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May 8, 2007

Discuss all options for deaf

From: Scotsman(Opinion) - Edinburgh,Scotland,UK - May 8, 2007


IT is now over 20 years since the first child in the UK was implanted and during that time the cochlear implant has seldom been far from controversy. There have been exaggerated claims in the media that the device can restore normal hearing. There has also been a debate over whether results justify the expense of surgery and therapy.

However, the main concerns regarding cochlear implants for children have come from the deaf community itself, which feels that it poses a serious threat to the survival of its culture.

But how can a device which apparently provides a deaf child with more access to sound be a bad thing?

The cochlear implant is an electronic device that restores a "sensation" of hearing to the profoundly deaf person. Unlike hearing aids which amplify sound, the cochlear implant converts sound to electrical impulses that directly stimulate the auditory nerve, bypassing the damaged haircells in the cochlea.

There are a number of important points to remember: only profoundly deaf individuals are appropriate candidates for implantation; the sensation of sound perceived in the brain is of a much poorer quality than normal hearing; it is an extremely invasive medical intervention and one that is not easily reversed.

For many in the deaf community it is this last point, which suggests that by medical intervention we are trying to "fix" the deaf child by turning them into a hearing child, that causes them to argue against the use of cochlear implants for very young deaf children.

Harland Lane, a psycholinguist at Northern University in Boston, says: "The idea of operating on a healthy baby makes us recoil. Deaf people argue they use a different language, and with it comes a different culture, but there is certainly nothing wrong with them that needs fixing with a surgeon's scalpel."

They further suggest that cochlear implants should only be used when the deaf child is old enough to give their own consent to have one fitted. In this way the profoundly deaf child can develop proficiency in sign language and become aware of their deaf identity within the deaf community.

However, there is a large and growing body of research that states that, the earlier the implant is obtained, the greater the benefits in language acquisition. So the critical period for implanting profoundly deaf children is between the ages of one and five.

So what do parents of deaf children do in this complex situation? They have to weigh up all these issues at a time when they may also be coming to terms with having a baby who is deaf.

Their priority has to be a solution that fits best for them. This is where professionals can play a vital role in helping and supporting parents by providing them with unbiased information and access to the full range of options and views available. Only then can each family resolve these issues for themselves and strive to provide the best possible environment for the emotional, social and linguistic development of their child.

• Joe O'Donnell is educational audiologist and teacher of the deaf at Donaldson's College