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"Cochlear implants will enable the deaf child to understand
speech." These are but a few examples of assurances given
to parents of young deaf children by professionals. The focus
of this column is on the pre-lingual deaf child. Generally,
throughout the world, parents make major medical decisions
on behalf of their deaf children on the basis of information
that is controlled by persons who have very little to do with
and/or understanding of identity development in deaf children.
Rosy pictures are often painted for parents who have a natural
desire to see their deaf children being able to hear and speak
like themselves. It is also a time when these parents are
at their most vulnerable, and yet it is also a time when they
need to ask hard questions not only of the professionals but
also of themselves since the decision will have a major impact
on the child. In this light, they would do well to ask these
questions which are suggested here.
"Cochlear
implants will greatly improve the deaf child's hearing and
speech" Do cochlear implants actually cure deafness?
Or do they simply raise the hearing threshold into the hard-of-hearing
range? If that is the case, do they simply transform the deaf
child into a hard of hearing child? Do cochlear implants in
themselves automatically lead to normal speech? Or does speech
happen only after years of intensive speech therapy? Even
then, will such speech be "normal" or even clearly
intelligible? Could it be that the intensive oral training
regimen may be a bigger factor than implants themselves in
the development of speech skills?
"Cochlear
implants will lead to normal lives" What is normal? Is
normalcy dependent on being able to "pass off" as
a "hearing" person or being able to live and function
in a hearing world? Is hearing and speech absolutely essential
for functioning in a hearing world? If my deaf child becomes
a hard of hearing child, will that make it any better for
him? Or worse? Do the implants eliminate the disability altogether,
or will the child continue to need special support and services?
Do implanted deaf children require interpreters in classrooms
and group situations?
"This
little deaf child with the implant can speak well" Many
parents of young deaf children are often impressed when implanted
deaf children with excellent oral skills are displayed to
them. They need to stand back with a more critical eye and
ask questions such as: Did this child already have auditory
language prior to becoming deaf and being implanted? Is this
child the exception rather than the rule? Are all implanted
deaf children like this one, especially pre-lingual deaf ones?
Can we also see them?
"Cochlear
implants have a high success rate" On what basis is this
claim made? What is the definition of success? In terms of
being able to utter some words clearly? In terms of attaining
a good education? In terms of attaining a healthy self-concept?
What does research generally say about implanted pre-lingual
deaf children as compared to implanted post-lingual deaf children?
How valid is this research?
"Event
if cochlear implants might not give my deaf child normal hearing
and speech, it will enhance his environmental awareness and
therefore his safety" Would regular hearing aids be sufficient?
WouldnFt implants take away from the deaf childFs natural
ability to pick up environmental cues of a different kind
such as visual and tactile cues that are ordinarily overlooked
by persons with normal hearing? Will implants actually make
things safer for my deaf child or give him a false sense of
security? Do implants give the deaf child a sense of where
sounds are coming from or will they all come from a single
direction? "The implant will be beneficial to the deaf
child"
Exactly
what are the benefits? Do the long-term benefits outweigh
the long-term disadvantages? Do we fully understand the long-term
consequences'of our decision? What are the possible effects
to our childFs self-concept? Do we have the time and energy
to stay focused for a long time on the strict oral regimen
that is required in order to attain the level of hearing and
speech ability we wish our child to have? Can we accept and
accommodate our child's deafness if the implant does not produce
as anticipated or if he decides to stop using the implant?
Would we want our child to assume the high costs of maintaining
and replacing the equipment when he reaches adulthood?
"What
alternative is there to cochlear implants?"
Do the professionals recommend that we meet and talk with
Deaf and hard of hearing persons? Did we talk with them? Do
we want to? If we donFt, why? Are there many deaf persons
who are successful without requiring implants? Why do most
orally trained deaf and hard of hearing persons switch to
sign language? Why do many discontinue using their hearing
aids? Can they still lead normal and healthy lives without
implants?
Finally,
the most important question: "For WHOSE benefit is the
cochlear implant?"
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