Friday, March 21, 2008

ASL Vlogs about Cochlear Implants

ASL-CI Community would like to thank Raychelle for donating these v/blogs she produced and published on her blogsite to help with spreading awareness about ASL and Cochlear Implants. Enjoy.

First Vlog: I Got The Surgery


In this ASL vlog, I talk about my surgery and how I believe it is analogous to cochlear implant surgeries. Would you change your opinion of a Deaf person you've known all your life, went to school with, who received a cochlear implant? Why? They're still the same person.

Cochlear implant surgeries, in my opinion, are similar to someone getting laser eye surgery. Both surgeries assist the person in seeing/hearing. Both surgeries have possible risks and complications.

Cochlear implant technology has improved drastically in the past ten years. Many of the things we know about CI's are outdated. In the following vlogs, to be posted soon, I will share more current information about cochlear implants.

Did you know that Cochlear Implant Education Center (CIEC) at Clerc Center of Gallaudet University was established in the year of 2000? Since that time they have been working with professionals and families both Deaf and Hearing to investigate how ASL and Cochlear Implants can work together. This vlog kicks off a series of vlogs of myself exploring the nature of CI’s and their presence in the Deaf community.

Disclaimer: I am not a certified medical professional, however, I have friends who have had the surgery, I have read research-based articles and chapters on this issue and I have had the information shared in this and the following vlogs/blogs confirmed by professionals at the Cochlear Implant Education Center at Gallaudet University/Clerc Center. Much gratitude goes to them for their willingness to help with editing and correcting information in this and subsequent blogs/vlogs on this topic.

Click here to go to the very informative Gallaudet University at Clerc Center, Cochlear Implant Education Center site.

This English print blog is not a word-for word translation of the ASL vlog above.



2nd Vlog: Myths About CI Surgeries

How long is the surgery itself? Actual surgery time can range from 1 ½ hours- 6 hours depending on the individual. The surgery is usually outpatient and after about a 2 hour recovery period the individual can go home.

What does the scar look like? The scars of the past do not apply to today's surgeries. The scars are very minimal, and for young infants, the scar is almost undetectable. Right after the surgery, there may be a little bleeding. The cotton/mesh wrap stays around the head for approximately 24 hours, then it may be removed. You will see small surgical tape covering the incisions and some dried blood in the area. Your head is not shaved bald but a small section just above the ear. There are no stitches or staples.

Does CI surgery destroy residual hearing?In more and more situations residual hearing can be preserved because the surgical techniques to insert the electrodes into the cochlea are improving. While the doctors can not guarantee that residual hearing won’t be destroyed, audiology tests done before and after the cochlear implant in many cases are showing that residual hearing does not necessarily change. (I fingerspelled 'auditory stem', what I should have fingerspelled was 'auditory nerve')

How long does it take to recover? CI surgery is usually done on an outpatient basis. There are some hospitals that might keep individuals overnight. By the second day, most children are usually back to themselves. Some adults report being tired and sometimes dizzy for a few days.

Each body heals in different ways at different points in your life. Of course, for infants/children, they heal much faster as opposed to adults, and this applies to any type of surgery. Most adults who have had the surgery report minimal pain or discomfort. Judging by watching the children after surgery, they don’t seem to be experiencing discomfort. There may be some adverse reactions to the anesthesia (which can be true for any type of surgery)

There is swelling around the site of the surgery. It usually takes about 3-4 weeks for the swelling to go away and the site to heal completely. That is why it is important to wait for that long before the outside part of the cochlear implant is added. That is called the “activation”.

Is there a difference in recovery time between infants vs. adults? Your body heals in different ways at different points in your life. Of course, for infants/children, they heal much faster as opposed to adults or older adults, and this applies to any type of surgery. Many factors affect recovery time - exercise, diet, amount of sleep and so on. Infants and children take a few hours to a couple of days to be their old self, while it is about a week for adults.

