At the start of every semester, before we dive into the
course’s syllabus, I stand before my university students and let them ask me
anything. Some ask about my writing career, grill me on the meaning of my
tattoos or request pictures of my dog. But at least a few students each year
ask me why I don’t have a cochlear implant and whether I want to get one.
This answer is, for me, an easy one. “No,” I say. “I’m happy
with how I am now.”
I explain that deafness offers me a unique perspective on
the world, or joke that I like it quiet when I’m writing, but I always end with
a fact: “It would be a big commitment — learning to use a cochlear implant
takes a lot of work.”
In my teaching, depending on the class, I use a combination
of American Sign Language with interpreters, my own voice and lip reading when
appropriate. I also use hearing aids that give me basic sound information. My
experience is far from exceptional. Most deaf people use multiple methods of
communication and technological support to interact with the hearing world…
Many medical professionals still present the decision to
parents of deaf children as a strict binary — either A.S.L. or implant, not
both — using outdated information about how this type of bilingualism hurts a
child’s speech development. In reality, most deaf people use a combination of
sign language and speech in everyday life, and few A.S.L. users are against
assistive technology. The most popular model of A.S.L.-based deaf education is
bimodal bilingualism, a methodology that uses A.S.L. as the primary language
and neurolinguistic framework through which to learn subsequent ones, the same
way most hearing people learn multiple languages.
Bimodal bilingualism is not a knee-jerk attempt to save sign
language. It’s grounded in recent neurolinguistics research about the “critical
period” of language development in the brain, from birth to 5 years old. When a
child doesn’t gain language fluency during this period, language deprivation
results, and one’s capacity for intellectual development is diminished
substantially and permanently.
Children with a cochlear implant and no access to visual
language may be unwittingly engaged in a race against the clock as they learn
to interpret the electrical signals provided by the implant. Some children are
successful in this pursuit, while others aren’t…
As with the rest of the American health care and education
system, the efficacy is influenced by race, class, disability, access to
therapeutic services and specialists, family support system, and the unique
physiology, learning style and personality of every user. The age at which
hearing loss was detected and whether a user is pre- or post-lingually deaf
also play a role.
“The literature on outcomes for deaf children with cochlear
implants shows patterned differences,” Dr. Laura Maudlin, the author of the
2016 book “Made to Hear: Cochlear Implants and Raising Deaf Children,”
explained to me in an email. “Children from lower socioeconomic backgrounds and
children of color fare worse with the implants. While there are clinical
factors associated with variability in outcomes, social factors are far less
understood. These are important because ‘success’ depends on the years of
follow-up care and training.” She added: “The C.I. is not an ‘instant fix;’ the
technology is embedded into people’s lives.”
Those who are good candidates still have a long road to
success after the operation. A cochlear implant sends sound as electrical
pulses to the auditory nerve; it does not come preloaded with language
information. The user must spend years in vigorous auditory-verbal training to
learn to decode the signals to understand sound and speech…
Dr. Kaitlin Stack Whitney, an assistant professor at the
Rochester Institute of Technology and the mother of a deaf preschooler, says
her family’s experience has made it clear that the goal of implantation for
many isn’t language access but rather to make the child “normal.”
Dr. Stack Whitney said that she and her husband are not
against implants and that their son will weigh in on the decision when he is
older.
“We are constantly asked why my A.S.L.-using preschooler,
whose language development is more than a year ahead for his age, doesn’t have
a C.I.,” she wrote in an email. “The focus isn’t on whether he’s educated,
happy, and thriving — it’s on passing. Meanwhile, we know children with C. I.s
who have language delays because of factors like age of hearing loss
identification and quality of support.”
Rachel Kolb, a doctoral candidate at Emory University who
has been deaf since birth and got an implant at 20 years old, believes that the
popular notion of cochlear-implant-assisted hearing as “automatic and normal”
is detrimental to those who use the technology. “My friends and acquaintances
genuinely did seem to think that my implant would make me almost hearing, or at
least that it would make me not deaf,” she said. “But I still am deaf.
Ironically, I’ve realized many more of the ways that I really am deaf since
getting my cochlear implant.” (Ms. Kolb contributed a wonderful essay and video
to this series on listening to music with her cochlear implant: “Sensations of
Sound: On Deafness and Music.”)
Ms. Kolb says applying a one-size-fits-all understanding to
the subjective natures of sound and hearing does a disservice to implant users.
“Because of the existing misperception of what cochlear implant technology
actually does, and the range of outcomes that actually exists for different
deaf people,” she says, “I’ve had to do a lot of work to explain to others what
I do hear, and also why I still need and benefit from accommodations. I think
this is the dangerous underside of perpetuating an uncomplicated story of
cochlear-implant-as-cure.”
A cochlear implant isn’t inherently bad, but it isn’t
inherently good, either; it is a neutral piece of technology, a tool, like a
hammer. Expecting an implant to cure deafness or magically generate speech is
to await the moment the hammer will fly out of one’s hand and build a house on
its own. The value of the tool lies only in the skill of its user, and for the
cochlear implant user, that skill is learned with much effort. To suggest
otherwise is to give a disingenuous prognosis to potential patients and their
parents, and discounts the hard work successful C.I. users do to communicate in
a way the hearing world deems acceptable.
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