Cochlear implants: not our choice

Cochlear implants have been on the rise since it was (before disapproved) later approved by FDA in the 1980s. Innumerable numbers of deaf babies have received cochlear implants against their will ("in the best interests of a child"). Plus, they are commonly forbidden, discouraged, and/or prevented from using sign language -- their primary and natural modality of language through eye.

While there is a few positive experiences and benefits of the CIs, there are also dark truths and risks about the CIs. A hearing hyperreality tends to focus on cure for deafness and applause for CIs along with other misconceptions; however, this post unveils reality, truth, and Deaf experiences. Our own voices.

Many deaf children experience, not just a physical, but also a linguistic, social, and psychological trauma in their lives with implants along with speech therapy. Implanting a child with cochlear implant(s) invades a child's otherwise healthy body -- a boundary line.

Source:

Coercion is not a cure

Historically, in seeking a "cure" for "deafness", hearing people have attempted some approaches such as an electronic shock therapy (20th century); cutting inside ears and pouring chemical fluids in them; radiation therapy which caused cancer in some deaf persons (20th century); hearing aids (from 20th century); cochlear implants (from late 20th century) plus speech therapy (hundreds+ of years). Ref

In contrary to most hearing people's belief, cochlear implants are not a cure nor a miracle for deafness.

Double standard and no choice

A phrase "a parent's choice" is often explained away in the medical community on cochlear implant and deaf children. In many situations, it was many hearing professionals putting pressure on hearing parents of deaf children. Even, some parents chose to use sign language, they were pressured not to.

Their other usual rationale is an argument on the critical period of language acquisition in name of speech. This in disguise poses high risks to language delay and deprivation which explains later in this post.

CI not my choice
Image source: Elizabeth Morris, 1995.

Hearing children are born with a privileged choice of either or both modalities. Parents are eager in using sign language with their hearing babies ("Baby Sign Language") for more efficient communication. And, "baby sign language", as they claim, boosts (hearing) babies' linguistic and cognitive benefits.

On the other hand, deaf children are born with one natural choice of modality (signing), which is widely oppressed by the hearing systemic oppression for the last hundreds of years, if not thousands. The deaf child is left with no choice.

the greatest irony: baby sign
The greatest irony." Illustrated by artist Maureen Klusza, 2007(?).

It should be a deaf child/adult's choice, not a parent's nor a hearing professional's choice. Is there really such as a choice for the child? Because, typically a choice among many parents and hearing professionals is phonocentric-biased. Is this truly a choice? The child is given virtually no choice.

First, below hightlights the brain facts and bilingualism before discussing some CI misconceptions and myths.

The power of brain and bilingualism

Let's go through these facts quickly. I know I've mentioned them thousands of times but they are the fundamentals before discussing anything.

Language is amodal which means that speech is not central to language. Neuroscience studies show that languages regardless of the signed or spoken forms (e.g. ASL and English) activate the same regions of the left brain that is responsible for language.

Signed language has the same timeline of language acquisition as spoken language. Language milestones in signing and speech are maturationally controlled; that is, Deaf children exposed to signed languages from birth acquire these languages on an identical maturational timeline as hearing children acquire spoken languages. (Dr. Pettito)

Signed language has all linguistic features from phonology to sociolinguistics as found in spoken language.

Bilingualism is generally known for enhancing a linguistic and cognitive development of bilingual or multilingual children who generally perform better than monolinguals.

There are many Deaf scholars (with Masters and PhDs), who don't or never hear nor vocally-speak, write and read English (or any language) as excellent as hearing counterparts. Not-hearing doesn't reduce a deaf person's language capabilities through eye. Language is amodal.

CI misconceptions and risks

ASL = language; CI = tool: To straigthen out, cochlear implant is a tool, not a language. ASL is a language, not a tool. A hearing professional audists had called sign language and ASL "a tool" and even an incredibly cruel and condescending term "crutch" in literature. Think this way, "speech language is a tool and a crutch." Keep in mind that speech and signing are the modalities -- a vehicle of language. ASL, English, and any other signed/spoken languages are languages.

"In the case of deafness, I would also really, really emphasize that the choice between a CI and American Sign Language (ASL) is a false choice. There is absolutely no reason at all that the two can't go together. Some may say that there is, but there is no actual, neurobiological barrier to learning two languages at once. Indeed, this is the norm across most of the globe." -- Laura Mauldin.

Using ASL (in the signed form) does not contest with English (in the form of speech), quite the opposite. Bilingualism boosts literacy and language development in both languages.

