Cochlear decison

[jillio]

An additional study published in same edition of the Journal of the American Medical Assoc. reported:

[I]Support for early implantation, however, must be tempered until sufficient longitudinal data are available. Behavioral studies supporting CI primarily use retrospective and case-series designs11 and variance in observed results is notoriously high.3–7 As a consequence, criteria remain unspecified regarding the timing of CI, especially those concerning the level of hearing loss and the associated delays in verbal language that should prompt CI.[/I]

Bolding is the poster's.

 

[Mountain Man]

She has 2 CIs through which she has full access to speech sounds at the levels of a typical hearing child...

That is physically impossible. Cochlear implants do not come even close to providing the same fidelity as natural hearing.

This is another example of those in favor of cochlear implants providing misleading or outright false information. But when I say that children with cochlear implants generally need years of intensive speech therapy, which any reputable audiologist will agree with and even Cochlear Americas says as much in their promotional literature, I'm accused of using "scare tactics". If telling the truth is a scare tactic then I can only assume that some here are afraid of the truth.

...and we found that from the start -- her CI was activated shortly before she turned 2 -- she began naturally acquiring English from her environment...

Again, this is far from typical for a child with cochlear implants, and parents considering having their child implanted should not expect this kind of apparently effortless success. In fact, they should expect the exact opposite: hard work and slow acquisition of auditory language skills.

 

[GrendelQ]

That is physically impossible. Cochlear implants do not come even close to providing the same fidelity as natural hearing.

This is another example of those in favor of cochlear implants providing misleading or outright false information. But when I say that children with cochlear implants generally need years of intensive speech therapy, which any reputable audiologist will agree with and even Cochlear Americas says as much in their promotional literature, I'm accused of using "scare tactics".



Again, this is far from typical for a child with cochlear implants, and parents considering having their child implanted should not expect this kind of apparently effortless success. In fact, they should expect the exact opposite: hard work and slow acquisition of auditory language skills.

Wow, you are objecting to the veracity of my child's audiogram and comprehension testing? She doesn't have the same hearing experience as a hearing child, but it's actually quite common for children implanted early these days to have access to sound at the same levels as a typical hearing child. Combining that level of access -- in which the child isn't struggling to listen to the sounds around him -- with immersion in the language during that early critical window can make acquiring the language as effortless (as you put it) as it is for a typical hearing child. Although, no, it's not truly effortless for either hearing or deaf child.

I'm providing a real example of a real child's experience. As have the others here. I don't know why you keep dismissing these experiences as atypical. Everyone's experience is going to be very different. For some it will be difficult: Faire Jour has described a situation in which her child was much older before getting an implant: at 5, I think. CoolGirlSpyer has written about her need for speech therapy throughout her childhood, both with her HAs, and continuing after getting her implant at 9 or so. I know several children with CIs implanted younger than my child who went through a brief period of learning to listen therapy once or twice a week, but have no formal "speech therapies" and from interacting with them, I wouldn't notice any need for additional training or therapy, and they are just starting kindergarten.

You mention that you have your children in speech therapy, so apparently you don't think of it as a torturous experience if you are choosing it. I don't think it has to be, either. My child is not in some kind of intensive speech therapy program, but in your focus on bashing CIs, are you missing the important fact that she is at a school for the deaf where she's taught as a deaf child in a class of 5 children with cochlear implants and two teachers? There may come a point when we feel there's more need for guidance than she gets in her regular classroom environment or at home. While some might not notice, I can tell her speaking is impacted, whether by the delay in exposing her to English, her academic environment (which is predominantly voices-off and has relatively few language models), or some other factor. But she's deaf, and we don't expect or require her to speak or hear in the same way a typical hearing child does, and she's in an environment and at an age where what she says is more important than how she says it. We're putting our efforts into developing two languages right now. Any mechanics that aren't organically developed in this process now can be addressed as we identify them later. Everything we've noticed so far has worked itself out as she's advanced in her use of language and with adjustments to her mappings (swapping Rs for Ls initially, Ks for Bs, general 'mushiness' at times), and we'll keep watching for anything that pops up.

 

[shushugah]

That is physically impossible. Cochlear implants do not come even close to providing the same fidelity as natural hearing.

