CI and Deaf-Blind Children

Within the Deaf/ASL Community, there are diverse group of people with different ways of being, and ways of orienteering through life. Some Deaf children are more visual than others, some children rely more on tactile, and others on their hearing aids or cochlear implants.
There is a rising number of children who navigate through their lives from a combination of senses: the sense of hearing and the sense of touch.
An website about Deaf-Blind children shows of an increase of cochlear implantation in children with deaf-blindness in the state of Texas from the years 2002 to 2005 alone. Click here to go to the full article.

The Right of the Deaf Child to Grow Up Bilingual

The right of the deaf child to grow up bilingual∗

François Grosjean
University of Neuchâtel, Switzerland

(Click here to go to this same article in 29 other languages)

Every deaf child, whatever the level of his/her hearing loss, should have the right to grow up bilingual. By knowing and using both a sign language and an oral language (in its written and, when possible, in its spoken modality), the child will attain his/her full cognitive, linguistic and social capabilities.

What a child needs to be able to do with language

The deaf child has to accomplish a number of things with language:

1. Communicate with parents and family members as soon as possible. A hearing child normally acquires language in the very first years of life on the condition that he/she is exposed to a language and can perceive it. Language in turn is an important means of establishing and solidifying social and personal ties between the child and his/her parents. What is true of the hearing child must also become true of the deaf child. He/she must be able to communicate with his/her parents by means of a natural language as soon, and as fully, as possible. It is with language that much of the parent-child affective bonding takes place.

2. Develop cognitive abilities in infancy. Through language, the child develops cognitive abilities that are critical to his/her personal development. Among these we find various types of reasoning, abstracting, memorizing, etc. The total absence of language, the adoption of a non-natural language or the use of a language that is poorly perceived or known, can have major negative consequences on the child's cognitive development.

3. Acquire world knowledge. The child will acquire knowledge about the world mainly through language. As he/she communicates with parents, other family members, children and adults, information about the world will be processed and exchanged. It is this knowledge, in turn, which serves as a basis for the activities that will take place in school. It is also world knowledge which facilitates language comprehension; there is no real language understanding without the support of this knowledge.

4. Communicate fully with the surrounding world. The deaf child, like the hearing child, must be able to communicate fully with those who are part of his/her life (parents, brothers and sisters, peers, teachers, various adults, etc.). Communication must take place at an optimal rate of information in a language that is appropriate to the interlocutor and the situation. In some cases it will be sign language, in other cases it will be the oral language (in one of its modalities), and sometimes it will be the two languages in alternation.

5. Acculturate into two worlds. Through language, the deaf child must progressively become a member of both the hearing and of the Deaf world. He/she must identify, at least in part, with the hearing world which is almost always the world o his/her parents and family members (90% of deaf children have hearing parents). But the child must also come into contact as early as possible with the world of the Deaf, his/her other world. The child must feel comfortable in these two worlds and must be able to identify with each as much as possible.


Bilingualism is the only way of meeting these needs

Bilingualism is the knowledge and regular use of two or more languages. A sign language - oral language bilingualism is the only way that the deaf child will meet his/her needs, that is, communicate early with his/her parents, develop his/her cognitive abilities, acquire knowledge of the world, communicate fully with the surrounding world, and acculturate into the world of the hearing and of the Deaf.

What kind of bilingualism?

The bilingualism of the deaf child will involve the sign language used by the Deaf community and the oral language used by the hearing majority. The latter language will be acquired in its written, and if possible, in its spoken modality. Depending on the child, the two languages will play different roles: some children will be dominant in sign language, others will be dominant in the oral language, and some will be balanced in their two languages. In addition, various types of bilingualism are possible since there are several levels of deafness and the language contact situation is itself complex (four language modalities, two production and two perception systems, etc.). This said, most deaf children will become bilingual and bicultural to varying degrees. In this sense, they will be no different than about half the world's population that lives with two or more languages. (It has been estimated that there are as many, if not more, bilinguals in the world today as monolinguals). Just like other bilingual children, they will use their languages in their everyday lives and they will belong, to varying degrees, to their two worlds - in this case, the hearing world and the Deaf world.

What role for sign language?

