Why - Why the Medical Society constantly pressure on the Parents?

[jillio]

Sure.. sure.. everyone that disagree with you are wrong and do not know anything. Let's talk a bit more about your childhood. Comfortable in that couch?

 

[jillio]

Sure you know deaf history?? May I ask you where you have this information from? This malpractice, where deaf children was sent to a TC program if failing oral education was common 20 years ago. It was even done 40 years ago. I suggest you to read some deaf history instead of doing the same mistakes again and again. This proves my point that the slogan of oralism for two centuries have been "but.. it's better now!".

Exactly flip. This is a perfect example of those who don't know history are doomed to repeat it.

 

[shel90]

Sure you know deaf history?? May I ask you where you have this information from? This malpractice, where deaf children was sent to a TC program if failing oral education was common 20 years ago. It was even done 40 years ago. I suggest you to read some deaf history instead of doing the same mistakes again and again. This proves my point that the slogan of oralism for two centuries have been "but.. it's better now!".

I agree...that's why we are still seeing an influx of older kids being referred to our program from the oral-only programs. Nope, it is not better now.

 

[shel90]

The Listening Center at Johns Hopkins


* Spoken Language is a natural and powerful system of human communication. The Listening Center at Johns Hopkins provides the medical, technical, and rehabilitative resources to enhance our patients' connection with spoken language through listening.

See how misleading that comment is. Spoken language is a natural and powerful system of human communication? Maybe so, but it is NOT the only one. I can see how the medical community indirectly pressures the parents with comments like these.

This really sucks cuz I was reading thru this website. No mention of ASL so of course, not all the options and information out there are being told to the parents.

 

[jillio]

The Listening Center at Johns Hopkins


* Spoken Language is a natural and powerful system of human communication. The Listening Center at Johns Hopkins provides the medical, technical, and rehabilitative resources to enhance our patients' connection with spoken language through listening.

See how misleading that comment is. Spoken language is a natural and powerful system of human communication? Maybe so, but it is NOT the only one. I can see how the medical community indirectly pressures the parents with comments like these.

This really sucks cuz I was reading thru this website. No mention of ASL so of course, not all the options and information out there are being told to the parents.

Exactly the point. Unless parents are provided with all information regarding all options, they are not being fully informed, and therefore, cannot be giving fully informed consent. Intentionally not giving information on a very viable option, for both CI implanted children and non-CI implanted children, implies that the option does not exist. This directly supports what other parents have stated...they were not given information regarding the options of sign and speech together by the medical community. I posted froma research article a while back where parents of CI implanted children who were unable to receive optimum benefit from CI stated exactly that. The information regarding ALL options was not provided to them. Only the oral option information was provided.

 

[jillio]

From yet another teaching hospital directly involved in pediatric implantation. This particular hospital also hosts an early intervention program...my son started in this program many years ago, until I realized how negatively some of their oral opnly practices were impacting him. At the time he was enrolled, it was known as the Mama Lere Preschool. I find it interesting that with the increased implantation and focus on oral only methods, that this early intervention program is now known as the "Mama Lere Hearing School." Yet is is an early intervention for deaf children.

Likewise, the list of resources offered by this hospital for those investigating CI are limited to either CI manufacturers or oral organizations, most notably, A.G. Bad.

As part of the cochlear implant process, the VBWC Cochlear Implant Program requires families to commit to intensive and consistent therapy for their child, with a professional who is specifically trained. This must occur before surgery is recommended. The rehabilitation process can take many years, much as it takes normal children many years to learn how to hear and to speak.

