Cochlear implants; What they are, how the work, and the controversy surrounding them

By Lisa Watson

May 2, 2006 | There is a battle going on that most are unaware of. It is centered around the cochlear implant. A large portion of the deaf community feels as though the cochlear implant is not a benefit to someone who is unable to hear. People in the hearing community disagree.

A cochlear implant is a small, complex electronic device that can help to provide a sense of sound to a person who is profoundly deaf or severely hard of hearing. The implant is surgically placed under the skin behind the ear. It has four basic parts: a microphone, which picks up sound from the environment; a speech processor, which selects and arranges sounds picked up by the microphone; a transmitter and receiver/stimulator, which receives signals from the speech processor and converts them into electric impulses; and electrodes, which collect the impulses from the stimulator and send them to the brain.

An implant does not restore or create normal hearing. When the recipient of the implant removes the magnet that allows the implant to work, they are still deaf. However, under the appropriate conditions, it can give a deaf person a useful auditory understanding of the environment and help them to understand speech when coupled with post-implantation therapy.

According to researchers at the University of Michigan, approximately 100,000 people worldwide have received cochlear implants; roughly half are children and half adults. The vast majority are in developed countries due to the prohibitive cost of the device, surgery and post-implantation therapy.

The controversy surrounding the implant has the medical profession on one side and the deaf community on the other. While cochlear implants have been welcomed by late-deafened adults, hearing parents of deaf children, audiologists, speech pathologists and surgeons, the implantation of deaf children has been vigorously opposed by many from the signing deaf community.

Someone who is not able to hear can unintentionally become an "outcast" in the hearing community. It is not a conscious decision to make an individual who is deaf feel that way, but with the obvious language barrier it does create an automatic disassociation. Many do not know a person who is deaf, or have the need to communicate with them. As a result many in the deaf community are treated badly. Not only by children but adults as well.

Not only are there social challenges, but educational ones as well. Renae Plumb has been a teachers aid at a pre-school for the deaf in Orem, Utah, and a sign language interpreter at junior high and high schools around the Salt Lake Valley.

"It is hard to keep the attention of a child who is deaf. Trying to teach one deaf child is like trying to teach five hearing children. With a hearing child you can easily get their attention, give them instruction, and if they get frustrated or have a question it is easily expressed. A deaf child gets frustrated easier, acts out more, and it is a very challenging task to keep them focused."

Renae has not only submersed herself in this silent world by the teaching opportunities she has had, but her husband, Kyle Plumb, is deaf. Kyle, however, was not born deaf. He lost his hearing at the age of two due to an ear infection that was not treated properly.

"It is not easy to go through life being different from everyone else. I get treated differently. When I go somewhere with Renae and people see my hearing aids, they ignore me. Even if I ask a direct question they direct the answer to Renae. At work I get treated as though I dont know anything. I am one of the hardest workers there, but becuase I have what they perceive to be a disability, I get treated poorly".

Kyle does not have a Cochlear Implant, but he does have hearing aids. His hearing aids allow him to hear somewhat. But there are sounds that are impossible for his hearing aids to pick up.

I was able to speak with Kyle's mother Sandra Plumb and ask her if a cochlear implant was something that they considered in an attempt to restore his hearing.

"Even though a cochlear implant was an opition that was considered, we decided that ultimately it would not be to Kyle's benefit. The technology that can improve a deaf persons hearing is constantly changing. In the twenty years that Kyle has been deaf we have been able to improve the technology of his hearing aids 5 times. With a cochlear implant it is a common practice to only have the surgery done on one ear. This is because the technology is constatnly changeing and improveing. What we considered to be a problem is that when there would be new or better technology, the old technology would only be in one ear and the new technology in the other. That would cause sounds to be different from one ear to the next causing consant headaches and a change in equilibrium."

The surgery is very invasive. A surgeon has to drill into a person's skull and go deep into the ear canal to implant the device. The surgery has become less invasive than it was twenty years ago, but the risks are still very high.

Kyle said, "People in the deaf community feel very rejected when someone who is deaf wants an implant. It means that they want to be differnt and they are not proud of who they are. This is generally centered around those who sign and have no type of hearing aid. Personally, I want to hear. At night I remove my hearing aids, and it is hard to know that for those eight hours I am in bed I will not be able to hear anything. It feels helpless. I am always going to be deaf. Putting my hearing aids on doesn't change that, so I have had to become fluent in sign. Sign is very differnt from regular speech. Not only for the obvious reason, but for the emotion that is conveyed in sign. When deaf people see hearing people speak, they think that there is nothing to it. They are just moving their lips. There is no way for a deaf person to understand the influction that is used to convey emotion. In sign physical expression is used to convey every emotion that is being felt. Sometimes I feel like I am not accepted by the hearing or even the deaf community".

With a cochlear implant the recipient would still have to learn to lips read, and like Kyle use sign language to be able to communicate. A problem that can arrise with using sign after the implant has been recieved is it can be used as a crutch. This would mean that their speech is never fully developed, and learning how to listen to speech is never mastered. It is also argued the children who are not able to be fully submersed in the deaf culture will never learn what it really means to be deaf.

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