Sign language must be the first language (or one of the first two languages) acquired by children who have a severe hearing loss. It is a natural, full-fledged language that ensures full and complete communication. Unlike an oral language, it allows the young deaf child and his/her parents to communicate early, and fully, on the condition that they acquire it quickly. Sign language will play an important role in the deaf child's cognitive and social development and it will help him/her acquire knowledge about the world. It will also allow the child to acculturate into the Deaf world (one of the two worlds he/she belongs to) as soon as contact is made with that world. In addition, sign language will facilitate the acquisition of the oral language, be it in its spoken or written modality. It is well known that a first language that has been acquired normally, be it an oral or a sign language, will greatly enhance the acquisition of a second language. Finally, being able to use sign language is a guarantee that the child will have mastered at least one language. Despite considerable effort on the part of deaf children and of the professionals that surround them, and despite the use of various technological aids, it is a fact that many deaf children have great difficulties producing and perceiving an oral language in its spoken modality. Having to wait several years to reach a satisfactory level that might never be attained, and in the meantime denying the deaf child access to a language that meets his/her immediate needs (sign language), is basically taking the risk that the child will fall behind in his/her development, be it linguistic, cognitive, social or personal.

What role for the oral language?

Being bilingual means knowing and using two or more languages. The deaf child's other language will be the oral language used by the hearing world to which he/she also belongs. This language, in its spoken and/or written modality, is the language of the child's parents, brothers and sisters, extended family, future friends and employers, etc. When those who interact with the child in everyday life do not know sign language, it is important that communication takes place nevertheless and this can only happen in the oral language. It is also this language, in its written modality mainly, that will be an important medium for the acquisition of knowledge. Much of what we learn is transmitted via writing be it at home or more generally at school. In addition, the deaf child's academic success and his/her future professional achievements will depend in large part on a good mastery of the oral language, in its written and if possible spoken modality.

Conclusion

It is our duty to allow the deaf child to acquire two languages, the sign language of the Deaf community (as a first language when the hearing loss is severe) and the oral language of the hearing majority. To achieve this, the child must be in contact with the two language communities and must feel the need to learn and use both languages. Counting solely on one language, the oral language, because of recent technological advances is betting on the deaf child's future. It is putting at risk the child's cognitive and personal development and it is negating the child's need to acculturate into the two world's that he/she belongs to. Early contact with the two languages will give the child more guarantees than contact with just one language, whatever his/her future will be, and whichever world he/she chooses to live in (in
case it is only one of them). One never regrets knowing several languages but one can certainly regret not knowing enough, especially if one's own development is at stake. The deaf child should have the right to grow up bilingual and it is our responsibility to help him/her do so.

∗ This short text is the result of much reflection over the years on bilingualism and deafness. Those who surround young deaf children (parents, doctors, language pathologists, educators, etc.) often do not perceive them as future bilingual and bicultural individuals. It is with these people in mind that I have written this paper. I would like to thank the following colleagues and friends for their helpful comments and suggestions: Robbin Battison, Penny Boyes-Braem, Eve Clark, Lysiane Grosjean, Judith Johnston, Harlan Lane, Rachel Mayberry, Lesley Milroy, Ila Parasnis and Trude Schermer.

By the same author

Grosjean, F. (1982). Life with Two Languages: An Introduction to Bilingualism. Cambridge, MA: Harvard University Press.

Grosjean, F. (1987). Bilingualism. In Gallaudet Encyclopedia of Deaf People and Deafness. New York: McGraw-Hill.

Grosjean, F. (1992). The bilingual and the bicultural person in the hearing and in the deaf world. Sign Language Studies, 77, 307-320.

Grosjean, F. (1994). Individual bilingualism. In The Encyclopedia of Language and Linguistics. Oxford: Pergamon Press.

Grosjean, F. (1994). Sign bilingualism: Issues. In The Encyclopedia of Language and Linguistics. Oxford: Pergamon Press.

Grosjean, F. (1996). Living with two languages and two cultures. In I. Parasnis (Ed.), Cultural and Language Diversity: Reflections on the Deaf Experience (pp. 20-37). Cambridge: Cambridge University Press.

Poem by an ASL-CI User

The Rectitude of the Deaf Community

It saddens me, the ignorance of those in the Deaf Community.

They fail to understand cochlear implant users and judge their every move.

They are blind to see that they are so close-minded.

Hypocrites! They are the ones that are so “hearing”, using ipods and hearing aids.

Crabs! Rejecting those whom become successful.

Audist! Judging those with cochlear implants and deciding who’s “deaf” or not.

Liars! Creating false tails and fibs about the implant out of fear it will destroy the community.

Critics! Blaming hearing parents and the implant itself for the decline in the deaf community.

Who’s missing out? Me, or you?

I have no fear of the hearing community and will bravely take them on any given day.

I will break from the flock of sheep and graze in a much larger field.

I will expand my options and become successful in the “outside” world.

I will have an open mind, open to learn from and experience new things.

My deaf culture will be able to always be within me, no matter where I go.

You will stay close, not out of love of the community, but out of fear of those unlike yourselves.

