CI often brings only limited benefit

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The following article was contributed by Mark 'Deffman' Drolsbaugh at 9 Jan 1995.
Hello! Im back (stop groaning, everyone)... and, as I promised, I would collect some objective-as-possible and specific information about the CI. As I mentioned previously, I have a friend who is an audiologist, and I consulted with her. Her name will remain confidential because I dont want to drag her into this morass. To her credit, though, she has shown me a level of objectivity one would expect from a true professional. She neither showed overwhelming support nor opposition to the CI. Anyway, here's the facts I have now:

From the "Issues and Answers" booklet from the people who produce the Nucleus 22 Channel Cochlear Implant and its newest model, the Mini System 22:

The results of FDA clinical trials are as follows:

  1. Children are able to detect conversational level environmental sounds, including speech, at comfortable loudness levels.
  2. Some children can identify everyday sounds such as car horns, doorbells and birds singing from a closed set of alternatives*
  3. Many children can distinguish among different speech patterns.
  4. Some children can identify speech in context.
  5. A few chilren can recognize speech without context.
  6. Some children exhibit improved speechreading.
  7. Many children demonstrate improvements in speech production and loudness control after training and experience with the device.

*NOTE: When the words "few", "some" and "many" are used, they represent the following percentage of children who participated in the clinical trials:

  • FEW= greater than 5%, less than or equal to 34%
  • SOME= greater than 34%, less than 52%
  • MANY= equal to or greater than 52%

Limitations: Can't help all hearing-impaired children; many factors (such as number of surviving auditory nerve fibers) affect the level of performance acheived with the CI; the CI cannot ensure satisfactory use and benefit; children and families must be willing to work with implant teams, rehabilitation and educational programs.

Risks: Same basic risks related to general anesthesia; potential risks related to operating on the head, such as inflammation or bleeding, numbness or stiffness about the ear, injury to or stimulation of the facial nerve, taste disturbance, dizziness, increased tinnitus, neck pain and perilymph leak (which may result in meningitis). Also, the presence of any foreign body under the skin can result in irritation, inflammation or breakdown of the skin in the area around the receiver/stimulator, and/or the extrusion of the device. Such complications may require additional medical treatment, surgery, and/or removal of the device.

THERE! That was the Pro-CI material I had, and it was quite objective. All of the above factors are enough to convince me that it STILL is not worth it to implant young children. However, it is only fair that I follow-up the Pro-CI booklet with some excerpts from an Anti-CI resource (stop groaning, you guys!)...

From "Cochlear Implants in Children: A Position Paper of the National Association of the Deaf", here are some observations:

"There is no evidence that the speech perception of these (implanted) children is materially enhanced but there is evidence that many profoundly deaf children would have better, however limited, speech perception with conventional hearing aids than with implants. There is no evidence that early-implanted children will have greater educational success than is currently experienced by children of similar circumstances who do not undergo this invasive surgical procedure. The FDA panel has required the device packaging to include the warning that congenitally deaf children may derive no benefit from the device but the evidence points to the same conclusion for children deafened below the age of three and possibly age five or later."

Also: "Current programs of research on cochlear implants in children are conducted without regard to the quality of life that the child will experience as a deaf adult implant user. It is presently unknown whether the implant and the profound commitment of parent and child to aural/oral training that is generally required, will delay the family's acceptance of the child's deafness and their acquisition of sign communication. The impact of the implant and the required aural/oral training on the child's social, intellectual and emotional development and mental health, or on the child's integration into the deaf community, have not been assessed. This failure alone to consider the impact of the implant on the child's future quality of life qualifies the implant programs as highly experimental--- just as the World Federation of the Deaf deplored when it resolved, "[implant developments are] encouraging for persons deafened after some years of hearing [but] experimentation with young deaf children is definitely not encouraged."

There you have it... the info I promised I would bring. After seeing both sides, my opinion STILL remains the same: I dont think young children should be subjected to it. I received some E-mail telling me it was not my place to tell parents what to do; Im not TELLING anyone what to do. Im stating an opinion, and supporting it with information which I think all parents should be aware of before THEY make a decision. Im not Mr. Superparent, just a concerned Deffman. And I do not totally oppose the CI; some, such as Scott Jordan, have apparently benefitted from it (as has one friend of mine back home); good for him. For little deaf kids, I still cringe at the thought. Oh well. Thats enough for me today, looking foward to your pro and con responses.

Last update date: 
1996 Feb 3