Dear Friends:
We are pleased to bring you the very first issue of Vox: a publication of the Vanderbilt
Bill Wilkerson Center for Otolaryngology and Communication Sciences. Vox will bring
you news of our research, people, and programs as we pursue our mission of being the first
fully integrated educational, research and patient care center in the country dedicated to
serving individuals with otolaryngologic and communicative disorders.
This issue focuses on how our new building, now a year old, has brought us together as
a team and helped us better our research and service abilities. You will learn more about
our brain mapping lab, new diagnostic procedures in the Voice Center, innovative
research in cochlear implant surgery, and the wonderful programs at the Mama Lere
Hearing School at Vanderbilt.Why Vox? Vox is Latin for voice, sound, language and tone. Vox represents much of the wide
array of subspecialties at work at the Vanderbilt Bill Wilkerson Center. More than that, Vox
will be the voice of the Center, keeping you in touch with our pursuits and accomplishments
into the future.
Sincerely,
Robert H. Ossoff, D.M.D., M.D. Fred H. Bess, Ph.D.
Director Associate Director
Vanderbilt Bill Wilkerson Center for Otolaryngology and Speech Scienceswww.shhh.org


Vanderbilt Medical Center, Key Sites

How anyone can say that the information being presented by the medical community is complete and unbiased is beyond me. JH and Vanderbilt are two of the most respected teaching hospitals in this country. It is obvious that they are training practitioners to address deafness from an audist perspective.

 

[jillio]

For those with profound hearing loss, the CI is likely the prosthetic device of preferred choice...so as to learn natural auditory-verbal communication. For those with severe-profound hearing loss, most will do better with implants. For those with severe hearing loss, hearing aids are typically the preferred choice of prosthetic devices providing aided thresholds in the 30-35 dB range (or better) can be attained at least in the low-to-mid frequency range as a result of assertive amplification and ongoing effective audiological management.
Ellen A. Rhoades, Ed.S., Cert. AVT, CED ©2000-2001 Auditory Verbal Training, Workshops, Consultations and Mentoring
ellen@AuditoryVerbalTraining.com

 

[vallee]

Vanderbilt Medical Center was my implant center. They are fantastic.

I am so thankful that they do require the children to undergo training. At least they are not implanting and leaving alone. For a cochlear implant patient to make gains, they have to practice and be committed to training.

Interesting that a doctor at Vanderbilt has asked for placement in the hard of hearing classroom in which they use primarily ASL. This is one of the requirements before implant surgery on a 5 year old.

My inclusion teacher's granddaughter is going to Mama Lere Preschool. She is hearing. Oh does she love it. It has made such great gains for her. She loves her friends and has learned so much from all of them. When I saw her last week, she commented that I worn the same thing that her friends wear, but most of them only have one.

When was that letter written, I have been going to them for at least 2 - 3 years and I wonder when they went to a new building. I go to the same place each time.

About your last posting, I am within the 25 to 35 db range.

 

[jillio]

Vanderbilt Medical Center was my implant center. They are fantastic.

I am so thankful that they do require the children to undergo training. At least they are not implanting and leaving alone. For a cochlear implant patient to make gains, they have to practice and be committed to training.

Interesting that a doctor at Vanderbilt has asked for placement in the hard of hearing classroom in which they use primarily ASL. This is one of the requirements before implant surgery on a 5 year old.

My inclusion teacher's granddaughter is going to Mama Lere Preschool. She is hearing. Oh does she love it. It has made such great gains for her. She loves her friends and has learned so much from all of them. When I saw her last week, she commented that I worn the same thing that her friends wear, but most of them only have one.

When was that letter written, I have been going to them for at least 2 - 3 years and I wonder when they went to a new building. I go to the same place each time.

About your last posting, I am within the 25 to 35 db range.

Could you provide a resource for the bolded statement above re: requirement being placed in a classroom that primarily uses ASL prior to implantation < 5 yrs? Everything I read from them tells me that the child must be placed in an aural/oral environment.

Re: the second bolded statement. It is no longer Mama Lere Preschool. It is now Mama Lere Hearing school, despite the fact that it is a facet of early intervention known as Parent/Infant Training aimed at deaf children.

I'm glad that your experience with Vanderbilt/Bill Wilkerson has been positive. Mine and my son's was less so, despite the fact that my husband was a graduate. But despite the differences in experiences, the previous post clearly demonstrates the oralist philosophy under which they function.

The point of my second post did not revolve around dB levels, but the statement that was bolded re: so to better learn auditory verbal communication.