What about surgery complications? As with ANY surgery, there are always risks and complications. This may prolong the recovery time. It is the responsibility of the patient/parent to investigate the reputation of the hospital/surgeon before making the decision.

Let me share my surgicial experience: I had the same knee surgery which was performed in 2006 on my left leg and then in 2007 on my right leg. Both were done by the same surgeon for the same purpose. Both surgical experiences, recovery, therapy and end result were VERY different.


Click here to go to Gallaudet University's website about CI surgery information...

This English print blog is not an exact translation of the ASL vlog above.


p.s. the photograph in the vlog of the CI coil is from http://www.ee.duke.edu/research/collins/ci.html


Third Vlog: Getting a CI – The Earlier, The Better

The earlier, the better saying could not be more true here. Brains are like sponges the first few years of a child’s life. After that, it has been shown that the plasticity/ flexibility of brain starts to decrease. The longer a young child does not have access to quality sound, the more difficult it becomes to make sense of the many sounds provided by a cochlear implant. So telling a parent to wait until the child grows up to make the decision if s/he wants a CI is not a valid recommendation.

Research shows that if the auditory areas of the brain are not stimulated at a young age, then the window of opportunity to develop spoken language will be significantly decreased. Research does not give an exact age, however research and observation are suggesting that children implanted before age 2 are more readily developing spoken language than children implanted after that age.

Going back to the saying of earlier is better. The same holds true for American Sign Language. Research is showing that the brain has the capacity to learn both a visual and an auditory language at the same time. And when children are young they can learn several languages effortlessly. It’s so easy for them!

For us adults, we struggle to pass HS classes in foreign languages and college classes in French, Spanish, and so on. Then at the end of the semester we can only remember a few Spanish words. Why is that?

Two reasons: 1) when we get older, we can only “learn” (not acquire) additional languages – which means we have to be taught, it’s harder to learn languages naturally like children. 2) our brains harden as we get older, so teaching our brains new things are harder than it is for children.

So this principle makes sense, we want to expose our infants/children to as many languages as possible – ASL and spoken/print English for the case of American deaf children. It doesn’t have to be an either/or choice of ASL or a cochlear implant. You can't lose if you're bilingual from birth. You win, and you win the best of both worlds - the Deaf world and the Hearing world.

Click here to go to the conference proceedings of Cochlear Implants and Sign Language: Putting It All Together in 2002.

Also, click here to go to Gallaudet University's CI site about who's a good and who's not a good CI candidate

The English print blog here is not an exact translation of the ASL vlog above.


4th Vlog: People With CI’s Can’t Drive Hybrids and Play Football?

Remember this vlog applies to the new and most recent CI’s.

Drive a hybrid? Yes.

Ride roller coasters? Yes

Scuba dive?
There is a depth limit. If a person with a cochlear implant goes beyond the specified depth the internal implant (plastic casing) holding the magnet will break. Ihe internal implant is validated to withstand pressure at a depth of 82 feet underwater.

Go into MRI machines? The problem is that the internal part of the cochlear implant has a magnet in it and an MRI means Magnetic Resonance Imaging. Having two technologies that contain magnets are not compatible. The test will not be effective. The person will not be harmed. Some of the newer cochlear implants are compatible with MRI equipment that does not have a strong magnetic strength. But… sometimes a weak MRI is not enough. So… with a cochlear implant, some people do have to have the magnet removed surgically—the implant is designed to have that done, then have the MRI and have the magnet put back in again. (that can happen all at the same time)

Play football/physical sports? Yes, of course the processor may fall off (just like eyeglasses) and may need to be left aside to continue playing. As with anyone who wants to protect themself during a rough sport—wear a helmet—if a person is hit in the head it can possibly dislodge the internal part of the CI, but this will not harm the person.

Airport metal detectors? Walking through will not harm the internal part of the cochlear implant or hurt the individual. Just to be on the safe side, remove the external speech processor and ask the airport personnel to not place it through the x-ray screener.

