ear.  He was born with a severe bilateral hearing loss.  He received intensive speech training in preschool, kindergarten, and first grade.  This was in a school for children with hearing loss and they focused on oral rather than non-oral language.  At age five he began using a hearing aid in one ear.  His hearing continued to deteriorate.  At the age of 57 his hearing in his right ear gave out and he could hear only an “ooommpphh” sound and had only 28% speech comprehension in his left ear.  After several months of researching cochlear implants, he decided to have one implanted in his right ear.  He used a hearing aid in his left.  After six years he had the left ear implanted.  He has mentioned that all his life (both pre- and post-implant) the sounds he heard were quite different from each ear.  When having both ears on, sounds were more pleasant, fuller, and three-dimensional.  (He says that may be a “brain” thing.)  He feels that he now has the best aided hearing of his life.

“Some of the soft sounds really impressed me.  Shortly after my first “turn-on”, my sister’s cat jumped off a chair and I could hear the sound of its paws hitting the carpeted floor.  Later, I was able to hear the wings of a bird taking off 100′ away.  I could understand speech from a person in another room in a quiet house, something I could never do before.  I could follow group conversation of people talking normally, at least in a quiet room, and often without directly facing the speakers.  I do not have to rely on lip-reading very much, which had been very tiring.”  (personal interview from Chuck Vlcek via email; February 11, 2020)Chuck did not have any negative experiences with the Deaf community as he did not have much direct contact with it.  As he says, there are always going to be a few “bad apples” in the hearing world that cause problems for deaf people like kids who deliberately mumble, groups making it difficult to join conversations, and being ignored when getting service in a store. He says:

“It is more work to communicate with a person with hearing loss and some folks just don’t want to be bothered.”  (personal interview with Chuck Vlcek via email February 15, 2020) In April of 2014  Lydia Denworth wrote an article for the New York Times entitled “I Can Hear You Whisper: An Intimate Journey through the Science of Sound and Language”. In that article she writes of a person named Brandon Edquist who had been deaf since he was two.  He got a cochlear implant when he was three.  He was never happy with it.  After many years of antics like dropping them in the toilet, wrapping them around a swing, switching it off, etc., his parents finally decided that it was of no use.  Their son was happier without the implant and they began communicating with ASL.

Another young man got an implant before he was seven.  Both his parents and a sibling were hearing and he lived with the device because it seemed to be the best choice.  When he went to study at Gallaudet University, he experienced new things. He said “Communicating and cooperating with a teacher who signs is just an eye-opening experience.  I could be myself and be comfortable around teachers at Gallaudet.”  He encountered Deaf — with a capital D — culture for the first time.  He realized he didn’t need an implant after all.   He said “While I was picking up the aspects of Deaf culture and the language of ASL, I finally realized that I’ve found my own identity,” he said. “I am Deaf and I am darn proud of it. From there, I didn’t see the purpose to continue wearing my implant.” (Denworth, 2014)

In a survey of Gallaudet students in 2013 one third of the students believed that it was ok for parents to choose cochlear implants for their children. “About fifteen years ago, during a panel discussion on cochlear implants, I raised this idea that in ten to fifteen years, Gallaudet is going to look different,” says Stephen Weiner, the university’s provost. “There was a lot of resistance. Now, especially the new generation, they don’t care anymore.” ASL is still the language of campus and presumably always will be, but Gallaudet does look different. The number of students with cochlear implants stands at 10 percent of undergraduates and 7 percent overall. In addition to more cochlear implants, there are more hearing students, mostly enrolled in graduate programs for interpreting and audiology.  “I want deaf students here to see everyone as their peers, whether they have a cochlear implant or are hard of hearing, can talk or can’t talk. I have friends who are oral. I have one rule: We’re not going to try to convert one another. We’re going to work together to improve the life of our people. The word ‘our’ is important. That’s what this place will be and must be. Otherwise, why bother?” (Denworth , 2014)

Gallaudet does not take a stand in the controversy.  They see themselves as an objective forum and people can make judgments from the information from there.  Sometime around 2003 “the National Association of the Deaf  had changed its position from opposing cochlear implants to a position of “qualified” support of them as one of many choices.So, in conclusion, it seems there will always be some controversy with cochlear implants.  It also seems that the big hubbub may have subsided a tiny bit and people on “both sides” might just be willing to accept the decisions that are made about the implants.  It’s important to note that the decision to have or not have cochlear implants remains a very important decision for the recipient, whether he/she be an adult or a child.  Much research into the whole procedure, costs, and implications is mandatory.

