Cochlear Implants: A School for the Deaf Perspective

The Issue

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Over 38,000 deaf children in the United States have under gone surgical procedures to receive a cochlear implant. As a result many schools for the deaf, including those that are bilingual (American Sign Language and English) have elected to develop special programs to serve children with cochlear implants. The cochlear implant technology is impressive but many caveats still remain. A cochlear implant does not restore normal hearing and is not for all deaf children. As educational programs evolve to service these children, we as practitioners and parents must come to know the advantages and limitations of this burgeoning technology.

What we know

Cochlear implants have been available (FDA approved) since 1985 for adults and 1990 for children, but only since 2002 for children as young as 2. In the intervening years, these devices have gone through many generations and at present are increasingly reliable devices. In those circumstances when the external device malfunctions, the manufacturer is able to service and repair the device typically within just a few days. In addition, the cochlear implant center (or audiology clinic) may provide a loaner device if a child’s implant is in need of repair.

A cochlear implant is designed to help the brain interpret sound. However, it is not enough to simply wear the device; hearing is not magically restored. Cochlear implants can be successful when their use is supported by quality speech-language therapy and auditory training. Ideally, the child’s educational programming, delivered or at least informed by certified teachers of the deaf, would include instruction using the modalities designed for the student based upon previous assessments.

One important aspect of educating students who have cochlear implants is to work with their parents on setting realistic goals for their child. Not all cochlear implant recipients will be able to maximize intended benefits of their implants. There is a wide range of benefit from children who obtain no benefit from their implant up to children who develop fluent spoken language skills and who use their implant to access the auditory world around them. It is important to support all students who have cochlear implants, regardless of where they fall on that continuum. We must provide them with as much access to language, communication, and people as they need and deserve. After all, recent neurological research finds that the brain does not discriminate against language or modality – for example, in the brain auditory and visual languages have equal status and the brain needs to be stimulated with accessible linguistic stimuli. Many parents and others do not realize that a student with a cochlear implant has vision that can and should be taken advantage of as a biological, and often the most-natural pathway to brain stimulation. It has been our keen observation that this has profound and highly positive ramifications for development of language and cognitive skills if we grant them with visual access to language and communication. We have seen again and again that early, on-going and quality dual access is of critical essence.

What we don’t know

We have established that children with cochlear implants must have a thoughtful support system to be successful. However, we cannot always be sure that a child’s public school or district can provide the needed array of services required, and it could be argued that given the large variability and outcomes following implantation, we do not yet have a full understanding of how best to educate children with cochlear implants. We do know that support must be strong in the child’s family and community. While cochlear implant centers provide orientation and instruction relative to the implant and its maintenance and care, there is still some uncertainty given the many unknowns related to external support and interpersonal dynamics about how best to support those children to optimize academic, social, and personal outcomes.

Implications

Technology is here to stay. Our society thrives on it. Cochlear implantation continues to establish new horizons, and we can only imagine what an additional decade of development will bring. Presently, we must continue to view deaf and hard-of-hearing children as full-fledged human beings, having a life beyond an external or internal listening device. It is interesting that a field that has been so polarized in the past is now coming to appreciate the value of a responsive “whole child” approach. It is critical that schools for the deaf, peopled with all of the requisite professionals, have adopted protocols to provide children with cochlear implants a meaningful wholesome education and whole person development.

Posted on July 1, 2015 by
Ronald Stern
ronald.stern {at} nmsd.k12.nm.us
Sheree Hall
Sheree.Hall {at} NMSD.k12.nm.us
New Mexico School for the Deaf

Further reading

Davidson, K., Lillo-Martin, D., & Chen Pichler, D. (2014). Spoken English language development among native signing children with cochlear implants. Journal of Deaf Studies and Deaf Education, 19, 238-250. view details

Mitchiner, J.C. (2015). Deaf parents of cochlear-implanted children: Beliefs on bimodal bilingualism. Journal of Deaf Studies and Deaf Education, 20, 51-66. view details

Spencer, P. E., Marschark, M., & Spencer, L.J. (2011). Cochlear implants: Advances, issues and implications. In M. Marschark & P. E. Spencer (Eds.), The Oxford handbook of deaf studies, language, and education, volume 1, second edition (pp. 452-471). New York: Oxford University Press. view details