PRO
Even though a CI cannot provide 100% hearing capability, it enables the individual to hear and understand most sounds. A cochlear implant does not amplify sounds like common external hearing aids, but stimulates the auditory nerve. The implant essentially replaces the function of the hair cells in the inner ear that usually register sound vibrations.
Most importantly, a CI enables the individual to hear itself and thus learn to speak and articulate, and thus an implant helps to communicate with hearing people who do not know sign language. It also saves from lip reading and generally depending on others for hearing help.
Another great advantage of having a CI for young people is that it can help them fully participate in mainstream schools and society, as well as broaden their career choices. While they may still be limited, the limitation won’t be as severe or as disabling as if they had no hearing choices available to them.
Being able to hear is also a measure of safety: the ability to locate sounds allows you to be more aware of perilous situations and hear impending danger such as a car coming from behind.
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| Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. - Own work, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=29025007 |
CONTRA
CI require a surgical insertion and obviously surgery of itself always bears risks. Since the device has become available, risks have been minimized, however, complications may include occasional facial numbness or minor facial paralysis. Among individuals wearing a CI, there is also higher incidence of bacterial meningitis than for the general population. Thus an immunization is recommended. The body may also reject the implant, which could require removal or further surgery.
It is important to keep in mind that a CI doesn’t guarantee that a person will be able to hear and speak at a normal level. In some cases, the person with the implant can only hear some environmental sounds. Particularly for adults who receive the implant, electronic signals might not register fully and some hearing impairment may still occur. Also it is important to acknowledge that the auditory cortex is not used to process sound in the same way if a person has been deaf for a long time, so a CI wouldn't help much.
Thus parents of hearing disabled children are urged to make a decision as soon as possible for their child. Most people with an implant still need special help in learning to speak and in many cases they will still be stigmatized. Even though they can hear and speak, their hearing capabilities are not the same as a hearing person's [2]. Luckily, the devices are getting better and improved sound perception lets the wearer of CI integrate better into mainstream society.
Obviously, it takes time to get used to the implant and especially in the beginning, many need to get the CI reprogrammed according to their needs. Also, people with CI are limited on some physical activities, especially those involving contact with water, as this could damage the implant.
Controversy in Deaf Society
The primary controversy regarding CI concerns the definition of deafness as a disability. Recently journalist Enno Park gave a talk at the Berlin re:publica conference , where he spoke about his very personal view on the two (hearing and non-hearing) sides of society [3].
The medical community generally regards deafness as a disability that should be treated, and mainstream (hearing) society is of the opinion that hearing allows for a more fulfilling life. Meanwhile, many individuals who are deaf, as well as others who are familiar with non-hearing society feel that deafness is a cultural identity rather than a disability [4]. As a result, they feel that CI implies that there is something wrong with them that needs to be fixed, and that living as a person with a hearing impairment is inherently less fulfilling than as a "normal" person. Thus, these members of the community perceive putting something technical in their brains as serious affront.
Within the non-hearing community, there is a long history of disagreement: Some signing people feel that CI wearers are betraying their culture. Some even go as far as to describe implantation of children as “child abuse”. Also, with more people wearing CI, the need for sign-language interpreters decreases to the disadvantage of those who still rely on their services. On the other hand, parents that do not want their children implanted have to deal with hostility not only from the hearing community, but also from CI-wearers.
--> Get an idea how sound is perceived, through a CI! <--
Interestingly, the attitude towards sign language differs from country to country. In Germany and France, most people working in deaf education even don't speak sign language, and emphasis is placed on children learning to lip read [2,3]. In contrast, in the US, every police department should have one or more interpreters available on call [5]. It is likely that these attitudes and values will change over time, both with the rise of improving hearing technology and activism from within the deaf community.
The decision to receive a CI is a very personal one that should be considered with the help of a medical professional. Every parent with a hearing disabled child needs to decide for themselves what the best choice for their situation is.
Claudia Willmes
PhD Alumna, AG Eickholt / AG Schmitz
Background:
From 2007 to 2008 I worked at the Institute le Bruckhof in Strasbourg, France - an institution for hearing disabled children, where many children wore cochlear implants [6]. They received special training in learning language and were encouraged to read lips instead of using sign language. However, I also took classes in an adult education center to learn DGS (German sign language) for one year and attended the university in Strasbourg to learn LSF (French sign language). Thus, I heard opinions from all sides: the hearing, the hearing disabled and signing, and those wearing CI.
[1] www.nad.org
[2] personal communication
[3] talk by Enno Park https://bit.ly/2K3MO8P
[4] Ohio University, The Institute for Applied & Professional Ethics https://bit.ly/2wxdrBg
[5] U.S. Department of Justice https://www.ada.gov/q%26a_law.htm
[6] www.bruckhof.org/
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