Language Development in Children With Cochlear Implants

Cochlear implants are surgically placed implants that bypass the damaged and non-functional portions of the ear to stimulate the auditory nerve. According to the National Institute on Deafness & Other Communicative disorders "Hearing through a cochlear implant is different from normal hearing and takes time to learn or relearn." You can not "hear" with the implant but the brain receives a sense of hearing. There is some controversy over the use of this implant, particularly in the Deaf community.

Language Development

• Prelingual deaf children are those who lost their hearing before the age of three. This is a significant period in the acquisition of language because it is when the child begins to learn language skills. A child who has never heard has no concept of spoken language or that sounds have meaning, which is why it is considered so important that a child receive the cochlear implant as soon as possible. According to Dr. Svirsky, author of a study on language acquisition in profoundly deaf children "The gap between a hearing impaired child's chronological age and his language age typically continues to increase as the child grows older. However, we have found that when a child receives a cochlear implant, the child begins to develop language skills at about the same rate as a child with normal hearing. In other words, the gap stops growing.The rate of language development in the profoundly deaf children after implantation was quite close to that of children with normal hearing, and it exceeded the development rate expected from unimplanted profoundly deaf children." The deaf child developing language goes through the same process as an infant, but because they have lost time, they are behind their non-deaf peers in this process. The child's ability to "catch up" appears to depend on how young they were on receiving the implant, as the greater amount of years spent not hearing sets the "language age" back by a comparable amount of time.

Hearing

• Most people who receive cochlear implants are either adults suffering from diminished hearing or very young children who were born deaf or lost their hearing at a very young age. These children may never have heard a sound and have no grasp of spoken language. They also do not have a natural understanding or processing of sound. Surgery is followed by a period of therapy during which most adults with hearing experience adapt quickly to the new stimuli. Children, on the other hand, have the more difficult task of learning the concept of sound and giving it meaning, a task most hearing people accomplish as infants.

Speech

• One of the major goals in giving children cochlear implants to help them achieve speech. American Sign Language (ASL), the major form of communication in the American Deaf community, does not correlate directly to the English language. ASL has its own syntax (word order) and rules, which work better for a language seen with the eyes rather than heard.

Controversy

• While hearing parents often feel few qualms about providing their deaf children with implants, the use of them is extremely controversial within the Deaf community. The term "Deaf" (with a capital D) is used to designate a hearing-impaired person or group of people who identify with the Deaf community and culture. The Deaf community is a minority with a distinct language and culture, and many members feel that this is threatened by the implant. They do not consider deafness to be a disability or handicap to be corrected by medical intervention but rather a shared cultural experience. They are also disturbed by the possible side effect of facial paralysis, especially because ASL frequently uses facial expressions to accentuate words (for example to differentiate between a statement and a question).

Considerations

• The implants do not work for everyone and it can take months or years before they are "attuned" properly. There are serious risks of infection and even paralysis and the long term effect of direct electrical stimulus on the nerve is unknown. The implant requires surgery to install and all the risk inherent of surgery (including infection, rejection, numbness, inflammation, etc.).