You will end up alone, despite those who say they will support you forever.

You will be hurting the deaf community by shunning those away who grow up differently and aren’t “deaf enough” or involved in the culture enough to meet your standards.

You will be isolated and unaware of the marvelous discoveries in the world, the “hearing” world.

You will see my success and grow angered within, at your own ignorance.

We are one. “Gallaudet-United-Stay”.

Yet, we continue to segregate and categorize each other based on hearing status.

You judge me because I am different.

Jewish people were judged because the color of their hair and eyes.

African American’s were judged because the color of their skin.

“Ghetto” people are judged for the way they talk and what they wear.

And I am judged for the way I hear and what I hear with.

I am here to be part of the community that I’ve grown to love.

And yet, I am pushed away because of the tool, the device that I use.

Where is my support? The hand that I may hold to add a longer link to the human chain to make this community grow?

I now see, you clearly don’t know what unity and acceptance means.

Inclusive and cognizant.

We are all humans, entitled to make our own mistakes.

We only hurt ourselves if we continue to be ignorant and close-minded.

This is the time we began to step out of the past and build for our future.

As the world changes, so must we.

This is not about tradition anymore. It’s about our community as one: cochlear implant users; hearing aid users; non-hearing aid users. We all fall under the same category: Deaf.

Tradition becomes worthless when the right values are lost.

If this community really means something to you, then you will know when it’s time to make a change. Be prudent and the community will thrive.

-Poem was written on November 9th, 2007 by Nicole LaMont, an ASL-CI User and Senior at Gallaudet University

*Disclaimer: This poem does not represent the feelings or experiences of all ASL-CI Users, but one's own. Although there is an increasing body of CI students at Gallaudet and everyone has their own opinion of Cochlear Implants, this is one of many messages of some ASL-CI Users who feel rejection because of their personal decision. We hope that this poem will make people aware of the impact of negative attitude towards ASL-CI Users. Nicole learned ASL at Gallaudet and learned to embrace it along with Deaf Culture, but does not abandon her cochlear implant because "people don't like it". She is a shining example for those who have "discovered" sign language and keeps Deaf Culture in her heart.
Thank you, Nicole, for being brave enough to submit this poem for the world to see and disclosing your name.

Welcome!

Welcome to this new site! We have set up a place where deaf people with cochlear implants, educators, doctors, parents, and the general deaf community can come together to share stories, ask questions, and learn more about different issues related with the Cochlear Implant, Sign Language, and the Deaf community.

Because of the long-standing controversial issues, some of us, especially those who are bilingual in both English and ASL, are afraid that this ongoing controversy will impact the future generation of the deaf community so we are taking a stand!

The mission of this blogsite is to educate the public about widespread misconceptions related to cochlear implants. We sincerely believe that the deaf and hearing communities* must come together and start driving towards a uniform belief:

That since Cochlear Implants are here to stay, we must do our best keeping our future deaf children (implanted or not) bilingual/bimodal in both sign language and spoken language.

This place welcomes those bilingual cochlear implant users to share their experiences. If you are an CI user that supports this goal, please email us at aslciusers@gmail.com so we can become a blogging/vlogging community. We are opening this mainly for those who have been hesitant to speak up, now is your chance!

We hope to develop different groups: ASL ci users, parents of CI users, CI users curious about ASL and Deaf community, and other group of people so they can have their "discussions" within this blog.

We are in the process of setting up the first "ASL-Cochlear Implant Community" vlog so this blogsite can be bilingual! Thank you for your patience and do check back often!

We will be united, we will stand against ignorance, and we will help the future generations of deaf children "cherish and defend our beautiful sign language as the noblest gift that God has given us"!
-George Veditz, 1910, "Preservation of Sign Language"

*please keep in mind that the "hearing community" does not mean cochlear implant users. There are no "sides", we are trying to break down the "wall" that CI users face because some members of the deaf community do not consider us one of them, when, technically, we are. When we mention "hearing community", we are referring to hearing people who are not familiar with Deaf culture and ASL. Although we recognize that there are some CI users who have never been exposed to Deaf Culture/ASL, we still consider them deaf AND hope that this blog will be their positive welcome into the Deaf World.

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.

Call for ASL-CI B/Vloggers!

This is a call for all ASL-CI people for your contributions to this site.  We accept typed blogs and ASL vlogs.  Send them in to:

ASLCIUSERS@gmail.com

We look forward to meeting you and sharing your work.  If you have a CI and use ASL, and you are interested in blogging or vlogging regularly, please create a GMAIL.com e-mail address, email us, and we'll add you to the list for this site so you can enter and post whenever you want to!  Parents of ASL-CI children are welcome to join as well!  

