Books about deafness & CI

Looking Inside or Outside? A Review of Inside Deaf Culture

Looking Inside or Outside? A Review of Inside Deaf Culture
Russell S. Rosen
Teachers College, Columbia University

C. Padden, & T. Humphries (2006). Inside Deaf Culture. Cambridge, MA: Harvard University Press. 208 pages. Textbook paperback. $15.95.

In Inside Deaf Culture, the authors seek to connect events in American Deaf culture not into a history, but a chronicle of its interfaces with the American hearing culture that attest to Deaf culture's persistent power in (re)defining Deaf people.

Deaf culture, the authors suggest, began at residential schools for the deaf in early 19th century, where deaf children were resuscitated from isolation in families and society; physically and sexually abused; and segregated by race, gender, and language by school administrators. The result of the interface with hearing people is the reproduction of their beliefs and practices in Deaf culture. Deaf people formed clubs, which reproduced racist, sexist, and language school practices and declined with changing economic conditions. They recorded their experiences, talents, and sign language in hearing people-created theaters, halls, and visual and acoustic technologies. Deaf theater proceeded from performances at schools, readings at Gallaudet theater, and interpreted Deaf community theater to shared voice with hearing actors at the National Theatre of the Deaf.

This interface, the authors argue, has pitfalls for Deaf culture. Although Deaf culture provides sanctuary for deaf individuals, it creates segregation from the hearing world and faces future struggles. The recent public recognition of ASL creates anxieties for personal identity and literary meaning. The demise of Deaf clubs makes the community more fluid, often found in non-Deaf community spaces. Deaf identity, sign language, and Deaf culture are currently under attack by medical advances, such as the Genome Project and cochlear implants, and social acknowledgments of cultural diversity.

Although the book focuses on the origin, location, and sustenance of Deaf culture and its interfaces with other cultures, it does not provide sufficient information on the constituents of Deaf culture and its relation to Deaf people's "ethos" and "volksgeist." It is uneven in culture creation, where symbols are created and allocated to entities and actions, and in culture change, where symbolic meanings and allocations alter by interfacing with other people and cultures in space and time. Deaf culture does not reproduce, but filters and reinterprets, hearing culture in accordance to its symbolic order. Although the book showed connections between Deaf culture and mainstream culture, it does not sufficiently relate how the experiences of Deaf people in families, schools, and society create symbols that become part of Deaf culture, and how its meanings and allocations are altered by internal and external changes.

In addition, the book has a few questionable analyses and a curious omission. For instance, an economic explanation is employed in the history of Deaf clubs, but many Deaf clubs were formed under conditions that did not match descriptions in the book. The book discussed about medicine's threats to Deaf culture that are unfounded; the history of technology and the deaf shows that technologies have not exterminated but are diffused into the culture. The Deaf President Now movement is omitted but is significant in that it led to the mainstreaming of Deaf voice in American society with recognition of ASL and Deaf community and culture. The authors could use these examples and attest to the power of culture in keeping a people together in the face of external changes.

For readers interested in American Deaf culture, the book contains many accounts that are newly uncovered and serves as a useful addition to Deaf Studies literature.

FREE Full Text (PDF)
 
Cloggy said:
Out of my league. I have no knowledge of the system in USA, but I can see the contradiction between saying "Deafness is not a disability" and "collecting disability support".

Wonder what Sweetmind, SxyPig and others have to say about it.
Click to expand...

that is the one thing I do agree with you , Cloggy, it is contradictory and stupid.

as far as I am concerned, deaf people will not progress until they own up to that it is a disability and join the Disabled people movement, then we can see more social changes.
 
Grummer said:
that is the one thing I do agree with you , Cloggy, it is contradictory and stupid.

as far as I am concerned, deaf people will not progress until they own up to that it is a disability and join the Disabled people movement, then we can see more social changes.
Click to expand...

This remind me of the attempt from deaflympics to get part of the paralympics, because the amount of cash in paralympics are better than deaflympics alone. It didn't work because not enough resources was found to get the terps required to make the deaf part communicate with the paralympics event. This is just one of more stories of leaders in the deaf communition trying to join richer disability movements.

