Location: Des Moines, Washington, United States

Friday, April 11, 2008

The Biggest Myths

The following discussion is specifically about profoundly deaf children. Yesterday on Jodi’s blog there was a discussion about myths and inaccuracies. One anonymous commenter chimed in with a comment about how much they disapprove of implanting babies. I know this blog is aimed at families who are already past this discussion, and are more interested in providing both spoken language and ASL for their implanted kids. However, sometimes we need to go back and visit other issues. Like myths. A common belief that I have encountered is that babies should not be implanted, that the child deserves to make this decision for him/herself. The myth then is that the implant will work as well for older kids and teens as it does for babies. An associated myth is that there is no way to estimate how successful the implant will be with a given individual, or that there is not enough information available to make an informed decision on the best age to implant your child. WRONG. On all counts. While it is true that you cannot guarantee results prior to implantation, there is plenty of information now to get a very good idea of how well the implant will work. It is not the same for everyone, and takes into account how much residual hearing you have had, how good your verbal speech is, what your history is, how old you are and how determined you are, among other things.

Last week, my family attended a seminar on early language acquisition, put on by Cochlear Corp. Heather Whitestone McCallum was there, and my daughter was invited to be part of her presentation. My daughter was invited because of her early implantation and subsequent success with her implant and verbal language abilities. We really enjoyed the seminar, and got some good information. Some of that information is relevant to this discussion. Dianne Hammes, with the Carle Clinic and Foundation presented a study regarding the outcomes of four groups of children, grouped by age of implantation. The results of her study showed that children implanted by 18 months of age had near normal speech and language ability, while those implanted after 19 months of age got farther and farther from hearing average the older they got. And the older they were at implantation, the more they deviated from the norm.

There has been quite a bit of research regarding age of implant versus level of acquisition of verbal language that supports that study: see here and here and here. These are just a couple of the many results I came up with when I Googled “Effects of early implantation on speech and language. All of them agree that earlier is better, and that children who are implanted by 18 months of age have a very good chance of achieving speech and language abilities in the same range as their hearing peers. This does not make them hearing. It means that their brains can understand verbal language at the same level.

The important point here is that the brain is an integral part of the success of the cochlear implant. How well the brain can integrate sound is directly connected to the age at which the brain is introduced to sound. By the time a child is old enough to decide for him or herself, they are well beyond the age when the brain can easily integrate sound into meaningful understanding. So the parents who choose to wait and let the child decide, are actually choosing against getting the implant. One way or the other, the parents DO decide. It is far better for them to be intentional in their decision making. I know parents who are now very angry at the Deaf Community because they were led to believe that they could wait, and it would not impact the success of the implant. When they found out otherwise, they felt that they had been lied to by the Deaf Community. This serves nobody. It is more important to keep the lines of communication open, and keep the relationship intact than it is to have the parents follow the “ASL only” ideology without full understanding of all of the options.

The children who will have the highest success with both American Sign Language and the verbal English Language are the ones who are implanted prior to 18 months of age and who are instructed in both English and ASL from birth. This will take dedicated parents and a supportive community.



Blogger Merry said...

That makes no sense to me. Don't people realize that the brain is developing while the child is growing? It seems obvious that the younger the age at which the implant is performed, the more chance the brain has to incorporate the new sensory input into its wiring.

I can see people hesitating to have a delicate operation performed on a tiny child, but I can't see hesitating for some other reason.

Obvious disclaimer: I don't have to make this decision, so perhaps I shouldn't speak. But I'm fascinated by developmental neurology. All the studies that have been done about teaching music to young children and the effect that has on their development, the Kodaly program, the Suzuki music program... there's so many opportunities out there that these children could take advantage of!

9:51 AM  

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