Children with CI.... Hard of hearing or just behind in language.??

[Cloggy]

A thought that crossed my mind - actually, it didn't cross, it got caught, is that the way we look at children with CI might be wrong. Wrong in the sense of what kind of support we give compared to the support they need.

Historically, CI's' were the next step from HA's. And with that, CI's are still regarded as such. A hearing aid. Working in a different way, but still, an aid to hear.
People with CI are therefore still regarded as Hard-of-hearing since "obviously" they use a hearing aid.

This might very well be true in many cases, but a new generation CI-users is emerging. Children that are implanted (often on two sides) before the age of three that do not conciously grow up deaf. CI is giving them sound that enables them to speak and understand language.
The "problem" these children have is not hearing. They hear very soft sounds, they understand and reply with whisper. In that sence they are not hearing impaired.

They ARE however behind in language and therefore cognitive thinking. The older the child, (1, 2, 3 years old) the more this is true. This is where the supportsystem should focus! On gaining on the lost language.

Obviously, the situation depends from child to child. 1 CI will make undrestanding in noisy environment much more difficult, and with that, there is a hearing impairement. But think of children that do well with bi-lateral CI. These children need language, speech and above all, comprehension.

Example,
Lotte is now in an all-hearing kindergarten, and with the language she has, she is behind compared to other 4-year olds. She is not able to master communication with children that otherwise would be her "equal" because the others do not understand her. The result is that she will look for other children that either ar younger but at her speech level, or children that are more fysical that communicative. (e.g. boys, playing outside... where screaming and actions goes a long way.)
Focus should be on making sure Lotte is understand. (And this is being done..)

It seems that for the children, focus is actually on communication and speech.
But what about the parents...
In Norway, the parents are offered sign-laguage classes free of charge. BUT, the focus is only on that. Sign. WE, Lotte's parents, do not have a need for that. Lotte does not use it any more. We need information in speech and language development. How does it work. What are the milestones... What to look for, how to play, what to do, what NOT to do.
BUT since children with CI are still looked at through "DEAF" glasses instead of "Language deprived" glasses, that support is not available. Only "DEAF" therefore "Sign" support...

How is that elsewhere..??
Is the support sysem different.
Like, AV-therapy. It's not available here in Norway, but I have a feeling that there the focus is on educating the parent.

Anyway, enough brainstorming.... You're next...

 

[Boult]

Cloggy,

eh, you would be surprised that NO ONE called the Bionic Woman a functionally-HOH like DD would like to label.

 

[highlands]

CI cannot restore or offer natural hearing . Natural hearing is very complex and science is still unable to know all details of it. So children or adults with CIs are 'still' hard of hearing (when CIs are on ) even though they get satisfactory results from implants .None of any devices can replace natural hearing !

- btw,I'm not against CIs. I totally support them -

 

[deafskeptic]

It's really too bad you can't qualify for a CI in your country. I wouldn't qualify in your country either and your loss is worse than mine. Maybe in a few years doors will open for you. A few years ago they wouldn't have implanted me.

I would call all CI'ers HOH because CIs don't really make you hearing as it can't replace natural hearing.

 

[R2D2]

I vote for HOH too. If a child with a CI is behind in language it obviously stems from not being able to hear as naturally as a hearing person. So basically it goes back to a hearing problem as the source.

 

[Boult]

actually when one hears at 20 to 30dbl that's not HOH that's normal hearing level. the only thing that they label Adult CI user functional-HOH is because of comprehension in understanding speech sound. So they require therapy to be able to internalize those sound...

But when one take off CI, he's deaf.

If I have HA and hear as much as I can and can internalize those sound then that would be "functional-hoh" ! But I wasn't functional-hoh 100% I only heard at 50dbl w/ HA.

We need to stop listening to DD eh.

 

[ashleysmommy]

As far as the AV therapy For me any way it is more about teaching me how to help Ashley. She already sees the AV that will be working with her after her surgery. We got her started early to establish a familiarity with the teacher and the surroundings. Having her implants we felt would be such a change we didn't want her to go into overload. Her teacher and I get down on the floor and she shows me how to get Ashley to associate the cause and effect of things right now. I know it will change somewhat once she has her implants and is activated. To me the therapy is more to teach me and see how well Ashley is learning as we go along. I still have a lot to learn and we haven't even had the surgery yet so maybe I am speaking out of turn.

 

[shel90]

So means no one will support sign language?

 

[highlands]

So means no one will support sign language?

That depends on situations of each individual . For me, I am oral and from hearing background so I always prefer getting appropriate hearing device which is hearing aids in my case.. Some prefer peace of silence and I don't have any problems with them and their choice and respect them as well

 

[highlands]

It's really too bad you can't qualify for a CI in your country. I wouldn't qualify in your country either and your loss is worse than mine. Maybe in a few years doors will open for you. A few years ago they wouldn't have implanted me....

