How to Decide on Cochlear Implant Surgery for Children

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jillio said:
They're available. Inf act, links and citations to many more than that have been posted here ad nausium.
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Honestly, you have said that here many times, but I am unable to find these posts. Is there any way that you could post them again. Perhaps some got lost with the server crash.
 
Ah, therein lies the rub. A) discrimination testing is done in a controlled environment and cannot be extrapolated to a real world environment. and B) doing the testing does not mean that the parents have been given an understandable explanation of the differences or the impact of such. And the perceptions of the general public are even more easily distorted

And how do you suggest that we do our "testing"? If not a controlled environment. If you have no basis to measure too? I do agree that there is a vast difference from the controlled environment and the real world but just for that reason we need the controlled environment as a basis. something to be able to measure. Sound is measured in DB and we have a basis to start with. Even with "normal" hearing people hear at different levels of sound. It is measurable because we have a place to start from. Fortunately or unfortunately depending on your view point I guess, we do live in a world of hearing people and it's a proven fact, right or wrong, that people with hearing disabilities are not on the average, able to do as well or actually are not treated the same way as hearing people. There are a lot of jobs that are closed to non hearing people and of course there are some jobs that are closed to hearing people but on a percentage bases, hearing wins out head over heals. That is Fact, unfortunate or not. We are learning all the time and while we probably will never achieve perfect "normal" hearing, as time and research advance we are and will do better and more. ASL is another language and great for those that can and want to learn it. However, we are talking about communication and for that reason alone Spanish or French are most often taught because of numbers to communicate with. Sure does not help the deaf community and with the music and noise around us all the time the deaf community is growing. Maybe some day it will be large enough that most/many people will all learn it but I don't see that happening. Again its numbers just like money or anything else. Size/numbers matters.
 
Rampratt said:
Ah, therein lies the rub. A) discrimination testing is done in a controlled environment and cannot be extrapolated to a real world environment. and B) doing the testing does not mean that the parents have been given an understandable explanation of the differences or the impact of such. And the perceptions of the general public are even more easily distorted

And how do you suggest that we do our "testing"? If not a controlled environment. If you have no basis to measure too? I do agree that there is a vast difference from the controlled environment and the real world but just for that reason we need the controlled environment as a basis. something to be able to measure. Sound is measured in DB and we have a basis to start with. Even with "normal" hearing people hear at different levels of sound. It is measurable because we have a place to start from. Fortunately or unfortunately depending on your view point I guess, we do live in a world of hearing people and it's a proven fact, right or wrong, that people with hearing disabilities are not on the average, able to do as well or actually are not treated the same way as hearing people. There are a lot of jobs that are closed to non hearing people and of course there are some jobs that are closed to hearing people but on a percentage bases, hearing wins out head over heals. That is Fact, unfortunate or not. We are learning all the time and while we probably will never achieve perfect "normal" hearing, as time and research advance we are and will do better and more. ASL is another language and great for those that can and want to learn it. However, we are talking about communication and for that reason alone Spanish or French are most often taught because of numbers to communicate with. Sure does not help the deaf community and with the music and noise around us all the time the deaf community is growing. Maybe some day it will be large enough that most/many people will all learn it but I don't see that happening. Again its numbers just like money or anything else. Size/numbers matters.
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You misunderstand. I am not suggesting that testing methods be altered. I am suggesting that you provide parents with the applicable results as they apply to real world situations. In other words, provide all the information. Tell them, "Yes, little Johnny can discriminate 57% in a controlled environment, but you must also understand that in an actual classroom situation, with all of the variables, that 56% will drop to what could be less than 20%." Be honest. That is what I am suggesting.
 
faire_jour said:
Honestly, you have said that here many times, but I am unable to find these posts. Is there any way that you could post them again. Perhaps some got lost with the server crash.
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Do you realize what you are asking me to do? You are asking me to go back and dig through more than 15 years worth of research, pull the article, quote the article, and cite the article. And for what? If people did not take advantage of that information being provided the first time around, why should I even expect that they will take advantage of it the 5th or 6th time it is posted?

But, when I have time, I will find some of what you are asking for. Please, however, this time, make use of it. I do not react well when people ask for information, and then fail to access it. It is too time consuming a task.
 
jillio said:
You misunderstand. I am not suggesting that testing methods be altered. I am suggesting that you provide parents with the applicable results as they apply to real world situations. In other words, provide all the information. Tell them, "Yes, little Johnny can discriminate 57% in a controlled environment, but you must also understand that in an actual classroom situation, with all of the variables, that 56% will drop to what could be less than 20%." Be honest. That is what I am suggesting.
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That is why audiologists also do testing in real enviroments as well. Our school audiologist comes into the classroom and does testing (with and without the FM). I suppose I could ask her to go to the cafeteria and do testing too.

