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American Annals of the Deaf

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Cochlear Implants: Evolving Perspectives
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Julie explains her changing views about implants this way:

My attitude about cochlear implants began to change slightly as I increased my knowledge about cochlear implants. I began to accept the idea of having adults receive cochlear implants, especially those who became deaf later in life. I was still completely against the idea of having parents make decisions about their children getting cochlear implants. I believed that the children should wait until they were old enough to make decisions themselves. . . . However, an increasing number of  researchers have suggested that the earlier the children got their implants, the better they were able to access sound and develop speech skills.

In 2000 when I first started working in a deaf program with preschoolers, my school boldly initiated a Cochlear Implant Education Center to share resources and information with families about cochlear implants. They also implemented a pilot class with preschoolers. They had a separate class only for children with cochlear implants in a small room next to my classroom. They had a hearing teacher with a hearing teacher aide. They used sign-supported spoken language as the communication approach. I had the opportunity to interact with the children from the pilot class. The more I interacted with them, the more I realized the role I need to play to support these children. My attitude began to change, and I realized I had many misconceptions about cochlear implants. The biggest misconception was that cochlear implants would change deaf children, and they would not maintain a sense of deaf pride. I began to realize that cochlear implants are simply tools. At the same time, I began to take courses in bilingual education in American Sign Language (ASL) and English and learned about the positive benefits of bilingualism. My hearing co-teacher and I began to discuss how we could better educate children with cochlear implants. We came up with several ideas and met with the administrators at the school about a new class. We wanted to teach children with cochlear implants. Since my co-teacher was hearing, she could provide spoken English language support, and I as a deaf teacher could provide sign language support. This way all children would get the best of both languages. My co-teacher and I taught a range of children, children with cochlear implants, children who were hard of hearing, and children who were profoundly deaf. The outcomes were positive. Children with cochlear implants could easily code-switch between spoken language and sign language. I remember one time when one of my students signed to me about something and then the next minute she used spoken language to tell my co-teacher the same thing she had just signed to me. This is what we wanted to accomplish. Deaf children were able to have deaf role models and maintain a sense of deaf pride with deaf teachers. We began to publicize our approach to other programs. My attitudes about children getting cochlear implants changed completely and I began to be open to it.

Several researchers have shown improvement in spoken language skills for children who received implants prior to 3 years of age and an increase in the number of children who use spoken language as their preferred mode of communication up to 5 years after implantation (e.g., McConkey Robbins, Burton Koch, Osberger, Zimmerman-Phillips, & Kishon-Rabin, 2004; Sharma, Dorman, & Spohr, 2002; Watson, Archbold, & Nikolopoulous, 2006; Yoshinaga-Itano, 2006). Although researchers have primarily focused on improvements in spoken language, a few have examined improvements in specific areas of language (Geers, Moog, Biedenstein, Brenner, & Hayes, 2009).

Why a Cochlear Implant for Deaf Children in Deaf Families?

Researchers have suggested that deaf children who are highly fluent in American Sign Language (ASL) are superior in academic achievement, reading and writing, and social development to deaf children who are not fluent signers (Singleton, Supalla, Litchfield, & Schley, 1998; Snoddon, 2008; Strong & Prinz, 1997, 2000). Deaf children consistently perform at higher levels on tests of both ASL and English in large part due to the early and consistent visual access to language (Israelite & Ewoldt, 1992). Early accessible and natural communication between parents and their deaf children results in a strong language foundation that is equal in all aspects to the language foundation that hearing children acquire from their hearing parents (Volterra & Iverson, 1995; Volterra, Iverson, & Castrataro, 2006). Family values and cultural traditions likewise are easily passed on when families and their children share the same language and communication modality.

Deaf children with deaf parents in general have demonstrated better outcomes than their peers with hearing nonsigning parents although many of these children have chosen not to use hearing technologies of any kind (Gallaudet Research Institute, 2006; Newport & Meier, 1985). Some deaf parents are now expressing a desire for more. That is, not only do they want their children to be academically successful and linguistically fluent in ASL and written English, but they also want their children to be competent users of spoken English. Many parents believe that by providing access to spoken English their children will have the same opportunities as their hearing peers. Deaf parents interviewed for the National Parent Project (Meadow-Orlans et al., 2003) emphasized high expectations for their children and the opportunity for their children to have the same choices and opportunities as all children.

Professionals and families alike have misconceptions about cochlear implants. Medical and other health care professionals tend to be leery about the use of sign language with children who have cochlear implants. Although research and practice are slowly dismantling the myth that sign language interferes with the development of spoken language, additional misinformation about cochlear implants persists. Cochlear implants are not a cure for being deaf and do not make deaf children into hearing children. Hearing technologies, such as hearing aids and cochlear implants, provide access to information from sound but do not fully restore hearing (Blamey, 2003). Although hearing technologies are extremely beneficial to some, others find these technologies unhelpful or choose not to use them. Families, both deaf and hearing, often find it difficult to obtain current, accurate, and nonbiased information about the outcomes for children who have cochlear implants (Johnson, 2006; Li, Bain, & Steinberg, 2003). For families who are deaf, these obstacles may be complicated by the lack of clear communication  with professionals (Meadow-Orlans et al., 2003). On the other hand, professionals may make assumptions that families who are deaf have already decided against cochlear implantation and therefore do not provide them with the same information that they provide hearing families.

Purpose and Research Questions

There is a plethora of resources and information about cochlear implants that are readily accessible to hearing parents, however, there is virtually no research to date and little information or resources available that specifically address deaf parents who have children with cochlear implants. This chapter presents an effort to ascertain how deaf parents obtained information about cochlear implants and what resources were most helpful to them.

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