Thanks I'm currently sticking with my hearing aid .. The conditions I mentioned was of 2003 .. perhaps they were updated I don't know current ones.. Whatever, I'm planning to wait one or two years to see more advanced implants.

Boult, I'm not talking like DD.. I am speaking of the difference between 'natural' hearing and 'functional' hearing with help of HA or CI.. No one can claim that HAs or CIs can offer hearing with exactly the same way and complexity of natural hearing system.. So there will always be some 'gaps' between natural hearing and 'functional' hearing and this leads to being hard of hearing ! This difference may be extremely small and invisible in daily life but the difference never disappears. of course, a person with CI can function in hearing world perfectly but this doesn't make the person have natural hearing.. and I alywas prefer using hearing devices as much as I can.

 

[Cousin Vinny]

Focus should be on making sure Lotte is understand. (And this is being done..)

Just curious; How is this being done? In the home or in the classroom, or both?

BUT, the focus is only on that. Sign. WE, Lotte's parents, do not have a need for that. Lotte does not use it any more.

I beg to differ. You may not need it, but your daughter certainly needs it. (If not now, but in the future.) I realize that you've essentially made up your mind on this subject, and only your daughter, when she gets older, can validate your decision on whether to use sign language. I understand that it's still a sensitive subject, I won't go any further, except to show disappointment.

We need information in speech and language development. How does it work. What are the milestones... What to look for, how to play, what to do, what NOT to do.

If I may suggest, focus on language development. Too much emphasis has been placed on speech or listening comphrehension. If you still insist on pursuing on a course of AV therapy, there's plenty of information out there. (Googling AV Therapy comes up with 1.9 million results!)

Have you ever looked into the possibility of using a Cued language approach with your daughter? If you're not willing to consider sign language, please at least explore Cued language and how you can use it in daily life with your daughter, building up her language through passive learning.

Again, I wish the very best for you and your daughter. Nothing would make me more happier to find out your daughter is doing very well in her native language, even if she never learns sign language.

 

[Cloggy]

Just curious; How is this being done? In the home or in the classroom, or both?I beg to differ. You may not need it, but your daughter certainly needs it. (If not now, but in the future.) I realize that you've essentially made up your mind on this subject, and only your daughter, when she gets older, can validate your decision on whether to use sign language. I understand that it's still a sensitive subject, I won't go any further, except to show disappointment.If I may suggest, focus on language development. Too much emphasis has been placed on speech or listening comphrehension. If you still insist on pursuing on a course of AV therapy, there's plenty of information out there. (Googling AV Therapy comes up with 1.9 million results!)

Have you ever looked into the possibility of using a Cued language approach with your daughter? If you're not willing to consider sign language, please at least explore Cued language and how you can use it in daily life with your daughter, building up her language through passive learning.

Again, I wish the very best for you and your daughter. Nothing would make me more happier to find out your daughter is doing very well in her native language, even if she never learns sign language.

Thanks for your post.

To rectify something. We have used sign and in some situations still do. Lotte also used sign, but inthe last year has used it less and now hardly ever uses it.
Another thing, she learns two languages now. Dutch at home and Norwegian in the kindergarden. (and at home when we have norwegians around)

Sign will allway be a possibility. But NOW, when the support comes ONLY in the form of courses for sign, it is not effective..
OUr child learns language. This should be the focus.

 

[Hear Again]

CIs provide "electronic" or "artificial" hearing -- they do not allow one to hear naturally.

CI users are considered hard of hearing because CIs do not restore hearing to normal. For example, even though I hear at 20-30 dB across all frequencies with my CIs, there are times I still have difficulty hearing in noise and require the use of an FM system.

Last weekend I attended an anniversary party for our local deafblind center. Since a majority of people were hard of hearing, this caused people to shout at each other making it extremely difficult to hear above the noise. The shouted speech also caused distortion in what I was able to hear with my CIs. So...although my audiogram indicates that I hear normally at some frequencies and have a mild loss in others, I'm still considered hard of hearing when wearing my CIs.

 

[jillio]

Just curious; How is this being done? In the home or in the classroom, or both?I beg to differ. You may not need it, but your daughter certainly needs it. (If not now, but in the future.) I realize that you've essentially made up your mind on this subject, and only your daughter, when she gets older, can validate your decision on whether to use sign language. I understand that it's still a sensitive subject, I won't go any further, except to show disappointment.If I may suggest, focus on language development. Too much emphasis has been placed on speech or listening comphrehension. If you still insist on pursuing on a course of AV therapy, there's plenty of information out there. (Googling AV Therapy comes up with 1.9 million results!)

