Criteria for a CI candidate?

[shel90]

No, Boult! I was referring to your comment that we (older generation of "deaf kids") had early intervention. We did, but it was more "toddler EI" rather then VERY early intervention, from birth or as babies. I know that today EI starts almost instantaously........but infant EI for dhh kids was rare, problaly up til infant screening became common.........and infant screening hasn't been around all that long.

Yea, I agree about infant screening not being around that long. Matter of fact, it started in AZ when my daughter was born in 97. That's only 10 years. I dont know about other states...

 

[jillio]

I have been reading a lot about CIs, how they function, how they work for some AD members here, and the criteria of hearing loss required.

I dont know if this was brought up before but here goes....

At my work, we are seeing more and more deaf children with other disabilities like mental retardation, autism, and a few others recieving the CIs. Now get this, one summer I worked for a public school working with a few of my students in their home school and that school served mostly hearing children with moderate to severe needs such as mental retardation, wheelchair bound, and so many more. Anyways, I saw this one girl from another class who was pratically in a vegative state and in a wheelchair. She had a CI and I asked her teacher about it. She said the doctors told the parents that with the CI, it was one less disability to worry about. I was SHOCKED beyond belief! I asked the teacher if she got the CI in this condition and the teacher said yes and that the parents were hoping the CI would bring her a little bit from her current condition. I asked the teacher if it worked and she said that she had the CI for 2 years and saw no improvement in her cognitive abilities. I was so speechless but I have to remember that this teacher had no training in deaf education so I couldnt really rely on her word due to her lack of knowledge of CIs. The point is that this child whose congnitive abilities are so severely delayed that it is almost in the vegative state and yet, she recieved a CI? Why?

Now, we are seeing more students at my work with those kinds of disabilities with CIs or in the process of getting CIs.

When I was studying for my master's at Gallaudet, I was taught that one of the criteria to meet the candidancy was to have normal congnitive (geez I cant find the right word) abilities. Apparently, the criteria continues to change doesnt it?

Do u think it is worth all the time and money to put CIs on children with moderate to severe congnitive delays such as retardation and autism or should doctors and parents take the risks for hopes that the CI will help their child's severe conditions?

The situation you describe is tatamount to experimentation on human children. The doctors who implanted this child preyed on these parents for monetary gain. This is one of the most unethical situations I have ever heard of.

 

[jillio]

This child went to another school in a public mainstreamed program. It was a summer program at another school.

I never said they didnt deserve them. I was just shocked to see that since during my studies at grad school, we were taught about those criteria and one of them was that the child must be of normal functioning without any mental retardation, autism, and any mental illness so it stuck in my head. To see the opposite really was a shocker but not in a bad way. I havent seen any differences in our special needs students after they got their CIs but it is still too early. I was simply asking why did they change the criteria..maybe some new research that I missed or what?

It is still too early for me to form an opinion cuz I havent seen a case where the child with severe congnitive delays benefit from the CIs yet. U have so I guess if it does help migitate the other disabilities then go for it.

Exposure to oral language and sound through the CI are not going to do much to enhance the cognitive disabilities in someone so severely impaired. It is not really a matter of whether they "deserve" to be implanted or not, but a matter of whether undergoing surgery (especially the risks of surgery with general anesthesia) is going to provide any measurable benefit to the child (or adult under a guardian's care).

 

[jillio]

I wouldn't implant a child with severe brain damage. I think that would be cruel. Particularly not an Autistic child as Autism generally makes you sound phobic. At least it does with me and I only suffer from mild asperger syndrome.

I have a nightmare sometimes when I turn into a cabbage and I get stuck with a CI. It scares me. If I had a stroke and lost all ability to communicate. How would anyone know how much I hate noise?

I agree with you dreama. Autism has many, many more neurological implications than hearing loss. Treating the hearing loss with a CI may well lead to a greater withdrawal from the environment because of a reduced tolerance to sound.

 

[jillio]

Autism covers a pretty wide spectrum, and many auties aren't overstimulated just by sound. And as far as judging whether an individual would benefit from sound based on whether or not they interact with you in a way that you expect (as opposed to seeming withdrawn, for instance), well, I think that judgment is being made from a very neurotypical perspective.

Anecdote: I have one autistic friend who finds loud noises somewhat distressing, and it irritates the heck out of him that this is the case. At the same time, though, he chooses to wear hearing aids, simply because they let him control how much sound he gets. (I think he has a mild hearing loss, so the aids give him a little bit of amplification, but most of it is filtering and compression.) He says communicating with speech is much harder for him without the aids, his audiogram notwithstanding, because there's just too much coming in without them.

While it is true that there is a diagnostic category known as autistic spectum disorders that include all of the various levels of severity and impairment, all do have certain features in common in order to classify them as one of the spectrum disorders. Sensory integration problems is one of the criteria.

 

[jillio]

When my daughter was born she was crying very loudly and when the nurses put her on the heat lamp table I said her name and she immediately became quiet, as my voice evidently was soothing to her.

When Drew was born he was not crying as much, but when the nurses put him on the heat lamp table I said his name and got no reaction. I thought it was a bit strange because my voice had such a clear effect on my daughter.

Of course, we later found out why Drew was not responding, he had never heard my voice in the womb, and was not hearing it then either.

Did it ever occur to you that your son,could have been responding to any one of a number of stimuli that he found unpleasant, and that his cries were a resopnse, rather than a lack of response? And for that matter, your daughter could have been responding to the heat from the lamp as much as to your voice.

 

[dreama]

I understand. I was just saying that that the comment "why bother" was a little harsh. I just wanted to throw my opinion into the conversation. I know what sensory overload does to a child. I have a preemie. She has LOTS of sensory issues. I am very sympathetic to anyone that has to endure multiple issues(for lack of a better word). I know how hard it is to try to make her life as trauma free as possible. Not calling anyone out at all. Sorry if it seemed that way.

I don't think "Why bother". I'm sure severely disabled deaf with learning difficulties/Autism need as much support as anyone else in learning to sign and even read if their learning difficulties are not too severe. I just think this can be achieved WITHOUT CI's. It's just that if a child is likely to suffer from sensory overload (and I've read that many Autistic do) then the last thing they need is to be faced with more noise.

 

[dreama]

I agree with you dreama. Autism has many, many more neurological implications than hearing loss. Treating the hearing loss with a CI may well lead to a greater withdrawal from the environment because of a reduced tolerance to sound.