Create any type of username for yourself... for example: 

-KISSFISTASLCI@gmail.com

-ASLCICHAMP@gmail.com

-MOMOFASLCI@gmail.com

Do not worry, we will not reveal your identity.  It is your decision if/when you want to reveal your identity.

The purpose of this is to have a 'virtual' center for bimodal (visual/auditory), bilingual (ASL/English) cochlear implanted people to show the world that they are Deaf, part of the Deaf community, and support bimodal bilingualism! 

If you do not feel ready to blog or vlog yet, feel do free to help out with the comments section.  If someone asks questions about our experience and CI's in general, do feel free to comment, answering their questions.

Frequently Asked Questions

Can cochlear implant users drive a hybrid car/SUV? 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.  The individual will not be affected. The 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). Note that the plastic casing holding the magnet and the coil inside the cochlea stays. Only the magnet is removed.

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.

Will static electricity affect the cochlear implant? Electrostatic discharge can cause damage to any electronic device, however, implant manufacturers are improving the design of implants to provide greater resistance to this problem. Clarion indicates that their CII Bionic ear implant system is designed with special safeguards for greater resistance to electrostatic discharge.

What is the risk of internal device failure? While the risk of device failure is small, it is possible. In these situations, additional surgery may be required to replace the device or in some situations to reposition a device that has migrated from its intended placement.

Can implanted children participate in sports? Cochlear implantation should not interfere with most recreational activities. Judgment should be utilized in determining if the external portion of the implant should be used during sports. Of course, the external processor should be removed for participation in water sports. In addition, be aware that sweating and moisture can affect the device. The surgically implanted portions of the implant will not be damaged by water sports or diving into a swimming pool. The only restriction that seems to be made by implant companies is related to deep-sea scuba diving. This is based on severe pressure changes. For sports that involve particular risk of head injury, common sense indicates that head protection be utilized. Clinics usually advise avoidance of activities like boxing, where a severe blow to the head is likely.

What about waiting for the technology to improve before choosing to implant? Research and observation suggest that early implantation in children is closely related to increased outcomes in spoken language development. Studies also suggest that shortened duration of deafness also positively impacts spoken language growth with an implant. Given these findings, waiting for new technology may negate the benefits of cochlear implantation. If early implantation and shortened duration of deafness are seen as primary impacting factors on cochlear implant success, then waiting for new technology would not be recommended.

In addition, as of early 2003, the three major implant manufacturers have introduced new technologies into the marketplace. It does not appear that there will be changes to the surgically implanted portion of the device in the near future. Changes to the devices, should they occur, will probably be related to external hardware and software of the systems. Persons obtaining cochlear implants at this time should therefore be able to take advantage of these advances without further surgery.

What are the surgical risks? In general, the surgical procedure is not considered risky. The risks reported are those associated with any surgery requiring anesthesia. The areas involved in surgery include the mastoid bone behind the ear (where the magnet portion of the implant is housed) and the cochlea housed in the inner ear (where the electrodes are implanted) . This is not "brain" surgery.

As the hearing system is close to the balance system, some patients report periods of dizziness following implantation. There are other possible, though uncommon, risks associated with surgery related to the facial nerve, sense of taste, and possible infection that should be discussed with the physician. (Also see the module, Surgical Considerations.)

What about the possible relationship between cochlear implants and the risk of meningitis? On July 24, 2002, the FDA issued a Public Health notification highlighting the possible association between cochlear implants and subsequent bacterial meningitis. While the FDA announcement discusses the possible association between implants and meningitis, it also explains that the implant has not been proven to be the cause of the meningitis in the cases noted. The full report, Cochlear Implant Recipients May Be At Greater Risk For Meningitis, can be found at: http://www.fda.gov/cdrh/safety/020606-cochlear.html.  Now it is a requirement for any child or adult considering a cochlear implant to be vaccinated for meningitis.

Related to the possible risk of meningitis, the following should be taken into consideration:
any surgery on the inner ear can increase the risk of infectious diseases like meningitis,
some deaf individuals may have congenital abnormalities of the inner ear that make them more prone to meningitis with or without a cochlear implant, and
some individuals who are deaf from meningitis may be at an increased risk for subsequent episodes of meningitis in comparison to the general population.
Is the residual hearing in the implanted ear destroyed as a result of surgery?

The design of improved electrode arrays and implantation procedures seem to be increasing the chance that the cochlea may be preserved following implantation. There continues to be the potential loss of residual hearing following implantation, and implant companies continue to warn patients that implantation will probably result in the loss of residual hearing.