Have you ever looked into the possibility of using a Cued language approach with your daughter? If you're not willing to consider sign language, please at least explore Cued language and how you can use it in daily life with your daughter, building up her language through passive learning.

Again, I wish the very best for you and your daughter. Nothing would make me more happier to find out your daughter is doing very well in her native language, even if she never learns sign language.

 

[Cloggy]

CIs provide "electronic" or "artificial" hearing -- they do not allow one to hear naturally.

CI users are considered hard of hearing because CIs do not restore hearing to normal. For example, even though I hear at 20-30 dB across all frequencies with my CIs, there are times I still have difficulty hearing in noise and require the use of an FM system.

Last weekend I attended an anniversary party for our local deafblind center. Since a majority of people were hard of hearing, this caused people to shout at each other making it extremely difficult to hear above the noise. The shouted speech also caused distortion in what I was able to hear with my CIs. So...although my audiogram indicates that I hear normally at some frequencies and have a mild loss in others, I'm still considered hard of hearing when wearing my CIs.

I realise that, but I am brainstorming about the "new" generation children that start off with CI very early....

 

[Hear Again]

I realise that, but I am brainstorming about the "new" generation children that start off with CI very early....

Other than what I've posted above, I can't add anything more to the discussion. Sorry.

 

[deafdyke]

This difference may be extremely small and invisible in daily life but the difference never disappears. of course, a person with CI can function in hearing world perfectly but this doesn't make the person have natural hearing..

That's really what I've been trying to articulate this whole time! I'm not anti CI at ALL. Why does everyone keep attacking me? You'd think I was one of those extremists who are anti oral skills and anti CI.
Cloggy, are there oral deaf programs where you live? It's quite common for oral deaf kids to have expressive language or pragmatic (social) language delays. Definitly continue with the mainstream program, but maybe see if there are any oral deaf or even Deaf academic programs. Also, even for those who are "oral sucesses" Sign and Deaf culture can be a really good social resource. Cued Speech can also be helpful.
Also Cloggy, you're right. There are many kids out there who get a lot of good benifit from hearing aids or CIs, but who still have a significent language delay. That's a disorder called apraxia, and it's VERY common in dhh kids. I even know of kids with UNILATERAL loss, who have signficient language delays. I think actually, that maybe you could go have Lotte see an Occupantional Therapist who is experianced with kids with apraxia. It might really help her expressive language along.

 

[sr171soars]

...

Last weekend I attended an anniversary party for our local deafblind center. Since a majority of people were hard of hearing, this caused people to shout at each other making it extremely difficult to hear above the noise. The shouted speech also caused distortion in what I was able to hear with my CIs. So...although my audiogram indicates that I hear normally at some frequencies and have a mild loss in others, I'm still considered hard of hearing when wearing my CIs.

I had to laugh at the scene as I could visualize how it must have been like. "Huh? Blah blah... WHAT? BLAH BLAH...SPEAK UP PLEASE!!! and on it goes..."

You're right that the louder it is the harder it is to hear as the CI has to deal with all that noise and still figure the speech components.

 

[Hear Again]

I had to laugh at the scene as I could visualize how it must have been like. "Huh? Blah blah... WHAT? BLAH BLAH...SPEAK UP PLEASE!!! and on it goes..."

You're right that the louder it is the harder it is to hear as the CI has to deal with all that noise and still figure the speech components.

That experience brought me back to my hearing aid days.

I'm glad you confirmed my experiences. I e-mailed my audi and told her what happened and she pretty much said the same thing.

By the way, when I mentioned the difficulty I was having hearing in noise to the person I was talking to, she laughed and said, "I know. Everyone is talking above each other so they can hear themselves over the noise."

I love my CIs, but when I came home later that day, I immediately took my processors off so I could enjoy a little peace and quiet.

 

[momtotoes]

I realise that, but I am brainstorming about the "new" generation children that start off with CI very early....

I get what you are trying to say, Cloggy.

I suppose I would, eh?

I believe the jury is still out on what is the best course of action for our children. Or what the proper "labeling" of our children should be. (Although I know we both hate labels)

I like to think that kids like Lotte and Erin (Toes) are blazing a trail of sorts.

"Early implantees of newer generation implants."

I keep looking for precedence to guide me in what I should be doing. And what I should be calling her situation. And most importantly, what I should be doing about her situation.

I have come to realize that we are just some of the parents figuring that out now for so many more children to come. Yes, there are 1,000s of kids like ours. But, that is not many, really.

What we do with our kids will start to set the standard. It is a scary thing, really. But it certainly is exciting!