Water sports? Most CI’s are now water resistant. It does not mean that they are water proof . So getting them wet with a small amount of water is ok. It is not recommended to shower with the external part of the cochlear implant or swim, but if they get wet in the rain or have excessive sweating it should not be a problem. CI’s still can’t be submerged, so when swimming, surfing, bathing the CI user is Deaf.

Become an astronaut? No idea, we’re still waiting for the first Deaf astronaut!

New Technology… many new things are being invented today that includes a magnetic field so we have no idea how the CI will fare in different situations. Technology progresses really fast, there are plans for a completely internal CI, but that does not yet seem to be in the near future.

The same applies to my knees. I was worried, because I had screws in my knees that I might not be able to go into a MRI – but no, found out that my screws were made of a plastic compound. New things are invented everyday and it’s our job to check ourselves/people about whether if it is safe for us.

For more information, click here to go to Gallaudet University's Cochlear Implant site to read about CI's and the environment.

This blog is not a strict translation of the ASL vlog above.


5th Vlog: CI Users are Still Deaf

CI's are unusual – you remove them, you are Deaf. This is not comparable with hard of hearing people who are always hard of hearing, 24/7. They cannot stop being hard of hearing. CI’s are similar to people who wear hearing aids and glasses, when they take them off they hear less/see less.

Cochlear implant break and get lost. When a person does not have their cochlear implant on they can not hear. That person is DEAF again. That is why it is important for CI users to have a visual language, to have ASL. Research has shown that two languages are better than one for cognitive and linguistic development. That is why we should always encourage parents to expose the child to two languages – ASL and Spoken/Print English. Because when their CI breaks, when they lose their CI, or during swimming lessons, they will need some language to fall back on – that’s where ASL enters the picture.

Research is beginning to show that an infant learning ASL/sign language along with CI/spoken English pick up spoken English at a more rapid pace than those infants who are not taught sign language.

What about bilateral implants? Are they necessary? Yes. Imagine being hearing in just one ear, but not the other ear. Bilateral implants are like surround sound – with two implants you can finally hear everything around you, not mostly on one side. But each person is different and should be evaluated to make sure that two cochlear implants are needed. There are many questions now about getting two implants—will insurance pay for two?, should they be done at the same time? Should one be done first and then one later?

But again, people with CI are still DEAF. Again, it doesn’t have to be a choice between a CI or ASL, both can work together beautifully.

Click here to go to the conference proceedings of Cochlear Implants and Sign Language: Putting It All Together in 2002.

For a comprehensive discussion about the merits of ASL-based education for children with CI's click here to go to Gallaudet University's sign language & the cochlear implant site.

For copies of the research showing ASL + CI advances language development, contact:
Christie.yoshi@colorado.edu or Lise.Mee@colorado.edu.
Citation:

Yoshingaga-Itano, Christine, Menn, Lise. A Lexical Sign Language Bootstrap to Spoken English. University of Colorado, Boulder.


6th Vlog: Who is Our Enemy?

Who are our enemies? The CI companies? The doctors? The parents?
No, our biggest enemy is ignorance. We must educate everyone – I mean everyone – on the merits, benefits and successes of implanted bimodal (visual/auditory) bilingual (ASL/English) Deaf children. (In the vlog, I did not distinguish between the visual and auditory modes very well - reading and writing should be under the visual mode, along with ASL)

This means changing our attitudes when we see an implanted child. Remember, the child has no idea the political ramifications of getting a cochlear implant. The parents are also innocent and only want the best for their child. They have no idea what’s going on in the Deaf community about cochlear implants, and if they do have a slight idea, they’re under extreme pressure to decide what’s the best for the family. Time is running out. They have to hurry and decide...and the concept of a CI versus a bad experience with an angry deaf community member makes it very easy for them to decide to go with a CI, and possibly deny their child ASL as well.

And for us to make faces at them, talk behind their backs, exclude/refuse to talk to them only makes matters worse. Children and people with CI are still human and deaf, just like us.