 

[jillio]

And yet another large teaching hospital speaks out:

The mission of the Cochlear Implant Team at Cincinnati Children's Hospital Medical Center is to be the leader in cochlear implantation, committed to providing quality care to infants, children and adolescents, along with their families, affected by hearing loss.
The Cochlear Implant Program at Cincinnati Children's Hospital Medical Center strives to help children with severe to profound sensorineural hearing loss.

Cochlear implantation represents one of the greatest advances in the management of children with severe to profound sensorineural hearing loss ("nerve deafness"). By implanting a computerized device into the inner ear, functional hearing can be restored to children who do not benefit from hearing aids.

For children not benefiting from hearing aids and whose families are committed to an oral mode of communication, cochlear implants offer an opportunity to restore functional hearing levels to children.

Cochlear Implant Program, Cincinnati Children's Hospital Medical Center

 

[jillio]

This, from Bostn Children's Hospital, comes closer to complete information than anything else I have seen. It doesn't surprise me, however, as they also have on their staff sign language specialists,(both deaf & hearing) specialists in deaf education,(both deaf and hearing), and utilize a trasitional team that includes both deaf and hearing team members.





Cochlear Implants


Habilitative Audiology Program Deaf and Hard of Hearing Program
Diagnostic Audiology Program






What is a cochlear implant?

A cochlear implant is an electronic device to provide a sensation of hearing to individuals who are deaf. It consists of two main parts: an external part worn somewhat like a hearing aid, and an internal part which must be implanted by a surgeon. The external part of a cochlear implant is the speech processor. It has a "microphone" worn over or behind the ear. A cord leads from the microphone to the speech processor. The speech processor codes the sound input into electrical signals which are sent back to the "transmitter," a thin plastic piece about one inch in diameter containing a magnet placed on the side of the head behind and slightly above the ear. The transmitter sends the signals across the skin to the internal part of the implant (the "receiver/stimulator"), which is under the skin. The receiver/stimulator sends the signals into the electrode array, which is a one-inch long wire surgically inserted into the inner ear. The electrode array consists of an array of electrode bands, each of which can provide a tiny current to the inner ear, to replace the function of the damaged or missing hair cells which ordinarily would stimulate the nerve endings of the auditory nerve. Implants from different manufacturers differ in the number of channels, programming strategy, and appearance of the externally worn device. Behind-the-ear processors are available to eliminate the need for a body pack for most cochlear implant users once they reach approximately kindergarten age or sometimes earlier.

Does a cochlear implant provide normal hearing?

No. A cochlear implant provides a limited sense of hearing. However, most individuals with good language abilities can integrate this sensation with visual cues to understand spoken language. Many cochlear implant users can learn to understand spoken sentences without looking at the person who is talking, particularly if there is not background noise.

Who can benefit from a cochlear implant?

Adults and children who used to have normal hearing or partial hearing, who learned to talk before they became deaf, often benefit from a cochlear implant. These individuals have the advantage of remembering what speech used to sound like, so they can use the sound sensation from the cochlear implant to supplement their lipreading ability. Children who were born deaf ("congenitally deaf") or who became deaf before they learned to talk ("prelinguistically deaf") also can benefit from a cochlear implant, although their progress in learning to understand spoken language with the implant may be slower than for individuals who became deaf later.

What range of hearing loss must a child have to benefit from an implant?

To be a candidate for a cochlear implant, a child must have a severe or profound sensorineural hearing loss in both ears. The average hearing level in the speech frequency range (500-2000Hz) must be poorer than 70 decibels in both ears without hearing aids, and with hearing aids the child must not be able to recognize single words clearly out of context without looking at the talker's face. If the child is under 24 months of age, the hearing loss must be 90 decibels or greater in both ears. If the child has more hearing than this range, then the child might receive more benefit from a hearing aid than from a cochlear implant. If the child has the ability to recognize words with a hearing aid, then a cochlear implant may not provide any more benefit.

At what age should a child receive a cochlear implant?