Works Cited

Svirsky, Mario (2017). “Cochlear implants and electronic hearing”. Physics Today. 70 (8): 52–58.

CBSNEWS.COM STAFF “The Cochlear Implant Controversy”. Sunday Morning. (June 2, 1998, 2:27 PM). https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/cochlear-implant-surgery

Denworth, Lydia (2014).  “Science Gave My Son the Gift of Sound”. Time Magazine. https://www.insider.com/why-deaf-people-turn-down-cochlear-implants-2016-12

https://stanfordhealthcare.org/medical-treatments/c/cochlear-implants/what-to-expect.html

Made to Hear

by Kenzie Hinote | September 29, 2020

The Cochlear Implant debate is one that is extremely divided. The hearing community views that not giving a child the implant is comparable to abuse while the Deaf community view that implanting an infant is forceful and is stealing that child from their community and those that can support them. Cochlear implants are seen as a threat to Deaf culture because they are purposely implanted into young children so they are unable to relate to the Deaf community. This conflict is greatly shown in the documentary Sound and Fury and by watching the film, one can understand Deaf culture and the feelings behind this debate.

There is a sort of pride in the Deaf community about their deafness. Rather than viewing it as a handicap like the hearing world, the Deaf community views their deafness as a difference. But with these differing views, the debate on what to do with this new technology shows. Some Deaf people view the trend of implanting young Deaf babies as a cultural genocide that will result in no more Deaf people existing. In the hearing world, a sense of pity is shed on Deaf people and the idea of deafness no longer existing does not sound harmful seeing as the hearing world largely knows nothing about Deaf culture and life. In the documentary, Heather’s grandmother does not want her granddaughter to go through the same pains she saw her son go through growing up as a Deaf person. While, yes, growing up different than all those around you is hard, this struggle can make one’s view of the world more defined. After this struggle, when Deaf people find their community it can bond them together unlike anything else.

In Deaf culture, community values and the existence of the group is very important. Going through many painful experiences can alter the mind and when one finds others like them, it can feel like finally finding one’s true family and where they belong. These kinds of values are put on display when in the documentary the family goes to a Deaf event and discusses the choice of Peter getting an implant even though he has a big Deaf family. It is also shown when Peter’s Deaf grandmother cries because she is scared he will make fun of her in the future for being Deaf. The community can shape other opinions and help each other with problems or struggles they may face. When Peter’s mom, Mari, tells the event’s attendees about her choice to implant her son, they feel threatened, and as if he is being stolen from his family.

The Cochlear Implant debate has many strong feelings attached on both sides, each viewing the other’s choice as abuse or that it will harm the child, but it should be the child’s choice whether or not to get implanted. It may feel as if the child is being taken away from the Deaf community and that eventually, Deafness will no longer exist, which is why hearing parents should be informed about Deaf culture and their languages before deciding this option for their child. Also, even though the earlier the implant is done makes the ability of speech better, the child should be able to decide what they want.

Sources:

Aronson, J. (Director). (2000). Sound and Fury [Motion picture on DVD]. United States: Artistic License Films.

Ladd, Paddy (2003). Understanding Deaf Culture: In Search of Deafhood. Multilingual Matters. p. 502. ISBN 978-1-85359-545-5.

Lane, Harlan L.; Richard Pillard; Ulf Hedberg (2011). The People of the Eye: Deaf Ethnicity and Ancestry. Oxford University Press. p. 269. ISBN 978-0-19-975929-3.

James, Susan Donaldson; Huang, Grace (December 13, 2006). “Deaf and Proud to Use Sign Language”. ABC News. Retrieved August 31, 2015.

Jay, M. (2011). Don’t just “sign”– communicate!: A student’s guide to ASL and the Deaf community. Los Angeles, California: Judea Media.

Michelle Jay

Michelle Jay is the founder of StartASL.com. She earned a Bachelor‘s Degree in Deaf Studies, with an emphasis in teaching, from one of the nation’s premier programs at California State University, Northridge. Michelle is a published author and has contributed thought-provoking articles to academic publishers such as Greenhaven Press. Her unique articles have done much to support Deaf Culture, and have been printed in resource publications such as American Chronicle and Perspectives on Diseases & Disorders: Deafness & Hearing Impairments.

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