We must make our deaf schools and programs CI friendly and embrace CI toddlers and children as our own or we will be advancing our very own cultural and linguistic genocide because almost every child born to hearing parents will be implanted. And the 5% of deaf children with deaf parents are not enough to sustain the Deaf community and language. We need to embrace the other 95% and to welcome them in our culture and language with no reservations. This means a long, hard look at our old prejudices and assumptions and updating them with new information and knowledge.

We need to look at the next generation of Deaf children. They will still be Deaf, however, some of these children will use a technology called a cochlear implant. So we will have a generation of children who are still deaf, they just happen to have the opportunity to have access to sound in a different way than other generations of deaf people. It is just that… a technology. And as we know no technology is perfect.

Most importantly, we don’t want to go back to the “oral failure” model—which means sending the deaf, implanted students to an oral program. And when/if they fail, then they are too old to learn language, and send them to learn “sign” at the deaf school after they are already delayed in language development. Use of a CI alone does not guarantee “oral success”. The best scenario is this: CI and ASL. This should be our main message for everyone out there.

Click here to read National Association for the Deaf (NAD)'s position paper on Cochlear Implants and the Deaf community, which discusses the importance of looking at the whole child.

Click here to watch a vlog by Dr. Laurene Simms, Dennis Berrigan and Francisca Rangel about the Deaf Community and Cochlear Implants

DISCLAIMER: This blog is not a word-for word translation of the ASL vlog above.

18 comments:

Billy Koch said...

Excellent VLOG! I'm no different than I was before and after I got the CI. Only thing as you said - it is a tool for me! Gives me the ability to do my job. :) Great job!

Tara said...

I was like you back then too...I see things differently after I learn something new each time. I was wondering about if the person has serve vertigo problem and will CI work? E mail me at tlsunz@yahoo.com and I look forward to get more information on that part. :-)

raychelle said...

Tara, you have a good question - people should see the answer here so they're not left wondering what the answer is!

But I don't have an answer to your question - I have heard that getting a CI helps with reducing vertigo, and I have heard that getting a CI came with increased vertigo problems (eeek!).

I do know one deaf woman who got a CI to deal with her vertigo. I'll ask her if she's willing to do an ASL vlog sharing her experience for this site.... This is definitely a good topic for blogging discussion (hint, hint, ASLCI)

Anyone else know more information about vertigos and CI's?

Raychelle

Anonymous said...

Raychelle, I am not sure why there was a link to Dr. Laurene Simms, Dennis Berrigan and Francisca Rangel's vlog. I don't know about Francisca, but Laurene and Dennis definitely are not supporting cochlear implants. They are just explaining what the deaf community. I feel you are trying to use them to mislead the audience into thinking they are endorsing cochlear implants like you. That is not a responsible way of journalism.

Steve

raychelle said...

Steve, (is this Steve Nover? if so, Hello!)

First of all, I never claimed to be a journalist. I am a v/blogger.

Second, did I in any of my v/blogs endorse CI's? I suggest you watch/read all of them again. I am merely arguing that CI's are simply tools, and that we all must unify our message in providing ASL from birth for all deaf children, with CI's or without Ci's.

Third, here is what I said in my v/blog:
"Click here to watch a vlog by Dr. Laurene Simms, Dennis Berrigan and Francisca Rangel about the Deaf Community and Cochlear Implants" I did not say whether if this was for or against Cochlear Implants. How is this irresponsible as you say?

Fourth, did you watch/read Dr. Simms, Berrigan and Rangel's video/transcript?

They discuss looking at the whole child, providing ASL access, which is the same as NAD position paper. They never say they are against CI's, and they never say they support CI's. That is the same position I hold - I believe having a CI is a personal decision and that we as a community should embrace all deaf people, regardless if they have CI's or not.

Allow me to quote some things from Dr. Simms, Berrigan and Rangel's video:

"The third common reaction is one of acceptance.  These  members accept the prevalence 
of the cochlear implant.  They understand and respect those who chose to have  implant. 
In  fact, some of these  members have chosen to have  implants  for themselves.  These members also encourage children who have the implants to learn  American Sign  Language." 