This is another example of those in favor of cochlear implants providing misleading or outright false information. But when I say that children with cochlear implants generally need years of intensive speech therapy, which any reputable audiologist will agree with and even Cochlear Americas says as much in their promotional literature, I'm accused of using "scare tactics". If telling the truth is a scare tactic then I can only assume that some here are afraid of the truth.



Again, this is far from typical for a child with cochlear implants, and parents considering having their child implanted should not expect this kind of apparently effortless success. In fact, they should expect the exact opposite: hard work and slow acquisition of auditory language skills.

I have one cochlear implant, and I can say my hearing is extremely good and even better than some of my peers. I have a very easy time listening in class, however I do not think it's the case for all CI users. It also depends on the company I suppose. For what it's worth, I use Advance Bionics. I agree it's not automatic, and it most certainly DOES require significant amount of effort and speech therapy if that's what you want.

 

[Mountain Man]

Wow, you are objecting to the veracity of my child's audiogram and comprehension testing?

No, I am objecting to your claim that she has the hearing of a typical hearing child when this is literally and unequivocally impossible. State of the art cochlear implants only have 24 electrodes versus the 16,000 hair cells that exist in a healthy cochlea. Thus, it is literally physically impossible for cochlear implants to provide anything even approaching the fidelity of natural hearing. This is indisputable. If someone is telling you otherwise then either they are grossly misinformed, or they're deliberately feeding you false information.

Although, no, it's not truly effortless for either hearing or deaf child.

Wrong again. Language acquisition is effortless provided there are no barriers to access. Read some of the landmark linguistic research conducted by Noam Chomsky. It is so effortless, in fact, that short of placing the child in complete isolation, it is impossible for a typical child to not acquire language.

I'm providing a real example of a real child's experience.

You're providing a real example of a distinctly atypical experience. Anybody considering cochlear implants for their child should not count on winning the "cochlear implant lottery" the way your family apparently did. Research shows that the typical implanted child struggles for years to keep up with their hearing peers (see the two studies cited by Jillio). Again, this is indisputable.

You mention that you have your children in speech therapy, so apparently you don't think of it as a torturous experience if you are choosing it.

Whatever gave you the idea I considered it tortuous? But you unwittingly bring up a point in my favor: the only reason my children are in speech therapy is because there were barriers preventing them from fully utilizing spoken language -- and in this particular case, the problem is articulation and not reception. Typical hearing children don't need any speech therapy at all. So if the audiological community says that the typical child with cochlear implants needs "years of intensive speech therapy" (their wording, not mine), what does that tell you about their ability to access auditory language?

...in your focus on bashing CIs...

Nobody here is "bashing CIs". I'm simply stating facts. That you consider this a bad thing says quite a lot about you.

 

[shushugah]

(swapping Rs for Ls initially, Ks for Bs, general 'mushiness' at times), and we'll keep watching for anything that pops up.

That's because she's chinese,

 

[shushugah]

I honestly have hard time accepting many of these Medical studies, regardless whether they support or are against me, because Deafness is very controversial unfortunately, for many parents, and so there is going to be a huge slant in the statistics (I still think they're the best we can get). Deafness is also commonly related in addition to other disabilities, particularly learning disabilities, and that totally changes the parameters of education and support needed, but does that necessarily reflect fairly on the CI itself?

I realize this is not a scientific or medical way of approaching my wariness to these medical studies, :P so please discuss as well.

I have easier time, using personal testimonies from my friends, which gives me a better sampling and understanding of how deafness and CI's interact with everyday life.

 

[GrendelQ]

That's because she's chinese,

 

[jillio]

No, I am objecting to your claim that she has the hearing of a typical hearing child when this is literally and unequivocally impossible. State of the art cochlear implants only have 24 electrodes versus the 16,000 hair cells that exist in a healthy cochlea. Thus, it is literally physically impossible for cochlear implants to provide anything even approaching the fidelity of natural hearing. This is indisputable. If someone is telling you otherwise then either they are grossly misinformed, or they're deliberately feeding you false information.



Wrong again. Language acquisition is effortless provided there are no barriers to access. Read some of the landmark linguistic research conducted by Noam Chomsky. It is so effortless, in fact, that short of placing the child in complete isolation, it is impossible for a typical child to not acquire language.