(Oh, and 56%? That is terrible discrim. If that child is in an oral classroom the family needs to investigate an increase in amplification, a CI or they need to add visual communication. 56% is a joke.)
 
jillio said:
Do you realize what you are asking me to do? You are asking me to go back and dig through more than 15 years worth of research, pull the article, quote the article, and cite the article. And for what? If people did not take advantage of that information being provided the first time around, why should I even expect that they will take advantage of it the 5th or 6th time it is posted?

But, when I have time, I will find some of what you are asking for. Please, however, this time, make use of it. I do not react well when people ask for information, and then fail to access it. It is too time consuming a task.
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I don't want 15 years of research, just something in the last year or two. And again, it doesn't have to be much, just a couple studies that say that most kids don't get spoken language discrimination from implants.

I understand that perhaps other people have not accessed this information in the past, but I have never had the opportunity to try. I have been on this site for about two years and I have not seen any information like that posted.
 
faire_jour said:
That is why audiologists also do testing in real enviroments as well. Our school audiologist comes into the classroom and does testing (with and without the FM). I suppose I could ask her to go to the cafeteria and do testing too.

(Oh, and 56%? That is terrible discrim. If that child is in an oral classroom the family needs to investigate an increase in amplification, a CI or they need to add visual communication. 56% is a joke.)
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Again, that is a controlled environment, even when in the classroom. The very fact that the testing is occurring leads to the environment being controlled.:roll:

Who said anything about where that child was placed? You do understand hypothetical, don't you? Those were random numbers used as an example.:roll:

And 56% is as good as it gets for some. I'm glad to see you think that the individual who is only capable of discriminating 56% is such a joke, but kids that are unable to discriminate any more than that are placed in oral classrooms and mainstream classrooms on a daily basis.
 
faire_jour said:
I don't want 15 years of research, just something in the last year or two. And again, it doesn't have to be much, just a couple studies that say that most kids don't get spoken language discrimination from implants.

I understand that perhaps other people have not accessed this information in the past, but I have never had the opportunity to try. I have been on this site for about two years and I have not seen any information like that posted.
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Do you want something that says most kids don't get any spoken language at all....because I have never seen anyone claim that. Or do you want the applicable research that indicates that even with the amount of spoken language a child can get, those that are the highest functioning academically and socially are those that are given the advantage of sign along with speech, and those with the most difficulties academically and socially are those that are restricted to an oral only environment.

You need to start putting the word,"usable" in front of speech. The way you continue to phrase, it would appear that you believe that just noise is a benefit.
 
jillio said:
Do you want something that says most kids don't get any spoken language at all....because I have never seen anyone claim that. Or do you want the applicable research that indicates that even with the amount of spoken language a child can get, those that are the highest functioning academically and socially are those that are given the advantage of sign along with speech, and those with the most difficulties academically and socially are those that are restricted to an oral only environment.

You need to start putting the word,"usable" in front of speech. The way you continue to phrase, it would appear that you believe that just noise is a benefit.
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This is the quote that I would like to see research to back up:

"Are you saying that there are not tens of thousands who have not been able to achieve the level of benefit he claims his daughter has?"

The ability that Rick's daughter has is to hear and understand spoken language. So, is there research that shows that tens of thosands of children are unable to understand spoken language using their CI's?

Also, you claimed that her experience was not the "norm". Is there research that shows that as well? That the average person implanted at around her age (2ish, I believe) does not receive the same benefits that she does?
 
Rampratt said:
Ah, therein lies the rub. A) discrimination testing is done in a controlled environment and cannot be extrapolated to a real world environment. and B) doing the testing does not mean that the parents have been given an understandable explanation of the differences or the impact of such. And the perceptions of the general public are even more easily distorted