Most deaf organizations I know are by the way members of major disability right movements, in addition to other movements like World Federation of the Deaf or national deaf assocations, who then again work with national disability movements.

But, nice attempt to bring up other topics by a such inane reply :)
 
flip said:
This remind me of the attempt from deaflympics to get part of the paralympics, because the amount of cash in paralympics are better than deaflympics alone. It didn't work because not enough resources was found to get the terps required to make the deaf part communicate with the paralympics event. This is just one of more stories of leaders in the deaf communition trying to join richer disability movements.

Most deaf organizations I know are by the way members of major disability right movements, in addition to other movements like World Federation of the Deaf or national deaf assocations, who then again work with national disability movements.

But, nice attempt to bring up other topics by a such inane reply :)
Click to expand...

I HAVE heard of this before, on both counts, the sports events and the relationship between deaf movements and disabilty movements. Your reply using inane is just polite way of saying im an idiot, you retard, you dont know the nature of politics and greed, you can get all technical and chronological about these 'published events' you still dont know what you're talking about. I'd tell you that to grasp the sense to realise that not all 'disability movement' are genuine as does some of the deaf organisation. If it looked closer you'd find the administrators are not 'fighting' on our behalf but rather, to climb up their own career ladders often unrelated to the cause.

Very very few organisation are genuine and especially ones those are, -receives minimal fundings, which of course is politically driven by and for those are hearing, and/or abled bodied in power.

As for sports, it is an industry with which 'commitments' has be restricted severed by those controlling the funds where in turn comes from the self-interest. For example, interpreters are greedy, and if you really know disabiliy studies, and what not, you'd understand that interpreters are not the 'not guilty parties' as well as those invovled in administrating these sporting events.

Many Disabled academics do not like disability organisations, for many varied good reasons, obviously you have overlooked that bit, you assumed they all on the same boat, not exactly.
 
Lastly, Flip you failed to read that Cloggy mentioned it is contradictory, which Iagree, because deaf people deny they are disabled, and yet expect to receive funds from disability organisations. Reality and ideals dont mix very well, it never has, and according to the deaf vs disabilty it wasn't an exception either. Recounting events is different from understanding the underlying assumptions hidden behind these politics.
 
Just read the most recent article by the audi. Considering the number of services suggested, it kind of blows that "cost effectiveness" argument right out of the water.

She continually used the term "hearing impaired", and once or twice resorted to the use of "handicapped". The medical model is alive and well.
 
Study Finds Cochlear Implants Cost-Effective In Children

Study Finds Cochlear Implants Cost-Effective In Children
Technology improves quality of life and saves $50,000 + over child's lifetime

Researchers at Johns Hopkins report that cochlear implants, electronic devices surgically implanted behind the ear to bring sound to profoundly deaf people, not only improve children's quality of life, but also are highly cost-effective, with an expected lifetime savings of $53,198. The study, published in the Aug. 16 issue of the Journal of the American Medical Association (JAMA), is the first to evaluate the cost of quality-of-life improvements in pediatric cochlear implant patients using U.S. cost data, the authors say.

According to Neil R. Powe, M.D., M.P.H., M.B.A., professor of medicine, epidemiology and health policy and management at Hopkins and one of the study's co-authors, the findings linking quality of life and cost-savings are unusual. "Most new interventions in medical care that improve health also raise the cost. In this case, we've found that when you include all the associated costs and consequences, the implant actually saves society money in the long term," he says. The cost-benefit comes in the form of fewer demands on special education and greater wage-earning opportunities of implant recipients.

Powe and his colleagues conducted a cost-utility analysis, measuring a cochlear implant's effect on quality of life against the costs of the device. They surveyed parents of children with implants, all patients at The Listening Center at Johns Hopkins. The children averaged 7.4 years of age with 1.9 years of implant use. Parents rated their children's health "now," "immediately before" and "1-year before" the implant, through a standard series of methods.

The team also estimated the costs directly associated with the implant (device, surgery, rehabilitation, maintenance, etc.) and those indirectly affected by the device (time off work, travel, and change in educational costs, etc.), as well as cost savings.

In 1992, cochlear implants were approved for use in profoundly deaf children who fail to benefit from conventional hearing aids. Since its entrance to the market, cochlear implant technology has been one of many new devices questioned by health insurers for reimbursement.

