Cochlear implants - more insights

A while ago, we had an interview with the founder of ONICI (lots of info on the website!), an independent information centre about cochlear implants. In stead of providing you with a long post about the topics we discussed with him, I'll just give you some interesting take home messages :-).

CI's are mostly implanted when children are about 10 months. Doing this at an even younger age is diffucult because babies' skulls are not thick enough to secure the the CI's internal part. Also, it is important for the parents to get used to communicating with their deaf child.

CI's consist of an internal and an external part. The internal part looks like a thin silicone cord with tiny electrodes at the end (see example left). This part is placed in the cochlea. On the other end of the cord, a receiver and stimulator are attached to the skull (underneath the skin). The external part consists of a microphone, a speech processor and a transmitter (attached tot he internal part via a magnet).

A lot of hospitals in Flanders are allowed to place CI's. The founder emphasizes that those medical centres who work with multidisciplinary teams (e.g. surgeons, throat, nose & ear specialists, speech therapists) are the best in that sense that they provide the best support. There are still quite some doctors who are convinced that the CI will (eventually) make deaf people hear like hearing people. Also, many of these doctors advise parents not to use sign language, since this would disrupt the spoken language development of the child (the ONICI founder fully disagrees).

Insurance companies cover for the medical costs of placing one CI (to be replaced every 5 to 10 years). Lots of parents decide to pay for a second CI (in the other ear) themselves, which costs about 10.000 Euros.

At the school, the teachers, therapists, educators, etc. all agreed to use either spoken language or sign language. Not both. This is done to teach the kids both languages in stead of a mixture. We noticed this during the Dovencultuurweek, where most hearing teachers, group leaders, etc. did not speak (sign language is the main language during this week), however most of them did move their lips as if they were speaking.

Wiki on CI's: http://en.wikipedia.org/wiki/Cochlear_implant
Simulation of hearing with a CI: http://www.hearingacademy.com/upload/De%20verschillen.swf

Interview with the school's psychologist

In July 2nd we had three interviews at the school. One with the psychologist, whom we had met twice before, one with the sign language teacher, and one with the head of the boarding school department. I'll try to list the most remarkable issues raised by the interviewees, starting with the psychologist.

Taboo of using sign language at school
The psychologist's main job is to monitor the development of the elementary school children. An important topic for her is the use of sign language at school. Until a couple of years ago, using sign language was not allowed at the school (as it wasn't at many schools for deaf children). The general opinion in the field of deaf education was that learning sign language would interfere with learning spoken/written language. The idea behind this was that learning spoken/written language is much harder for deaf children, so it was feared that deaf children would choose to learn sign language only. The psychologist put a lot of effort in making sign language less of a taboo at the school. At the moment, she is quite satisfied with the situation. Sign language is not prohibited anymore and sign language is used during classes more often, next to spoken/written language.

Development
The psychologist tells us that most children at the school come in via the nursery school. Some children (mostly those with progressive forms of hearing impairments) start at the school when they are older. Each child is individually discussed every year by the whole team of the teacher, the psychologist, the speech therapist, etc. the psychologist informs the parents about the development of their children. A common worry amongst parents is the speech development of their children. the psychologist mentions that for the parents, being able to speak is a sign that their child is doing well. Usually the psychologist gives the parents some advice and some tips to playfully work with their children on their speech development at home. Such tips include giving positive feedback on articulation errors, reading books, replicating the visualisation methods used at school, etc.

Another problem that the psychologist raises is the fact that many parents are told that their child's hearing impairment is solved after they get a CI. Unfortunately, this is not true and the school has to disappoint many parents. Children have to learn to hear after getting implanted and have missed an important period in their auditory development (more on this in the interview with the sign language teacher).

Assistive technology & translator
The psychologist mentions assistive technologies used by the children at school. Besides the CI and the audio induction loop used in the class rooms, a few additional tools are used: a flash alarm on the play ground and in class, and vibration alarm clocks or flash alarm clocks. The psychologist also mentions the sign language translator as an aid for deaf children. Deaf people are entitled to hire a translator for school (5 hr. per week per child, at secondary school) and for private matters (e.g. doctor's visit, ceremonies, for 18 hr per year). However, to be able to understand a translator, you have to 'speak' sign language, another reason for the psychologist to emphasize the importance teaching sign language to deaf children.

Awareness of being deaf
The psychologist tells that the school tries to work on the children's awareness of being deaf. This is important, because the children grow up in a environment where being deaf and wearing a CI is normal. "It is very, very, very important to show the kids that there are deaf adults as well, and that their impairment will not go away when they grow older." A deaf role models sits in the classes regularly to work with the children. Unfortunately, there are very limited resources for this.

Deaf culture
Next to this awareness, the school tries to introduce the children to the so-called deaf culture. Children talk about their identity as a deaf person, sign language, growing up in a hearing or in a deaf family, hearing aids, clubs for deaf, culture, etc. the school aims to integrate the children as much as possible in both the hearing world and in the deaf world. The deaf see themselves as a cultural minority, not as a handicapped group. The deaf have their own culture, with their own rules. The psychologist compares it to Black Power: Deaf Power.

Karin