You're providing a real example of a distinctly atypical experience. Anybody considering cochlear implants for their child should not count on winning the "cochlear implant lottery" the way your family apparently did. Research shows that the typical implanted child struggles for years to keep up with their hearing peers (see the two studies cited by Jillio). Again, this is indisputable.



Whatever gave you the idea I considered it tortuous? But you unwittingly bring up a point in my favor: the only reason my children are in speech therapy is because there were barriers preventing them from fully utilizing spoken language -- and in this particular case, the problem is articulation and not reception. Typical hearing children don't need any speech therapy at all. So if the audiological community says that the typical child with cochlear implants needs "years of intensive speech therapy" (their wording, not mine), what does that tell you about their ability to access auditory language?



Nobody here is "bashing CIs". I'm simply stating facts. That you consider this a bad thing says quite a lot about you.

Exactly. You cannot prevent a child from acquiring, through passive learning processes, language that they are exposed to. This is a linguisitic and developmental fact. It is truly a shame that so many fail to realize it. We don't have to engage in directive excercise to teach a hearing child spoken language, and we do not have to engage in directive exercise to teach a deaf child ASL. They naturally acquire it. The only time that we must engage in these directive measures is when a chiild has been prevented from having natural exposure to language. Then we have to remediate and teach what should be acquired. And there is a huge difference between the terms "teach and learn" and "acquire". People fail to take notice of that, as well.

 

[jillio]

I honestly have hard time accepting many of these Medical studies, regardless whether they support or are against me, because Deafness is very controversial unfortunately, for many parents, and so there is going to be a huge slant in the statistics (I still think they're the best we can get). Deafness is also commonly related in addition to other disabilities, particularly learning disabilities, and that totally changes the parameters of education and support needed, but does that necessarily reflect fairly on the CI itself?

I realize this is not a scientific or medical way of approaching my wariness to these medical studies, :P so please discuss as well.

I have easier time, using personal testimonies from my friends, which gives me a better sampling and understanding of how deafness and CI's interact with everyday life.

Actually, comorbidity of deafness and other disabilities is relatively low. The vast majority of deaf students do not suffer any other cognitive disability that interferes with their ability to perform academically.

You can rely on anecdote if you so choose, but that is a fairly ineffective and unrealistic way to determine realistic benefits and expectations. And you do realize, don't you, that the data that is produced comes from people like your friends. It simply removes personal bias and give accurate data.

Anecdotal stories from friends is the least reliable form of information and is not generalizable beyond that one single individual. Just as Grendel's stories about her daughter apply to no other individual save her daughter. Studies done empirically are generalizable to the general population of deaf children falling within that populations sampling parameters. So which is more valuable in determining the most probable outcomes? Why, the empirical, generalizable studies, of course. To imply that anecdote is more accurate and valuable in determining probable outcomes is just downright naive.

 

[Beowulf]

Actually, comorbidity of deafness and other disabilities is relatively low. The vast majority of deaf students do not suffer any other cognitive disability that interferes with their ability to perform academically.

You can rely on anecdote if you so choose, but that is a fairly ineffective and unrealistic way to determine realistic benefits and expectations. And you do realize, don't you, that the data that is produced comes from people like your friends. It simply removes personal bias and give accurate data.

Anecdotal stories from friends is the least reliable form of information and is not generalizable beyond that one single individual.

I am aware that anecdotal stores from friends of friends are the least reliable. When I am in a group of deafies that are discussing CI's among children of friends, I am still struck by how little difference the CI makes in speech abilities, as compared to those with hearing aids (or even none). There MUST be some truth to it, or they wouldn't be discussing it. I do not know the deaf community to be a bunch of liars.

 

[jillio]

I am aware that anecdotal stores from friends of friends are the least reliable. When I am in a group of deafies that are discussing CI's among children of friends, I am still struck by how little difference the CI makes in speech abilities, as compared to those with hearing aids (or even none). There MUST be some truth to it, or they wouldn't be discussing it. I do not know the deaf community to be a bunch of liars.

The deaf community, in general, is brutally honest. That is why so many hearing take offense at what they have to say.