"Providing an option to profound deafness is neither easy nor cheap, and for many years we've ignored the financial aspects of this treatment, thinking that for young children, cost should not be an issue," says senior author John K. Niparko, M.D., professor of otolaryngology head and neck surgery and director of the Listening Center. "However, rising health care costs have led to pressures that discourage technologies such as the cochlear implant, and many health care plans cite 'no timely cost-effectiveness data' as a barrier to reimbursement for the device. This study, by weighing costs of both the device and the benefit provided to a large group of children, provides the beginning of evidence that from a societal perspective, cochlear implantation in children is highly cost-effective." Niparko hopes that these findings will encourage similar research on a national level.

Earlier research had shown the device was cost-effective in adults, and it was speculated that children, because of their prolonged use of the device, stood to reap a greater cost-benefit over a longer period of time. Previous pediatric cochlear implant studies either considered quality-of-life benefits in a hypothetical way or used data from adults and were performed in England or Australia.

Setting aside the special education and greater wage-earning opportunities of implant recipients, the cost-utility of pediatric cochlear implantation ($9,029 per quality adjusted life year [QALY]) compares favorably (less dollars paid for the benefit) to many other implantable technologies, including the implantable defibrillator ($34,846 per QALY), knee replacement ($59,292 per QALY), and adult cochlear implantation ($11,125 per QALY).

The principal investigator of the study is Andre Cheng, M.D., Ph.D. In addition to Powe and Niparko, co-investigators include: Haya Rubin, M.D., Ph.D., Nancy Mellon, M.S., and Howard Francis, M.D. Their work was supported in part by a training grant from the National Institute on Deafness and Other Communication Disorders, National Institutes of Health, and grants from the Deafness Research Foundation, the Advisory Board Foundation and the Sidgmore Family Foundation.

++++++++++++++++++++++++++++++++++++++

http://jama.ama-assn.org/cgi/reprint/284/7/850.pdf

JAMA -- Cost-Utility Analysis of the Cochlear Implant in Children, August 16, 2000, Cheng et al. 284 (7): 850
 
Boult said:
Study Finds Cochlear Implants Cost-Effective In Children

Study Finds Cochlear Implants Cost-Effective In Children
Technology improves quality of life and saves $50,000 + over child's lifetime

Researchers at Johns Hopkins report that cochlear implants, electronic devices surgically implanted behind the ear to bring sound to profoundly deaf people, not only improve children's quality of life, but also are highly cost-effective, with an expected lifetime savings of $53,198. The study, published in the Aug. 16 issue of the Journal of the American Medical Association (JAMA), is the first to evaluate the cost of quality-of-life improvements in pediatric cochlear implant patients using U.S. cost data, the authors say.

According to Neil R. Powe, M.D., M.P.H., M.B.A., professor of medicine, epidemiology and health policy and management at Hopkins and one of the study's co-authors, the findings linking quality of life and cost-savings are unusual. "Most new interventions in medical care that improve health also raise the cost. In this case, we've found that when you include all the associated costs and consequences, the implant actually saves society money in the long term," he says. The cost-benefit comes in the form of fewer demands on special education and greater wage-earning opportunities of implant recipients.

Powe and his colleagues conducted a cost-utility analysis, measuring a cochlear implant's effect on quality of life against the costs of the device. They surveyed parents of children with implants, all patients at The Listening Center at Johns Hopkins. The children averaged 7.4 years of age with 1.9 years of implant use. Parents rated their children's health "now," "immediately before" and "1-year before" the implant, through a standard series of methods.

The team also estimated the costs directly associated with the implant (device, surgery, rehabilitation, maintenance, etc.) and those indirectly affected by the device (time off work, travel, and change in educational costs, etc.), as well as cost savings.

In 1992, cochlear implants were approved for use in profoundly deaf children who fail to benefit from conventional hearing aids. Since its entrance to the market, cochlear implant technology has been one of many new devices questioned by health insurers for reimbursement.

