A Family with Cochlear Implants and Cued Speech
http://www.cuedspeech.org/PDF/Winter2009_OnCue.pdf
Why does our family cue with our two preschool-age sons who use cochlear implants? We frequently field this question from both the general public and certain professionals who serve the deaf and hard of hearing. Those aware only of signed language as a visual communication option are trying to reconcile what seems to be a contradiction: we are “signing” to children that seem to hear just fine. Their question sometimes reflects nervousness, as they worry that they will be unable to communicate unless they can “do that hand thing” also. When asked by professionals of the auditory-oral or –verbal persuasion, the question is usually tinged with disappointment, as most of them regard anything visual in communication with the hard of hearing as a “crutch” that creates dependence. Both Cued Speech and cochlear implants are necessary to provide our children complete access to receptive and expressive spoken language: together they make every word count. We try to convey to the general public that Cued Speech, unlike American Sign Language, makes spoken language clear and completely accessible. (“It clarifies lipreading” is the one-liner that we usually say in the grocery store, etc., and is generally followed by a relieved expression on the part of the questioner who now feels that they can talk. The picture of spoken language that Cued Speech provides is the way to true independence in the hearing world. Using Cued Speech makes every word count by allowing us to maintain communication when the implant technology cannot be used and in difficult listening situations. We almost daily avert disasters in the bathtub (and other watery environments) with clear, fluent communication.
A dramatic example of the value of having a way to communicate visually came when we evacuated our home, which was in the path of a wildfire. We left the house with the clothes we had on our backs; the battery chargers had to be left behind. When the batteries died that evening, our deaf children calmed down immediately following our cued discussions of the strange surroundings and events.
Restaurants and other noisy surroundings do not give us concern that they will be left out of conversation. One of our favorite memories is that of a meal in a Greek restaurant packed with chatty diners. When we cued across the table to our 3-year-old that he was eating “laudia” (a dessert he was trying for the first time), he sternly informed us, repeating the word with perfect clarity, “It’s not laudia, it’s banana bread.”
But we not only cue in situations when the implant must be off or when we know it is a difficult listening environment. In fact, we not only cue directly to them, we try to cue everything we say—phone conversations, discussions between hearing family members—and we try to keep expanding our cueing skills. We are fighting for classroom transliterators and we persuade teachers to learn the system. Why would a family with so much to juggle make this a priority?
Cued Speech enables our children to make the most of their cochlear implants. They are enabled not only to respond to clear direct communication, but also to gain language through overhearing—the way children learn language best and the way technology has yet to truly succeed in making that accessible. Their brains are constantly triangulating sounds, especially speech that is not visually clarified, using context to fill in what was misheard or not heard. This process requires solid knowledge of the language being used.
For example, a cueing therapist was reading a book to one of the boys one day. While he gazed at the page, she said “Look, a zebra. Black and white stripes.” He repeated, “Glass and white?” When she had him look at her as she cued “Black and white,” he got it immediately, repeating “Black and white.” The next time he hears what seems to be “glass and white,” his brain will go through an unconscious process “this is what I heard, but we’re talking about colors, so it must be “black and white.” How much more important is it for a language learner to have clear access to vocabulary, syntax, and grammar?
One answer to that question came a few months ago during testing for our son who is preparing to enter school. The day after he had had auditory comprehension testing, on which he was correctly repeating back about 90 percent of the speech pathologist’s sentences, he had an audiogram. Despite pure-tone thresholds in the mild hearing loss range across all frequencies for both his implants, the audiologists’ speech perception testing revealed the true challenge our son is faced with when left to learn language through auditory means alone. He made numerous discrimination errors of the glass/black type, perceiving with complete clarity 70 percent, at best, of the words he heard. Our suspicion was confirmed: the input from cochlear implants alone is inadequate for complete, clear, facile language learning. How does he bridge the gap from 70 percent single-word perception to 90 percent correct sentence repetition? The solid knowledge of language he has gained through Cued Speech, on par with hearing children his age, allows him to use context to correctly fill in the unheard or misheard words in a sentence, which is why the general public does not have to do “that hand thing” in order to communicate. However, at home and in the classroom, those of us responsible for presenting spoken language must present it as clearly as we would to a child with full hearing. Cueing is the most natural way to do this for spoken language, the only way for the preliterate child.
Since cuers had good access to language long before cochlear implants were in the picture, how do the implants help make every word count? It still seems miraculous that our profoundly deaf child can holler from behind a closed door, “Go get my scissors!” and his brother with a severe hearing loss will answer, “OK, I’m going upstairs for scissors!”
There are times when we have to fall back on auditory-only means of communication. Sometimes directions (“Stop!”) must be given with utmost speed to allow bodily integrity to be maintained (“His fingers are in the door!”). Visual contact can be difficult to obtain or maintain with small people who are constantly on the go. At times it is difficult, if not impossible, for grownups to free a hand: southern California traffic can require two white-knuckled hands on the wheel. In those circumstances we are grateful for the ability to give verbal-only answers to questions. Then, too, humans have their limits: in our family, some are more conscientious cuers than others, but rather than create resentment by constantly badgering them to cue, we accept what they can do. Last, but not least, for those times when just finding the words to express a murky or tangled thought takes all our effort, we have the freedom to simply speak our mind and then clarify what we have said.
How has making every word count impacted our family? We do not have words to express how blessed we are. When we began this journey with hearing loss, our most challenging goal was to give all of our six children as normal a childhood as possible. For the hearing ones, that meant that the spoken language of our home should flow as naturally as before, but also that their own needs could be met even if it meant temporarily taking our focus off the language lessons that the Auditory-Verbal therapists wanted us to be immersed in. All of our children know that whatever family health, economic, or educational crisis arises, we can respond to them with the attention they need, knowing we are always providing clear language although it may take a month to complete a lesson that the therapist wanted done in a week. For our sons, the hearing that the cochlear implants provide has made speech and language therapy an eagerly anticipated event and a source of confidence instead of the dull, self-esteem eroding chore we were afraid it would become.
From time to time, we hear rumors to the effect that prestigious implanting institutions somehow don’t really believe in the efficacy of what they are doing. Legitimately concerned by implanted children’s sometimes less-than-optimal language and literacy results, they drag their feet with candidates, or outright refuse them. Others perform the surgery, but then recommend signed language as the primary mode of communication. How sad to think children are denied the power of technology because the tool that makes it truly useful is unknown, ignored, or discounted. For us, the bridge of technology rests on the pillars of language clarity and completeness provided by Cued Speech. On this structure, our family has the freedom to traverse the chasm of inadequate communication with confidence that we can make every word count.
Alan Beveridge (Marcia Beveridge)
http://www.cuedspeech.org/PDF/Winter2009_OnCue.pdf