I received a response in the comments section of my last blog from Marina. She needs advice, and I think it needs a bigger response than any one of us can handle alone.
Marina writes: "I am an advocate for the Deaf in Armenia, a country where the latest "trend" or "fashion" is to have deaf children implanted. The tragedy is that the parents and the deaf community is not well informed about cochlear implants. I do have a site, called http://www.unheardvoicesofarmenia.blogspot.com/. Please advise."
My answer is this: It is very important, if anyone is contemplating getting an implant, to be as educated as possible. You need to know what to expect for both the surgery, and the aural therapy required afterwards. You need to decide what type of therapy you want; Auditory/Verbal, Auditory/Oral, Total Communication, ASL-Verbal (or whatever sign language is called in Armenia); Verbal with Cued Speech or some other combination of the above. You also need to become educated on where the implant works well and where it doesn't, so your expectations are reasonable. To get an implant without understanding the therapy needs afterwards is a very bad idea. The doctors absolutely need to be sure that the patient (and/or the parents if the patient is a child) clearly understands that the implant is not a quick fix, and that it will take years of dedicated therapy to get the maximum value out of the implant.
It is also important to become well educated about the local Deaf Community. There is support there and options for families that many parents do not even know about. But whatever decision the parents make, there needs to be trust and continued communication between the parents and the Deaf Community. That can only happen if everyone is willing to be open without condemnation for choices made or not made. This goes both ways, and is essential for trust to be given.
How about it? What advice can you give Marina?
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You have to have reasonable expectations for what the implant can do for a child. Like you said, implants are not a magic fix for deafness - intensive, continuing habilitation goes into each successful user. It's been my experience that auditory-verbal and auditory-oral approaches result in the best outcomes, but there are TC kids who are successful; however, these kids are generally successful because of high ability, no other adverse factors, and heavy parental involvement.
It takes serious work on the family's part to make implants work for the child. I have yet to meet a successful implant user (and even HA user) whose family was not wholly in support of their child using spoken language. I've read it, heard it, and I believe it: the number one factor in a deaf child's success is their family.
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