"Providing an option to profound deafness is neither easy nor cheap, and for many years we've ignored the financial aspects of this treatment, thinking that for young children, cost should not be an issue," says senior author John K. Niparko, M.D., professor of otolaryngology head and neck surgery and director of the Listening Center. "However, rising health care costs have led to pressures that discourage technologies such as the cochlear implant, and many health care plans cite 'no timely cost-effectiveness data' as a barrier to reimbursement for the device. This study, by weighing costs of both the device and the benefit provided to a large group of children, provides the beginning of evidence that from a societal perspective, cochlear implantation in children is highly cost-effective." Niparko hopes that these findings will encourage similar research on a national level.

Earlier research had shown the device was cost-effective in adults, and it was speculated that children, because of their prolonged use of the device, stood to reap a greater cost-benefit over a longer period of time. Previous pediatric cochlear implant studies either considered quality-of-life benefits in a hypothetical way or used data from adults and were performed in England or Australia.

Setting aside the special education and greater wage-earning opportunities of implant recipients, the cost-utility of pediatric cochlear implantation ($9,029 per quality adjusted life year [QALY]) compares favorably (less dollars paid for the benefit) to many other implantable technologies, including the implantable defibrillator ($34,846 per QALY), knee replacement ($59,292 per QALY), and adult cochlear implantation ($11,125 per QALY).

The principal investigator of the study is Andre Cheng, M.D., Ph.D. In addition to Powe and Niparko, co-investigators include: Haya Rubin, M.D., Ph.D., Nancy Mellon, M.S., and Howard Francis, M.D. Their work was supported in part by a training grant from the National Institute on Deafness and Other Communication Disorders, National Institutes of Health, and grants from the Deafness Research Foundation, the Advisory Board Foundation and the Sidgmore Family Foundation.

++++++++++++++++++++++++++++++++++++++

http://jama.ama-assn.org/cgi/reprint/284/7/850.pdf

JAMA -- Cost-Utility Analysis of the Cochlear Implant in Children, August 16, 2000, Cheng et al. 284 (7): 850
Click to expand...

Quality of life is subjective and based on individual perceptions. Since they have not offered an operational definition of quality of life, nor how it was measured, it is impossible to either support or refute this statement.

How was the 50,000 savings determined? If a CI implanted child in the mainstream is receiving services from a mainstream teacher, a TOD, a speech and language pathologist, a tutor, and very possibly either a terp or CART services, where is the savings over the child who is not CI implanted?

I notice that your article came from JAMA. This is just more of the medical perspective of "cost effectiveness" that misplaces the deciding criteria from individual benefit to correction of pathology in order to save money for the greater socieity. Nothing new there.

Now, let's get back to the topic. Read any good books on deafness lately?
 
Boult said:
Study Finds Cochlear Implants Cost-Effective In Children

Study Finds Cochlear Implants Cost-Effective In Children
Technology improves quality of life and saves $50,000 + over child's lifetime

Researchers at Johns Hopkins report that cochlear implants, electronic devices surgically implanted behind the ear to bring sound to profoundly deaf people, not only improve children's quality of life, but also are highly cost-effective, with an expected lifetime savings of $53,198. The study, published in the Aug. 16 issue of the Journal of the American Medical Association (JAMA), is the first to evaluate the cost of quality-of-life improvements in pediatric cochlear implant patients using U.S. cost data, the authors say.

According to Neil R. Powe, M.D., M.P.H., M.B.A., professor of medicine, epidemiology and health policy and management at Hopkins and one of the study's co-authors, the findings linking quality of life and cost-savings are unusual. "Most new interventions in medical care that improve health also raise the cost. In this case, we've found that when you include all the associated costs and consequences, the implant actually saves society money in the long term," he says. The cost-benefit comes in the form of fewer demands on special education and greater wage-earning opportunities of implant recipients.

Powe and his colleagues conducted a cost-utility analysis, measuring a cochlear implant's effect on quality of life against the costs of the device. They surveyed parents of children with implants, all patients at The Listening Center at Johns Hopkins. The children averaged 7.4 years of age with 1.9 years of implant use. Parents rated their children's health "now," "immediately before" and "1-year before" the implant, through a standard series of methods.

The team also estimated the costs directly associated with the implant (device, surgery, rehabilitation, maintenance, etc.) and those indirectly affected by the device (time off work, travel, and change in educational costs, etc.), as well as cost savings.