The type of anecdote that is the least reliable is that which contains inherent bias, such as the report from a parent regarding a child's performance. Everyone thinks their child is a genius, and performing in the 99th percentile. But the factual perspective is that very, very few children will actually prove to have genius level IQ and only 2% of all children perform in the 99th percentile. The laws of probablity say that my child, or anyone else's child, is more likely not to be a genius or to perform in a manner so far outside the norm than they are to be in that very small group. This is particularly so if that child has suffered any form of deprivation in their infancy.

 

[Beowulf]

The deaf community, in general, is brutally honest. That is why so many hearing take offense at what they have to say.

The type of anecdote that is the least reliable is that which contains inherent bias, such as the report from a parent regarding a child's performance. Everyone thinks their child is a genius, and performing in the 99th percentile. But the factual perspective is that very, very few children will actually prove to have genius level IQ and only 2% of all children perform in the 99th percentile. The laws of probablity say that my child, or anyone else's child, is more likely not to be a genius or to perform in a manner so far outside the norm than they are to be in that very small group. This is particularly so if that child has suffered any form of deprivation in their infancy.

Yeah, if we can can get certain parents to argue among themselves on whose child has more genius, we could catch a break.

 

[jillio]

Yeah, if we can can get certain parents to argue among themselves on whose child has more genius, we could catch a break.

I think there is a CI forum especially for that. Maybe the competition is too stiff over there.

 

[GrendelQ]

@ MountainMan, I don't understand why you are bashing an option you don't know and a valid experience. I've had the experience of both HAs and CIs with my daughter. I'm not speaking to the HA option because our experience is very limited compared to others here, they simply didn't work for my child's level of hearing loss. I can speak about our decision to get CIs, and share my child's outcomes and experiences. I'm not telling the OP what to do -- CIs are most certainly not right for every child -- and I made that very clear in my first post.

I think it would be valuable for the OP to hear from you about your own child's experience (with HAs?) and whatever your academic placement is, rather than hear your arguments against our experience and to see people mocking deaf children's abilities, whatever they may be.

But please read more carefully before accusing me of claiming my daughter has the hearing of a typical hearing child. She is deaf. I said she has access to sound at the same level -- that's something that can be measured and is a fact. It doesn't mean she hears just like you do or processes that sound like you do. But it does mean she hears all the sounds that you do, likely many more. And that's important, it means she doesn't have that barrier you refer to.

 

[AlleyCat]

How totally unbelievably ironic this thread has turned into.

 

[Mountain Man]

I don't understand why you are bashing an option you don't know and a valid experience.

I don't understand why you think I'm bashing anything when all I'm doing is stating facts. Why do you find this so distasteful?

...she hears all the sounds that you do, likely many more.

Again, no. This is a physical impossibility. 24 electrodes verses 16,000 hair cells. It's simply no contest in favor of natural hearing. If someone is telling you that she has access to the full range of sounds like a typical hearing person then they're not being honest with you. I'm sorry if that's hard for you to hear, but it's the truth.

...she doesn't have that barrier you refer to.

If her language acquisition has really developed as effortlessly as you claim then she's 1 in a million. The vast majority of children with implants do not enjoy that kind of incredible success and find the road much more difficult. Again, I'm sorry if that's hard for you to hear, but it's the truth.

 

[Mountain Man]

Here's a simulation of what cochlear implants sound like:

Cochlear Implant Simulations

Please tell me that even the 32 channel sample (pretty much state of the art for current CI technology) is as good as natural hearing.

 

[Beach girl]

So, Mountain Man, what do you do with your kid(s)? What is their hearing loss, what do they use, how well are they learning language and their other school subjects?

That might be useful for someone to know if they are deciding between CIs, HAs, nothing at all and using ASL-only, or whatever combination.

 

[Banjo]

Again, no. This is a physical impossibility. 24 electrodes verses 16,000 hair cells. It's simply no contest in favor of natural hearing. If someone is telling you that she has access to the full range of sounds like a typical hearing person then they're not being honest with you. I'm sorry if that's hard for you to hear, but it's the truth.

Rush Limbaugh (Yes, I know he's a blowhard jerk) once described that music didn't hear the same to him after getting a cochlear implant. He said that he could only enjoy listening to the songs he listened to before he went deaf. The interesting part is, the only way to enjoy these songs was to recall the way they heard while listening.

Basically, it confirms what you said. It's a physical impossibility.