Raising and Educating a Deaf Child

International experts answer your questions about the choices, controversies, and decisions faced by the parents and educators of deaf and hard-of-hearing children.

Question from T., Minneapolis, MN

A friend recently met a woman who had a deaf child with a cochlear implant. She was not happy with the outcome of the implant on her child and admitted that she should have contacted a deaf person first before making a final decision to get the implant for her child. Now she is taking an ASL course. It is widely known that about 30% of deaf children with cochlear implants have success. That child I mentioned above falls into the 70% group. I am aware that there are some more deaf persons who no longer use cochlear implants. Also, I have met more people and parents who are disgruntled with cochlear implants. Enough to require a legislative action? But we do need statistics. Where can we get the statistics? Should we ask legislators to create a bill to research and collect progress data and outcome on the children with cochlear implants?

Question from T., Minneapolis, MN. Posted January 21, 2010.
Response from Marc Marschark, NTID

First, let me clear up a misunderstanding: Different people mean different things by “success” with cochlear implants, but by far, the vast majority are at least “satisfied” and most are happier than that.  Cochlear implants benefit most deaf children with regard to hearing, speech, language, and academic achievement, although none of these necessarily reach the same levels as hearing children. Not all children are successful with spoken language, but even when they are not, access to environmental sounds can be beneficial for incidental learning and cognitive development.

Certainly, parents should seek a variety of perspectives before choosing a cochlear implant for their child. In fact, the amount of time parents spend with such investigations is a good predictor of children’s “success.” In part that is because some parents discover that their child is not a good candidate for an implant (thus reducing the chances of a poor outcome), and other parents learn just how much long-term support is necessary, so that their children are more likely to receive the therapy and other services that will allow them to optimally benefit from their implant. In this context, parents also learn that cochlear implants do not turn their deaf children into hearing children. The typical child with a cochlear implant functions as though they have a mild to moderate hearing loss – some better, some worse.

While most deaf children benefit from the cochlear implants, it is not clear how many “disgruntled” former implant users are out there. Those individuals may be more visible, but they likely are a relatively small minority. And, I freely admit that prior to 2000-2001, I was not a supporter of pediatric implants, because I did not think there was enough evidence to support their value given the relatively risky surgery. Since that time, the surgical risks have been minimized, and there is now abundant evidence of the great value of implants for most kids. Enough to convince me.

It would be helpful to all concerned if parents received full, objective information about pediatric cochlear implantation. Pollard (1996) discussed this issue in the context of  “Informed consent at a phenomenological… conceived as freedom from undue bias based on ignorance or unfounded beliefs about life with deafness or, more specifically, life with or without a cochlear implant.” That information would include the fact that sign language is not necessarily a bad thing for children with cochlear implants and may be helpful in supporting spoken language development as well as social-emotional development and academic achievement.

For more information, see Pollard, R.Q (1996). Conceptualizing and conducting preoperative psychological assessments of cochlear implant candidates. Journal of Deaf Studies and Deaf Education, 1, 16-28.

Spencer, P. E., Marschark, M., & Spencer, L.J. (in press). Cochlear implants: Advances, issues and implications. In M. Marschark & P. E. Spencer, Editors (in press). Oxford Handbook of Deaf Studies, Language, and Education, Volume 1, second edition. New York: Oxford University Press.