In 1992, cochlear implants were approved for use in profoundly deaf children who fail to benefit from conventional hearing aids. Since its entrance to the market, cochlear implant technology has been one of many new devices questioned by health insurers for reimbursement.

"Providing an option to profound deafness is neither easy nor cheap, and for many years we've ignored the financial aspects of this treatment, thinking that for young children, cost should not be an issue," says senior author John K. Niparko, M.D., professor of otolaryngology head and neck surgery and director of the Listening Center. "However, rising health care costs have led to pressures that discourage technologies such as the cochlear implant, and many health care plans cite 'no timely cost-effectiveness data' as a barrier to reimbursement for the device. This study, by weighing costs of both the device and the benefit provided to a large group of children, provides the beginning of evidence that from a societal perspective, cochlear implantation in children is highly cost-effective." Niparko hopes that these findings will encourage similar research on a national level.

Earlier research had shown the device was cost-effective in adults, and it was speculated that children, because of their prolonged use of the device, stood to reap a greater cost-benefit over a longer period of time. Previous pediatric cochlear implant studies either considered quality-of-life benefits in a hypothetical way or used data from adults and were performed in England or Australia.

Setting aside the special education and greater wage-earning opportunities of implant recipients, the cost-utility of pediatric cochlear implantation ($9,029 per quality adjusted life year [QALY]) compares favorably (less dollars paid for the benefit) to many other implantable technologies, including the implantable defibrillator ($34,846 per QALY), knee replacement ($59,292 per QALY), and adult cochlear implantation ($11,125 per QALY).

The principal investigator of the study is Andre Cheng, M.D., Ph.D. In addition to Powe and Niparko, co-investigators include: Haya Rubin, M.D., Ph.D., Nancy Mellon, M.S., and Howard Francis, M.D. Their work was supported in part by a training grant from the National Institute on Deafness and Other Communication Disorders, National Institutes of Health, and grants from the Deafness Research Foundation, the Advisory Board Foundation and the Sidgmore Family Foundation.

++++++++++++++++++++++++++++++++++++++

http://jama.ama-assn.org/cgi/reprint/284/7/850.pdf

JAMA -- Cost-Utility Analysis of the Cochlear Implant in Children, August 16, 2000, Cheng et al. 284 (7): 850
Click to expand...

Let's see....JAMA= Journal of the American Medical Association. Cost effectiveness analysisi=medical model misplacing the benefits of an elective surgery performed on the individual to the benefit to a society. Nothing new here. Just another indication of the attempt to normalize the deaf population according to hearing standards, and to dictate personal decision based on the hearing norms. More evidence of the true concern of the medical establishment...MONEY< MONEY< MONEY. Saving an individual's neighbors a few dollars in taxes hardly seems justification for making a decision that impacts the individual. Come get a CI...your neighbors will be able to afford a new car it you do! It's cheaper to hear. And your doctor will love you, because the more CIs that are done, the greater the profit margin for the practitioners.
 
jillio said:
Let's see....JAMA= Journal of the American Medical Association. Cost effectiveness analysisi=medical model misplacing the benefits of an elective surgery performed on the individual to the benefit to a society. Nothing new here. Just another indication of the attempt to normalize the deaf population according to hearing standards, and to dictate personal decision based on the hearing norms. More evidence of the true concern of the medical establishment...MONEY< MONEY< MONEY. Saving an individual's neighbors a few dollars in taxes hardly seems justification for making a decision that impacts the individual. Come get a CI...your neighbors will be able to afford a new car it you do! It's cheaper to hear. And your doctor will love you, because the more CIs that are done, the greater the profit margin for the practitioners.
Click to expand...

This cost effectiveness mentality from the medical community could do so many, especially the ones who dont qualify For or couldnt benefit from CIS, more damage economically, socially, and emotionally because it will teach the general public the view that deaf/hoh people who fall in that category as a burden to society. That is something we do not need and it will be discriminatory.
 
Thanks for getting us back on topic, Contradicta!

Here's a good one for all parents of deaf/hh kids:

Legal Rights of the Deaf. Its published by Galluadet, and is a valuable resource for any parent of a deaf child who wishes to advocate effectively for their child within the school system. Also contains valuable information for deaf/Deaf adults and their rights within the world of employment.
 
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