"The position paper by the National  Associat ion of  the Deaf, or NAD, clearly stated that 
language and communication are not the same as speech.  The ability to speak and or 
hear should not be equated with  intelligence,  lifelong success, and a sense of well  being. 
The NAD emphasizes that communication,  language, and cognition are critical.  Whether 
the information is visual or auditory, emphasis should be on the overall development of the Deaf child.  That is the crucial point of  focus." 

Finally, I would not put words in another person's "hands", like you just did by saying that Berrigan and Simms are against CI's. If they have that opinion, then they should say that for themselves.

Raychelle

Anonymous said...

How much or severe is vertigo?

I can't wear my hearing aid as it makes me lightheaded/nausea. If I had worn it longer, it could be worse. I am told hearing aids should not do that so something must be going on in my inner ear. Now that I don't wear my hearing aid, I am getting tinnitus. All this happened over a month ago.

I imagine there are many deaf/HoH people who can not wear hearings aids because of sudden hearing loss or became sentitive to noise.
Suey

Anonymous said...

Arguing that CIs are simply tools is one of the ways of endorsing CIs. It makes sense why people thought you are endorsing CIs. Are you saying you are not endorsing CIs?

Some people would say breast implants are simply tools for men to enjoy. Why would women want to enlarge their breasts so men can play with them? Often people change themselves to please others(hearing people, men)

Allison

raychelle said...

allison,

i've said again and again in my vlogs that Ci's are a personal decision, and the same goes for breast implants. whatever people want to do with their bodies - be it tattoos, body piercing, implants, so on, fine with me. i'm not for or against CI's.

it is up to you to judge whether if they're doing it because they want to or because they're doing it for their boyfriends or for their hearing family or whatever. i'm not really interested in the psychoanalysis of why people do things - just as long as:

children have 100% access to a language (or more) from birth. and in the case of deaf children... that is ASL. that's always been my argument.

raychelle

Anonymous said...

I'd not mind if people say they support Deaf children have 100% access to ASL. I agree with you on that part. Obviously, we can't control what parents do to their children. We can keep on pushing ASL for these children, BUT to say CI is fine and join them in the fad of implanting is another story. I may have misunderstood your vlogs. It did look like to me you were cheering for CIs. We should appreciate what NATURE gives us. If NATURE gives us small breasts, embrace them. If NATURE makes us Deaf, we should embrace our being Deaf. NATURE is beautiful. Why do men want to change NATURE -- cutting trees, implanting people, and so on?

Allison

raychelle said...

allison, if we want to get into the nature/organic argument we won't go anywhere. most of the things we do nowadays are not natural and inorganic anyway - wash our clothes in a washing machine? wear eyeglasses? drive to work? eat GMO veggies/fruits/etc? use a pager? you name it.

the purpose of my vlogs were to clarify the many misconceptions related to CI's, and many people misunderstand that to mean i support CI's. that's a personal decision for the parent or for the individual....

my message is - if you just have to get a CI for your child - it doesn't have to be a choice between a CI or ASL - you can have both.

Anonymous said...

I LOVE YOU!!
I have a friend who has vertigo problems and just had CI implanted. She has NO problems.

- Renee J.

Anonymous said...

Very informative vlogs. My questions on two things: What is the difference between CI and hearing aids? What is wrong with hearing aids...do not have to go through the surgery(ies). 2nd thing is:Why most parents prefer CI first thing in their minds..you know most of us want to seek for second opinion before surgery...why cant the parents seek for more information about deaf and communication?

raychelle said...

hi anonymous,

great questions. i'm no audiologist, but i'll try to explain the huge difference between hearing aids and ci's. they're like apples and oranges. nothing similar about how they process sound -

hearing aids amplify sound. it's like a speakerphone, where all sound in the environment is increased for the person wearing the aids. this is why this works for some hard of hearing children, and not for most profoundly deaf children.