The Food and Drug Administration allows cochlear implants for children beginning at age 12 months. A congenitally deaf child who is going to have a cochlear implant should have the surgery before the age of four years, earlier if possible. This early implantation gives the child the best chance to learn to use sound while language skills are developing. Some congenitally or prelinguistically deaf children who receive cochlear implants when they are older do not develop the ability to recognize speech with the implant, and ultimately may reject its use. However, a school-age deaf child who makes maximal use of hearing aids and who already uses spoken language may benefit from a cochlear implant.
Children who once had normal hearing or partial hearing, and then became deaf, may be implanted as soon as it is clear that the child's hearing is not going to recover and that there is no benefit from a hearing aid. Older children and teenagers who lose their hearing must participate in the decision whether to have a cochlear implant.


What factors might favor or limit my child's benefit from a cochlear implant?

Factors which favor a beneficial outcome from a cochlear implant are normal cochlear anatomy; surgery at a young age; good underlying language abilities; a solid base of language development prior to surgery; a high level of motivation and commitment on the part of the family to keep frequent appointments, maintain the device, and encourage listening skills; an appropriate educational program which incorporates listening activities into the curriculum; and regular speech/language therapy given by a clinician with specific expertise and experience in the area of spoken language development in deaf children using cochlear implants. Determination of the appropriateness of the available program of education and therapy is part of the decision process regarding whether a particular child may benefit from a cochlear implant.
The benefit from a cochlear implant may be limited by a child's previous language deprivation or by a particular child's disorder in language acquisition skills. The anatomy of the child's ear and auditory nerve also may limit sound reception and clarity with an implant. Children who have cochlear dysplasia (congenital malformation of the inner ear, such as a Mondini deformity) may not be able to accommodate the entire electrode array in the cochlea, and may have fewer electrodes usable to stimulate different sensations of hearing for different frequencies. Children who have had meningitis as the cause of their hearing impairment may have ossification (bony growth) in the cochlea which may require extra drilling for electrode placement, and may limit the extent to which the electrode array can be inserted into the cochlea. This ossification usually can be seen on a CT scan of the temporal bones. Although the auditory nerve, which will be stimulated by the implant, may be seen on an MRI prior to surgery, the function of the auditory nerve can not be predicted accurately.


What does the cochlear implant surgery consist of?

The surgery is performed under general anesthesia and takes three to six hours. The child stays in the hospital one or two nights after the surgery. A parent may sleep in the child's hospital room. During the surgery, the receiver/stimulator and electrode array are implanted. An incision is made behind the ear for the surgeon to expose the area of the round window, a tiny membrane at the separation between the middle ear and the inner ear. Then the surgeon places the receiver/stimulator in a small area on the side of the head where the bone has been drilled thinner to make a place for the receiver/stimulator to fit, outside the skull but under the skin. The brain is not exposed or penetrated during the surgery. The electrode array is inserted into the inner ear, and the receiver/stimulator is fixed in place over the bone. Electrical recordings are made to show that the electrodes are providing stimulation. The skin is surgically closed over the implant.
When the external parts of the implant are not being worn, the implant is not visible from the outside and the patient cannot hear.


What are the risks of the surgery?

The risks of anesthesia are the same as for any surgery. Surgery to the inner ear also carries the risks (although uncommon) of facial nerve paralysis, loss of taste sensation, dizziness, or ringing in the ear. The surgery does destroy any ability the individual may have had to hear with a conventional hearing aid in that ear. It is possible that at some point in the future, the implant may stop working and may need to be replaced in another operation.

Harvard Medicine - Basic Facts


Still not as complete as it could be, but much better than the majority. I don't think it is a coincidence that Boston also has a large Deaf/deaf community.

 

[vallee]

Could you provide a resource for the bolded statement above re: requirement being placed in a classroom that primarily uses ASL prior to implantation < 5 yrs? Everything I read from them tells me that the child must be placed in an aural/oral environment.

Re: the second bolded statement. It is no longer Mama Lere Preschool. It is now Mama Lere Hearing school, despite the fact that it is a facet of early intervention known as Parent/Infant Training aimed at deaf children.

