Thursday, May 21, 2009

Is it Speech or Language Therapy?

As I read different blogs and comments, I keep running into a similar comment. ASL teaches the child language. Speech therapy teaches kids to parrot sounds. ASL involves brain development. Speech therapy revolves around voice and ears only.

I would like to clearly and distinctly refute that claim. First off, I fully agree that teaching ASL teaches language. No question there. But speech therapy today must be way different than 20+ years ago. At least it is for kids learning language with a cochlear implant. Before we go any farther, I want to stress that I believe ASL and verbal language can and should compliment each other. Deaf kids should be taught both. But there is a reason that speech therapy is so important for implant recipients.

The determination of success (or failure) of the cochlear implant comes down to how well the person can make sense of sound. One of the shortcomings of hearing aids is that if there are no residual hair cells in the cochlea, no amount of amplification can get sound through the cochlea to the auditory nerve, and on to the brain. With the implant, if you have a functioning auditory nerve, and can get a good insertion of the electrode array into the cochlea, sound WILL get to the brain. The question really is how well can the brain make sense of the sounds it is now receiving? Think of it like a projector that is out of focus. The sound coming in from the implant is fuzzy. The brain has the ability to make the sound quality better and clearer. In effect, it focuses the projector to sharpen the image. How well the brain can focus the sound is the key to the implant’s success.

In the “olden” days, speech therapy consisted of trying to teach a deaf person how to imitate a sound that they may or may not even be able to understand. It focused on teaching the person how to speak clearly enough to be understood. Many of the sounds they learned to make, they never learned to understand.

With the implant, the key is to understand the sounds you are hearing. Verbal language is all about putting meaning to the sounds you are hearing. Yes, speech articulation is part of it, but the majority of the emphasis is on learning to understand the sounds you are hearing. It is all about the brain. 100%. You learn to make sense of sound, put meaning to words, paraphrase what you see and hear, initiate and reply to conversations. In short, you are learning verbal language. The success of the implant rests on how completely you learn language. And how well you learn language rests on how well your brain is able to interpret the sounds the implant is giving you. Meaningless parroting has no place here. It is all about brain development. Speech therapy is the way the brain learns to focus the sound, so the sound has meaning. I really think it is no longer appropriately named. Maybe calling it speech therapy was what was happening in the “olden” days.

As a parent who has been intimately involved with my daughter’s speech therapy over the years, first with her initial implant and now with her second bilateral implant, I can tell you that there is one thing I know well. It may be called speech therapy. What she is getting is NOT speech therapy. It is LANGUAGE therapy.


Monday, May 18, 2009

New Documentary about a Deaf Family with CIs

The Stark family of Chicago: a deaf, ASL using family with cochlear implants.  Jeffrey (almost 3 years old) has had a CI since he was 17 months old and and 7 month old Melissa who will get a cochlear implant soon. Their mother, Jill, will get a cochlear implant this month. The documentary will be released soon. Here's the link to the ABC story on this documentary and click here to go to the documentary's website.  

A nice quote from the documentary:  "(Cochlear implants) doesn't stop them from being deaf."

Monday, May 11, 2009

Video of an ASL- CI user

Click here to watch a video of Michael Chorost talking about his cochlear implant and how it works. He is currently a visiting professor with the ASL & Deaf Studies Department at Gallaudet University and is learning ASL.

The video is on Exploratorium website in the Listening section; this section also includes x-rays of Michael's skull, links to Michael's written work and to the NAD position on CIs.  To see all of these, click here.

Thursday, May 7, 2009

Line in the Sand

My daughter was implanted in May of 1999. She was 12 ½ months old. At that time, the minimum recommended age of implantation was 18 months of age, unless there were extenuating circumstances. Ossification from meningitis was one of them. Newborn hearing screening was a rarity. The doctors had yet to truly understand how critical the magical first three years was in regards to language acquisition.

Before the ossification in her right ear was discovered, the doctor was fairly unconcerned about how much time would be lost between when she lost her hearing and when the implant would get activated. Her belief that if we implanted somewhere between 15 and 18 months that would be good enough, and that there really wouldn’t be that much lost in the process. The ossification was discovered at about 9 months of age, and that changed everything. If they wanted to get a good insertion of the electrode array into her left ear before it too ossified, they needed to hurry. The ossification process had just begun in her left ear when they operated. They were able to slide the array right through the bit of fibrous tissue they encountered, and got a full insertion. She was the first 12 month old at that hospital, and one of the first in the country to receive an implant at that age.

She is now 11 years old, and will start in middle school in the fall. She is the line in the sand. The number of kids implanted younger than 18 months of age, who are older than my daughter are few and far between. When she was two, the minimum recommended age of implantation lowered to 12 months. When she was three, newborn screening was more common than not, and now it is in place across the country, for all babies. And now, the doctors are far more aware of the brain development that occurs during those critical first three years.

There were no ASL CI programs available when she was little, so we went with a TC program. She still signs SEE, but is learning ASL, and will be around other kids who know ASL when she gets into middle school. But we know of no families with kids in her age group who were implanted as young as she was. We were forging our own path for the most part. When kids enter the teen years, they start to come into their own. How she does in middle school will be the beginning of our parental report card. That is usually when the payoff for early intervention begins. We will see where we did things right, and we will see where we did things wrong. This payoff period will last at least through high school, and into college. But it begins in September.

Up until now, the number of kids implanted early, who are in middle and high school have been a trickle. Most of the teens who have implants got them at over the age of three. However, behind my daughter the trickle will turn into a stream, then a wave. It will be at least five to ten more years before enough early implanted kids get to the upper levels of school before the trend can be seen as to their success. Success with both their implants and with education and language in general. But my daughter is at the head of the wave.

I am looking forward to the journey.


Wednesday, May 6, 2009

ASL-CI Families Needed for Book

A Book about Your Family’s Story: In Narrative and Photographs


Families with children who are deaf and who use ASL are invited to participate in a project that gives families an opportunity to share their experiences as a family. Families with deaf child(ren) who use ASL and CI are also welcome. What is life like with a child who is deaf—at home, in the community, and at school. What communication decisions have you made? What are your family’s goals for now and for the future? What kind of literacy experiences does your child have at home?

Our visits with the families will involve informal interviews around these and other topics that come up during the conversation. We will videotape the interviews only to record the information and not to be shown to anyone.

“A picture is worth 1000 words!” Family photographs are an important part of the project. Informal black and white photographs of the families at home will be taken. The purpose of the photographs is to show the overall “spirit” of each family as a group and individual family members; family diversity, communication and bits and pieces of family life can be communicated through photographs.

The overall approach is collaborative between the families and the project leaders. What stories are shared is the decision of the individual family; we will ask questions to keep the discussion going. What photographs are taken is also up to the family; again, we will make suggestions. The family will be the final decision-maker on the photographs and narrative included in the book.

The book will make an important contribution to the literature.  Very little information is available today about families who use ASL or who use ASL and CI. This is a unique opportunity to provide information from families to other families, teachers, and anyone who might be interested.

What we are asking of the families who participate:

Usually one (sometimes two) home visit (1 ½ hr.—2 hrs each); family members will be videotaped as they discuss their family stories in an informal interview; families will be photographed informally.

Stipend:  We will offer the families a $100 stipend.

Project directors:

Barbara Bodner-Johnson                            

Department of Education                            

Gallaudet University                              

Beth Benedict

Department of Communication

Gallaudet University