cochlear implants go directly to the auditory nerve, and bypasses everything else in between and does not amplify sound. there's a computer program in the encasing under the skin by your ear that processes sound in binary codes, 0, 1, 1, 0, etc. your brain learns (in some cases, e.g. formerly hearing people or hard of hearing people, they are re-learning) to connect those processed sounds with the concepts (a sound = bird chirping). that's why you have 'mapping' appointments which modify the processed sounds for better understanding. chorost, in his book, says mapping appointments is like changing font size till it fits you (your brain).

your next question - why can't parents seek second opinions? i'm sure they do. but they're stuck with the one camp that "welcomes" their questions. this "camp" happens to be the pro-CI folks.

when they try to ask the other camp, the anti-CI folks, most of the time, they get information that really contradicts with what they see with CI kids. for instance, the anti-CI folks might say, oh your child can't play football, your child can't go on roller coasters, would you want that? oh, cochlear implants don't really work, it's better to be deaf, etc.

which camp do you think the parents will believe? the doctors, who show a CI child happily playing football and understanding a coach's shouted instructions to him on the field?

we have not done our research about CI's and shot ourselves in the foot by saying erroneous or outdated information about CI's to the parents. we need to know CI's well to be able to discuss them with the parents seeking a second opinion.

that is why i propose we shift our discussion with these parents seeking a second opinion - just by saying, oh you're considering a cochlear implant for your child? are you going to learn ASL too? ASL is 100% accessible and enables your child to have a strong foundation in a visual language while your child is in the process of learning sound - concept connections. can you imagine your child learning the sign for a concept, then learning the spoken word for the same concept - much faster than simply struggling to figure out the spoken word for the same concept alone. becoming bilingual is fantastic!

raychelle

Jennifer Bruno Conde said...

Hello Raychelle, I have to tell you how much I appreciate your well thought out vlogs and the way you calmly set out to provide information and correct misconceptions, while taking flack in the process.

There is more than one way to be deaf and by respecting the choices other people make can only enhance the deaf community, not destroy it. Thank you again!

Jennifer

Amanda's Cochlear Implant Journey
http://jenniferbrunoconde.blogspot.com

Anonymous said...

Wonderful vlog!
I work in an environment where I am continually bombarded by disapproval for my choice to have my son implanted and for mainstreaming him. However, regardless of the "cold shoulder" I now receive from the local Deaf community, I did what I had to do to provide my son with the most options in life. If he chooses to remove the device when he is grown and use only ASL or if he chooses to continue to use the implant as a tool in communication, it is now HIS choice. He is mainstreamed because the deaf school he attended did not place enough importance on learning English. Regardless of whether my son can hear or not, he needs to be able to read and write English to survive independently. His ASL skills have not suffered all that much, he may use a bit more English grammar than his deaf educated friends, but, they have no trouble understanding one another. Personally, I don't care what anyone thinks, my primary concern is giving my son as many options and chances at independence as I am capable of providing. Then it is up to him what he wants to do with his options.
I become very frustrated with the either/or mentality of the Deaf community deaf is deaf, whether you wear implants or hearing aids or nothing at all.

Anonymous said...

Excellent article.

As an ASL Deaf adult user with lack of spoken language reared from deaf school/Gallaudet and deaf since birth, I will prefer to have CI and learn to use spoken language if I am a deaf baby again so I can have best of two different worlds. Not only that, I don't have to depend on interpreters and I have more job opportunites to choose than what I have now.

I don't blame parents for choosing CI for their deaf babies so they know that they will have more choices than deaf people without spoken language.

Thanks for sharing the article.

sukhvir said...

Thanks for nice post, i like your post and i wan't to share with my friends.your blog is very nice and i like it. PHYSICIANS AUDIOLOGY CENTER information for visit this website-PHYSICIANS AUDIOLOGY CENTER

tory said...

Hi
Thank you so much for giving us such kind of handy content which will be most useful to me as well.... I will follow your blog always. Thanks!!!