Cochlear implants in children: ethics and choices

Cochlear Implants in Children: Ethics and vices by John B. Christia and Irene W. Leigh. (Washington, D.C.: Gallaudet University Press, 2002, 340 pp., casebound, $49.95) LIKE MANY readers of this journal, I have followed the cochlear implant controversy with a cautious and curious stance, not wanting to take sides with any level of passion. As an educator, I would welcome any technological advance that might enhance cognitive and/or linguistic development in deaf children. Months ago, I saw a segment on television about a young deaf girl who received an implant. I watched as she was playing in the yard and "heard" an airplane flying overhead. The thought that she was made aware of something in the environment and this may have stimulated her thinking about the world around her was quickly lost when the medical doctor and interviewer focused on how long it would be before the young girl would speak like her hearing peers. "Wrong focus," I thought. Before advocating the use of such technology on a large-scale basis, I would want to see some research results showing its potential for improving the quality of life. Deaf education has a long history of armchair philosophizing about technology. Closed and open captions, the TTY, and now the Internet, for example, have all been touted in books, magazines, and journals in terms of their potential effects on learning. Yet, there is no great body of research that provides evidence of benefits beyond increased access to information for deaf and hard of hearing people. A glimpse into history also provides some understanding of why there is so much emotion attached to technological advances. "Advances" in voice telephony led to a ninety-year delay in access to the telephone for deaf people. "Advances" in adding the sound track to silent movies led to more than forty years of lost access to films. For hundreds of years, deaf people, viewed as "disabled," have been treated with chemical and electrical "cures," sent up for airplane dives, and subjected to a multitude of other medical fixes. Emotions have long been a part of Deaf education history. The Deaf community has long included many different types of people, and we have experienced technology's impact in different ways. The TTY, for example, eliminated the need for face-to-face communication, saving deaf people long drives to a Deaf club or to the homes of family members and friends just for personal communication. In turn, instant messaging and the Internet may be having an impact on the need for the TTY. Regardless, the TTY would never have come about without collaboration between signing and nonsigning deaf people in the National Association of the Deaf and the Alexander Graham Bell Association for the Deaf (through the organization now known as Telecommunications for the Deaf, Inc., or TDI). All the while, American Sign Language (ASL) has become recognized as a true language and is used increasingly by many deaf and hearing people. A number of universities and state education departments recognize ASL as a foreign language. As a deaf person myself, I have deaf friends who have had a range of experiences with cochlear implants. One just received an implant at the age of fifty-six and is delighted with it. So are two friends who are in their thirties. Another received hers fifteen years ago and blames the implant for migraines and frequent nausea. A fourth friend had several implants over the past ten years and does not use an implant now. It only makes me curious. I have wondered also about the range of experiences younger deaf children have with implants. While at a conference at James Madison University last fall I dropped in at the end of a presentation by a cochlear implant expert and was delighted to see him advocating continued use of sign language with implanted children. Yet I also read an article about a school established for implanted children that would not allow the use of sign language. …