What about Magnetic Resonance Imaging (MRI) for persons with cochlear implants? Implants and MRIs are generally not compatible due the magnetic component of the implant. The Nucleus 24 device designed by the Cochlear Corporation has a surgically removable magnet and a design feature to withstand some MRIs. If MRIs are an issue of concern, this should be discussed with your hospital implant center. The MED-EL Device, COMBI 40+, is under investigation for allowing MRIs under certain conditions.

Some of the questions/answers here came from Gallaudet University's Cochlear Implant Education Center (CIEC) page - click here to go directly to their page.

We will continue to add your new questions and our answers to this post.

Cochlear Implant Statistics

We are working on compiling information on the numbers of people who have a cochlear implant in the USA. International statistics are also welcome. Your help in bringing sources to us would be appreciated (email us at: aslciusers@gmail.com).

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According to the Gallaudet Annual Survey of school age children, approximately

37,500 children were surveyed in 2005.

only 4,000 were listed with cochlear implants.

This survey underestimates the numbers of children in the US with cochlear implants. We know that is not the case because of the manufacturer data.

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Manufacturer data:

As of 2007, approximately 120,000 individuals have cochlear implants worldwide according to the three cochlear implant manufacturers (Cochlear Corporation, Med El, and Advanced Bionics). There are at least 25,000 children under 18 who have obtained cochlear implants who are in the US. More than 1/2 of these students are reported to be under the age of 5.

Cochlear Corporation
91,000 individuals with their CI in the world
42,000 of those are children
48,300 of those are adults

In the USA:
35,500 in US
17,800 of those are children
21,700 of those are adults
Over 50% of the children being implanted are under 5 years old.

Advanced Bionics
24,000 with their CI in the world

55% of those are adults

45% of those are children

of that, 1,200 have bilateral cochlear implants

45% of adults have bilateral cochlear implants

55% of children have bilateral cochlear implants

Med El

we don't have their current statistics (if any of you know, let us know)

As of October 2005,

2,803 bilaterally implanted individuals by all three manufacters

1,638 were children

As of Fall 2006,

That number rose to 4,600

As of Fall 2007

That number rose to 6,000-7,000

At Kendall Demonstration Elementary School

1999: No children with cochlear implants

2007-2008: 26

At Model Secondary School for the Deaf

1999: One teenager with cochlear implant

2007-2008: 21

At Gallaudet University

2007-2008: 65 undergraduate students have a cochlear implant (representing 6 percent of all undergraduates)

24 of them being new students (representing 11% of the new students enrolled)

Special thanks to Gallaudet University Clerc Center's Cochlear Implant Education Center for the statistics. Click here to go to their website.

At Rochester Institute of Technology (RIT/NTID)
1999: 29 identified students and one faculty that have cochlear implants.
2007: 217 students have cochlear implant.

Special thanks to a Deaf mother of a CI child, for submitting this article. Click here to see the article in NTID/RIT's 2007 Focus newsletter, page 12-13.

The Brain and Cochlear Implants

At birth, the brain is basically a blank canvas. It has some major pre-wiring, but most of the work has yet to be done. The primary goal of the newborn brain is to learn how to think. As time goes on, it switches gears into thinking to learn. The vast majority of the neural synaptic connections that are made during a person's lifetime occur during the first year. In the first 3 years or so, the entire structure of the brain is laid out. The foundation is formed. That is when language acquisition occurs. As language is learned, it in turn helps create more of the foundation. Visual language is learned separately from oral language. While the two can support and assist each other, if either is delayed, that language cannot assist in basic brain development.

The auditory center of the brain REQUIRES sound and language in order to develop. And it generally requires the same amount of time as the rest of the brain, about 3 years. The longer sound and verbal language is delayed, the less brain development occurs in the auditory center. For those with mild to moderate hearing loss, a hearing aid is usually adequate in providing that basic verbal language acquisition. For those babies with a severe to profound loss, hearing aids simply cannot supply the needed input in all frequencies. If any frequency is missing, then that area of the auditory center does not develop.

The reason many older kids and adults don't do as well with their cochlear implants as infants and toddlers do, is that they are past the point where the auditory center can do much development. If they had adequate auditory brain development as infants (a progressive loss, good use of hearing aids, etc…) then they will probably do quite well with the implant. If the auditory center did not get full development, then no matter how well the implant works, the brain simply is not capable of making sense of the sound. Thus, it becomes meaningless noise. This is a simplified version, showing two ends of the spectrum. The more developed the auditory center is or can become, the better the implant works.

So while children with a mild to moderate loss, or those who get good results with hearing aids have time on their sides, those with a severe to profound loss that don't respond well to hearing aids do not. For those babies, the clock is ticking, and time is not their friend.

K.L.