With hearing aids or cochlear implants, hearing and speaking skills are highly variable which affects a high variability of language development when signing is deprived. Why give a deaf child a spoken language when their ears are not available and deprive them of a signed language when their eyes are normal and available?

Art (2014) by Pratigya Shakya, Deaf artist.

"Black Noises"

'Restore hearing' is misleading. For deaf-born, to be able to hear sounds either with hearing aids or cochlear implants does not mean to be able to understand and/or recognize sounds and words on the spot.

Implantation would require many years of training to process and recognize the sounds and the patterns of language..

"Many people don't realize that the surgery is only a small piece of the puzzle," a deaf father of an implanted deaf son told INSIDER. (He asked to remain anonymous to protect his privacy.) "Cochlear implant is a shock to the brain because it's never had to interpret these kind of signals before. I'd imagine it's like trying to read the jumbled scrolling code in the Matrix for the first time. The process is very physically and mentally taxing — there is real fatigue due to working so hard to understand the sounds." -- Insider.com

Imagine yourself to be bombarded by this colorful fast-moving fuzz on the screen for hours and hours day after day. Imagine in the 1980s, you couldn't turn this off. It's running 24/7 in front of your eyes even while sleeping. Torture? Isn't "a miracle"?

Fuzz tv
Credit: random screenshot from Internet.

Plus, you'd have to take many years of training to process this ocular sensory input to recognize the visual patterns and to recognize the patterns of language.

Many deaf people turn their hearing aids or cochlear implants off. It would take years of training to recognize the patterns of sounds or phonemes of words... or never. It works for some deaf after many years. It never works for some others.

Dr. David Pisoni, lab researcher from Indiana University concluded that CIs do not help to restore normal hearing sounds and impact child's functions. And Dr. Schroeder from Hostfra University is against taking medical consent from child while putting forcible CI in their heads. Medical, legal, psychological, education and all are affected! -- aguabo. 2016?

Aside some or less positive results, there is a study on attention disorders in children with CI. There were reports of painful headaches (later to find some mold inside CI during the medical operation), deaths from CI complications in the 1980s, injury to the facial nerve ("lopsided smile"), attacks of dizziness or vertigo, tinnitus, numbness around the ear, infection, other unknown effects, and so on.

Risks and benefits

For more information on the risks of Cochlear Implants at on the fda.gov website: https://www.fda.gov/medical-devices/cochlear-implants/benefits-and-risks-cochlear-implants

Hearing aids have much less risks. Similiar linguistic risks as CIs, except for the physical risks.

In my nearly 40 years of life...I've yet to meet a single deaf person who was traumatized by sign language. Yet, I can't count how many were traumatized by mainstreamed and oral education. -- Jeanine Gingras.

A signed language is simply our natural language and communication the same way hearing people use a spoken language. Signed language is the natural solution, just like a spoken language.

Language delay risks and preventions

"Speech now, signing later" mistake: If a non-bilingual, non-bimodal child doesn't attain speech development to some degrees, the child may be turned to learning signed language at a later time. In this case, it's often past the critical period or window of language development. After the critical period, a deaf child may likely have some difficulty with language in signed and/or written/spoken forms.

Then, one easily scapegoats deafness and deaf children, getting away with the true responsibility of language deprivation on the hearing part. Vicious cycle.

"Cochlear implants (CI) are the most successful intervention for ameliorating hearing loss in severely or profoundly deaf children. Despite this, educational performance in children with CI continues to lag behind their hearing peers. From animal models and human neuroimaging studies it has been proposed the integrative functions of auditory cortex are compromised by crossmodal plasticity. This has been argued to result partly from the use of a visual language. Here we argue that 'cochlear implant sensitive periods' comprise both auditory and language sensitive periods, and thus cannot be fully described with animal models. Despite prevailing assumptions, there is no evidence to link the use of a visual language to poorer CI outcome. Crossmodal reorganisation of auditory cortex occurs regardless of compensatory strategies, such as sign language, used by the deaf person. In contrast, language deprivation during early sensitive periods has been repeatedly linked to poor language outcomes. Language sensitive periods have largely been ignored when considering variation in CI outcome, leading to ill-founded recommendations concerning visual language in CI habilitation." -- Source

Research shows no evidence that signing hinders speech development. It's not unusual to easily accuse signing if used when speech developemnt doesn't turn out well. It doesn't make any difference when an oral path simply doesn't work for a child without the use of sign language.

Language (e.g. ASL) does not hinder another language (e.g. English). It is no more different than a child acquiring both spoken French (or any other spoken language) and English. Rather, two languages enhance each other.