I'm glad that your experience with Vanderbilt/Bill Wilkerson has been positive. Mine and my son's was less so, despite the fact that my husband was a graduate. But despite the differences in experiences, the previous post clearly demonstrates the oralist philosophy under which they function.

The point of my second post did not revolve around dB levels, but the statement that was bolded re: so to better learn auditory verbal communication.

I am part of support team in discussions of IEPs that is what a special education teacher does. I am on a team that reviews testing and recommedations before the parent meeting is set up. The doctor recommended a Preschool who is going to be implanted move into the hard of hearing class. Our classrooms are primarily ASL and English. It provides either self-contained, inclusion, or part-time inclusion according to the child's needs. The doctor has to release records and that was his recommendation. You can't make a generalization about doctors. I know what was discussed and recommend to the parents and school.

Oh we as a team also provided resources for ASL for the parents.

 

[vallee]

On the second part - I teach in an inclusion classroom. The teacher teaches regular education. Her granddaughter goes to that preschool. The granddaughter is hearing.

 

[jillio]

I am part of support team in discussions of IEPs that is what a special education teacher does. I am on a team that reviews testing and recommedations before the parent meeting is set up. The doctor recommended a Preschool who is going to be implanted move into the hard of hearing class. Our classrooms are primarily ASL and English. It provides either self-contained, inclusion, or part-time inclusion according to the child's needs. The doctor has to release records and that was his recommendation. You can't make a generalization about doctors. I know what was discussed and recommend to the parents and school.

Oh we as a team also provided resources for ASL for the parents.

Calm down...I simply asked you for a resource. I am not making generalizations at all, I am posting directly from a hospital website, and have not implied that it was specific to anything other than that particular hospital.

Regarding the bolded statement: I'm confused. You teach in a Bi-Bi program?

 

[jillio]

On the second part - I teach in an inclusion classroom. The teacher teaches regular education. Her granddaughter goes to that preschool. The granddaughter is hearing.

I'm aware of that. I read it in your previous post. How does that change the fact that Mama Lere Hearing School is the Parent/Infant training faciliity for Bill Wilkerson? My question would be this: are the hearing kids exposed to ASL as part of the inclusion, or are the deaf kids just there to be exposed to oral language?

 

[vallee]

Calm down...I simply asked you for a resource. I am not making generalizations at all, I am posting directly from a hospital website, and have not implied that it was specific to anything other than that particular hospital.

Regarding the bolded statement: I'm confused. You teach in a Bi-Bi program?

I understand, I am typing and eating a blizzard at the same time. Sorry. It is from Vandy the hostipal you posted. Not all doctors there believe everything that the web site pushes.

I am a special education teacher. If a student is in my school, the whole special education team is involve in m-teams. I was also asked by the parents to assist in transition since they use me as a resource for questions and assistance. I do not teach this child, he is in preschool and I teach 5th grade. (I am certificated pre-k to 12).

 

[vallee]

I'm aware of that. I read it in your previous post. How does that change the fact that Mama Lere Hearing School is the Parent/Infant training faciliity for Bill Wilkerson? My question would be this: are the hearing kids exposed to ASL as part of the inclusion, or are the deaf kids just there to be exposed to oral language?

I don't know the answer, but I will find out.

 

[loml]

No mention of ASL so of course, not all the options and information out there are being told to the parents.

Why do you think that the reponsibilty lies within The Listening Center at Johns Hopkins, to promote ASL or any other method?

 

[jillio]

I understand, I am typing and eating a blizzard at the same time. Sorry. It is from Vandy the hostipal you posted. Not all doctors there believe everything that the web site pushes.

I am a special education teacher. If a student is in my school, the whole special education team is involve in m-teams. I was also asked by the parents to assist in transition since they use me as a resource for questions and assistance. I do not teach this child, he is in preschool and I teach 5th grade. (I am certificated pre-k to 12).

Enjoy your Blizzard...too cold here for ice cream!

 

[jillio]

I don't know the answer, but I will find out.