And how do you suggest that we do our "testing"? If not a controlled environment. If you have no basis to measure too? I do agree that there is a vast difference from the controlled environment and the real world but just for that reason we need the controlled environment as a basis. something to be able to measure. Sound is measured in DB and we have a basis to start with. Even with "normal" hearing people hear at different levels of sound. It is measurable because we have a place to start from. Fortunately or unfortunately depending on your view point I guess, we do live in a world of hearing people and it's a proven fact, right or wrong, that people with hearing disabilities are not on the average, able to do as well or actually are not treated the same way as hearing people. There are a lot of jobs that are closed to non hearing people and of course there are some jobs that are closed to hearing people but on a percentage bases, hearing wins out head over heals. That is Fact, unfortunate or not. We are learning all the time and while we probably will never achieve perfect "normal" hearing, as time and research advance we are and will do better and more. ASL is another language and great for those that can and want to learn it. However, we are talking about communication and for that reason alone Spanish or French are most often taught because of numbers to communicate with. Sure does not help the deaf community and with the music and noise around us all the time the deaf community is growing. Maybe some day it will be large enough that most/many people will all learn it but I don't see that happening. Again its numbers just like money or anything else. Size/numbers matters.
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Are you late deafened?
 
jillio said:
Again, that is a controlled environment, even when in the classroom. The very fact that the testing is occurring leads to the environment being controlled.:roll:

Who said anything about where that child was placed? You do understand hypothetical, don't you? Those were random numbers used as an example.:roll:

And 56% is as good as it gets for some. I'm glad to see you think that the individual who is only capable of discriminating 56% is such a joke, but kids that are unable to discriminate any more than that are placed in oral classrooms and mainstream classrooms on a daily basis.
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I was saying that no child who discriminates at 56% should be placed in an oral only enviroment. It is ridiculous. The child who be completely unable to access the curriculum. That would be irresponsible.
 
faire_jour said:
This is the quote that I would like to see research to back up:

"Are you saying that there are not tens of thousands who have not been able to achieve the level of benefit he claims his daughter has?"

The ability that Rick's daughter has is to hear and understand spoken language. So, is there research that shows that tens of thosands of children are unable to understand spoken language using their CI's?

Also, you claimed that her experience was not the "norm". Is there research that shows that as well? That the average person implanted at around her age (2ish, I believe) does not receive the same benefits that she does?
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Well, the research I just described most certainly backs that up. And it has been posted several times. And, if you want to do a comparison, then we must do an accurrate comparison. Rick claims that his daughter is able to hear and understand speech through her CI alone to the degree that she needs no visual input, needed no accommodation in school, and in effect, uses no accommodation in her daily communications. Do I say that there are tens of thousands that do not achieve that level of success? Of course I do. And so do the tens of thousands who are living with the implant that do not get that level of success. That level of success is not the norm.
 
faire_jour said:
I was saying that no child who discriminates at 56% should be placed in an oral only enviroment. It is ridiculous. The child who be completely unable to access the curriculum. That would be irresponsible.
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Preaching to the choir. Reality is that it happens. Some of them are CI users.
 
jillio said:
Well, the research I just described most certainly backs that up. And it has been posted several times. And, if you want to do a comparison, then we must do an accurrate comparison. Rick claims that his daughter is able to hear and understand speech through her CI alone to the degree that she needs no visual input, needed no accommodation in school, and in effect, uses no accommodation in her daily communications. Do I say that there are tens of thousands that do not achieve that level of success? Of course I do. And so do the tens of thousands who are living with the implant that do not get that level of success. That level of success is not the norm.
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Can I see that research? What does it say is the average outcome of a child implanted before, say age 2?
 
faire_jour said:
Can I see that research? What does it say is the average outcome of a child implanted before, say age 2?
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Sure you can see it. Check out Marc Marsharck in the Journal of Deaf Studies and Deaf Education.
 
faire_jour said:
Is that a particular book or a publication?
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The Journal of Deaf Studies and Deaf Education is an academic journal published by Oxford Press. Marc Marsharck is one of the best known researchers into deaf education and the learning process as applied to the deaf in the country.
 
jillio said:
The Journal of Deaf Studies and Deaf Education is an academic journal published by Oxford Press. Marc Marsharck is one of the best known researchers into deaf education and the learning process as applied to the deaf in the country.
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So, how, more specifically, can I find the information we were discussing? Since you have the studies, can you tell me how to access that information? A journal that has been published for many years is a lot of information to dig through. Can I have the title of the article you were referencing and the year it was published?
 
faire_jour said:
So, how, more specifically, can I find the information we were discussing? Since you have the studies, can you tell me how to access that information? A journal that has been published for many years is a lot of information to dig through. Can I have the title of the article you were referencing and the year it was published?
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Raising and Educating a Deaf Child: A Comprehensive Guide to the Choices, Controversies, and Decisions Faced by Parents and Educators by Marc Marschark
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This book keeps getting reissued and updated and contains a lot of that information.
 
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