Contrastly, a limited hearing skill in deaf children with cochlear implants with no access to sign language may hinder the development of language to the fullest, especially during the critical period of language. Deaf people prioritize full-fledged language and literacy (through eye) over speech modality (through ear). Who wants good speech skills with a limited language?

A three-year-old deaf child with a 5-10 well-pronounced words in spoken English vs a three-year-old deaf child with normal 500-1000 words in spoken ASL? Not all deaf people experience the same with speech/hearing training -- some with an "easy" ride, some with stressful struggles or trauma, some somewhere on the continuum.

There are many bilingual deaf people who have succeeded with some listening and speaking skills by merely wearing hearing aids. When asking these deaf with hearing aids if they would consider having cochlear implants. Most, if not all, of them choose not to!

Many Deaf people don't vocally-speak or hear well with CI; conversely, many Deaf people with hearing aids can vocally-speak well or communicate in vocal-aural modality. That is, hearing aids should also be considered an option. Cochlear implants shouldn't be the sole answer nor the best option.

In some cases, deaf people with CI have decided to undergo surgery to remove cochlear implants if finance permits. Otherwise, most of them just turn off their cochlear implants or choose not to use them.

Several young deaf adults in Europe chose to remove their cochlear implants. A deaf person in a Swiss documentary explained, "It's not part of me." Hearing aids ideally would give deaf people the freedom and a true choice for themselves. Deaf people's bodies are theirs, not a property of the phonocentric superstructure.

According to the National Association of the Deaf (NAD), "Reliance on only spoken language input via cochlear implants may result in linguistic deprivation if sign language is excluded from the environment of the child. Put simply, if the child is only provided linguistic input through speech and hearing and the CI does not provide the child clear and unambiguous access to this input, language learning is compromised." Ref

Lifetime emotional scars are there for many. They might be better off if they were given bilingualism (and hearing aids if parents wish) in the first place. It's truly their choice, not a hearing person's.

Resistance

"'I would attempt to 'accidentally' break my cochlears by dropping into the toilet, [or] wrapping the wire around a swing and claiming it got caught on the chain," he said. "Despite my fruitless efforts, my parents always took me back to the audiologist for a new cochlear.'" -- Insider.com

A deaf guy told his story in the documentary video "Unveiled Audism". When he was kid, he was tired of his hearing aids. He came up a plan to lose his hearing aids forever. Before a buyer came to his father's house to take the truck, he planted his hearing aids under the truck. When the buyer came to pick up the truck and drove away, he was a happy boy. Bye-bye!

Many kids in schools wear implants but switch them off. Same true with hearing aids. They get punished or grounded for turning them off. In my time, several classmates and I turned off our hearing aids and our Deaf teachers understood.

Our choice and in the best interests of a child

To give a child a true choice with the maximalized language acquisition in both languages (ASL and English) is to give him/her bilingualism. It's not only a child's choice, but also, more importantly, a child's human right to language regardless of the modality.

This bilingual path guarantees a child's maximalized language acquisition, whereas with only cochlear implant and speech therapy both as tools for English-only language acquisition is highly variable.

Bilingualism and bimodalism allows full-fledged language acquisition for all deaf children in either 'signed language and written language' or 'signed language plus written and variable speech language', whether the child has hearing aids, cochlear implants, or none. It gives all deaf children with a equal footing in language acquisition, regardless of their variable speech skills.

A deaf child who does well with partial hearing via cochlear implants may still benefit from bilingualism using both languages (ASL and English). Brain doesn't favor one over another. Language is language for the brain.

Most Deaf are bilinguals when provided full access to signed language at the earliest and then fluent written language follows. They are quite intelligent, beautiful and vibrant. Embrace diversity.

Now hopefully you can see it's not about Deaf people being against the ability to hear, but it's about cochlear implants as the hardcore object of oppression, literally and/or symbolically.

Allyship

Get educated as much as about the true nature of language, bilingualism, information from Deaf professionals and professional hearing allies. Get a fair, informed decision for the child.

Give the child a true choice to make later in life by providing the child both languages, rather than enforcing one language-modality.

Hearing aids shouldn't be neglected in the decision-making process over cochlear implants.

Consider human rights, language rights, diversity, inclusivity, and equity.

Learn about phonocentrism, audism, linguicism, hearing privilege, etc. Unpack -isms.

Recognize that bilingual-bicultural-bimodalism is the natural solution for deaf people and it's mostly our choice. There shouldn't be a debate or controversary with Deaf people about such issues. It's our decisions. It's our own life. Our rights.

Related posts

Learn about institutional audism.

Cure for Deafness, Deaf people's Speech Therapy experiences.

How deaf people resist against oppression.

Resources on cochlear implants.