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Ear implant success sparks culture war for deaf - 01/02/07 - The Detroit News Online
Could the end of sign language for deaf children be in sight? A spate of new studies has shown that profoundly deaf babies who receive cochlear implants in their first year of life develop language and speech skills remarkably close to those of hearing children. Many of the children even learn to sing passably well and function almost flawlessly in the hearing world.
These findings may sound like a triumph to audiologists and the hearing parents of deaf babies. But they have done little to convince those in the deaf community who maintain that it is unethical to give deaf babies cochlear implants, which bypass damaged areas of the ear and stimulate the auditory nerve directly.
"The idea of operating on a healthy baby makes us all recoil," says Harlan Lane, a psycholinguist at Northeastern University in Boston, Mass. "Deaf people argue that they use a different language, and with it comes a different culture, but there is certainly nothing wrong with them that needs fixing with a surgeon's scalpel. We should listen."
Ever since cochlear implants became commercially available 20 years ago, they have been seen as a threat to the culture and language of those born profoundly deaf. The fiercest opposition has been to their use in children, who could otherwise grow up proficient in sign language. Until recently, there was no good evidence that implants routinely improved children's chances of developing normal speech and language, raising fears that those fitted with implants would be stuck in a no-man's land -- part of neither the hearing world nor the deaf one.
That concern may be put to rest by the new studies. In one, presented in November at the Bionic Ear Institute in Melbourne, Australia, a team led by Richard Dowell at the University of Melbourne showed that 11 profoundly deaf children who received cochlear implants before the age of 1 had entirely normal language development at least up to age 4 to 5. Language skills were assessed using a battery of tests, including routine tests of comprehension and expression and observing at what age they started different types of babbling and using key words.
Their language development was also superior to a further 36 children who had been implanted at age 1 or 2, suggesting that the earlier the implant is fitted the better. "The kids still don't have normal hearing, but they have normal language. They can have a conversation, make a joke, lie, tease -- all those normal things that 4- or 5-year-olds do," says team member Shani Dettman.
The team's findings are supported by other studies, including one from Johanna Nicholas, of Washington University in St. Louis, and Ann Geers of the University of Texas-Dallas. It showed a dramatic improvement in the spoken language skills of 76 profoundly deaf children at the age of 3, if they had received their cochlear implant closer to 1 year old rather than 3 years.
The findings are particularly important because spoken language skills seem key to a child's chance of fully integrating into hearing society. A separate study by Thomas Lenarz and Anke Lesinski-Schiedat of the University of Hannover in Germany found that a child who gets a cochlear implant before the age of 2 has a 70 percent chance of attending an ordinary school, compared with a 30 percent chance for a child who receives an implant between the ages of 2 and 4.
Geers agrees deaf culture may be under threat, but says, "there is no hostility here. People are doing this so that deaf people can live in the hearing world, marry who they like and work where they like, and so that hearing parents can have their children as part of their culture. But it must seem like genocide to the deaf."
Until these latest findings, implants had only been shown successful in adults who'd gone deaf later in life, rather than in the estimated 1 in 2,000 people born profoundly deaf each year. The majority of those born deaf had had their implants fitted when they were older than 3, and while many could understand speech, very few developed normal language abilities.
The new results show that very young children can learn the complex rules of language using a cochlear implant, presumably because the infant brain is so adaptable.
Could the end of sign language for deaf children be in sight? A spate of new studies has shown that profoundly deaf babies who receive cochlear implants in their first year of life develop language and speech skills remarkably close to those of hearing children. Many of the children even learn to sing passably well and function almost flawlessly in the hearing world.
These findings may sound like a triumph to audiologists and the hearing parents of deaf babies. But they have done little to convince those in the deaf community who maintain that it is unethical to give deaf babies cochlear implants, which bypass damaged areas of the ear and stimulate the auditory nerve directly.
"The idea of operating on a healthy baby makes us all recoil," says Harlan Lane, a psycholinguist at Northeastern University in Boston, Mass. "Deaf people argue that they use a different language, and with it comes a different culture, but there is certainly nothing wrong with them that needs fixing with a surgeon's scalpel. We should listen."
Ever since cochlear implants became commercially available 20 years ago, they have been seen as a threat to the culture and language of those born profoundly deaf. The fiercest opposition has been to their use in children, who could otherwise grow up proficient in sign language. Until recently, there was no good evidence that implants routinely improved children's chances of developing normal speech and language, raising fears that those fitted with implants would be stuck in a no-man's land -- part of neither the hearing world nor the deaf one.
That concern may be put to rest by the new studies. In one, presented in November at the Bionic Ear Institute in Melbourne, Australia, a team led by Richard Dowell at the University of Melbourne showed that 11 profoundly deaf children who received cochlear implants before the age of 1 had entirely normal language development at least up to age 4 to 5. Language skills were assessed using a battery of tests, including routine tests of comprehension and expression and observing at what age they started different types of babbling and using key words.
Their language development was also superior to a further 36 children who had been implanted at age 1 or 2, suggesting that the earlier the implant is fitted the better. "The kids still don't have normal hearing, but they have normal language. They can have a conversation, make a joke, lie, tease -- all those normal things that 4- or 5-year-olds do," says team member Shani Dettman.
The team's findings are supported by other studies, including one from Johanna Nicholas, of Washington University in St. Louis, and Ann Geers of the University of Texas-Dallas. It showed a dramatic improvement in the spoken language skills of 76 profoundly deaf children at the age of 3, if they had received their cochlear implant closer to 1 year old rather than 3 years.
The findings are particularly important because spoken language skills seem key to a child's chance of fully integrating into hearing society. A separate study by Thomas Lenarz and Anke Lesinski-Schiedat of the University of Hannover in Germany found that a child who gets a cochlear implant before the age of 2 has a 70 percent chance of attending an ordinary school, compared with a 30 percent chance for a child who receives an implant between the ages of 2 and 4.
Geers agrees deaf culture may be under threat, but says, "there is no hostility here. People are doing this so that deaf people can live in the hearing world, marry who they like and work where they like, and so that hearing parents can have their children as part of their culture. But it must seem like genocide to the deaf."
Until these latest findings, implants had only been shown successful in adults who'd gone deaf later in life, rather than in the estimated 1 in 2,000 people born profoundly deaf each year. The majority of those born deaf had had their implants fitted when they were older than 3, and while many could understand speech, very few developed normal language abilities.
The new results show that very young children can learn the complex rules of language using a cochlear implant, presumably because the infant brain is so adaptable.
