When the silence is broken
Young children with hearing loss who have received a cochlear implant are suddenly able to perceive speech. A team led by Professor Annette Leonhardt of LMU Munich is now studying what else changes for them.
“For almost three years she never used her voice, and couldn’t hear – and now there is this huge change. She can speak, she can hear.” This was what the deaf mother of a three-year-old daughter who had received a cochlear implant signed to LMU educational therapist Kirstin Busch in an interview. A cochlear implant (CI) is a prosthetic device which converts sound waves into nerve impulses that stimulate the auditory nerve. Since 2011 Busch has been studying how family life changes when hearing-impaired children of deaf parents are fitted with a CI. With the help of interviews, a psychological test, and questionnaires, she has characterized the impact of the intervention, both from the perspective of the deaf parents and that of the child.
In most cases CIs are implanted when the patient is between 1 and 3 years of age. The families studied by Karin Busch are very pleased with the results. Some parents report that relationships within the family – between siblings, for instance – have improved, and that the CI has a positive effect on the child’s development. “Ever since he got the cochlear implant, he has been more cheerful and sociable; he goes up to people and speaks to them. He has changed completely, and I think it’s wonderful,” said one mother.
Sign language remains important
Daily routines hardly change at all. Sign language remains the primary means of communication between parents and children, although deaf parents do tend to make more use of vocalization than before. Research done by Johanna Dumanski supports these observations. Dumanski has been studying the development of vocabulary in children who have received a CI, and whose parents are either profoundly deaf or are hard of hearing. Depending on the context, the child will use either sign language or speech. Moreover, half of the children studied acquire a vocabulary that is similar to that of their hearing peers. “The speech tests are standardized for children who are raised in a normal auditory environment,” Dumanski points out. “So the children of deaf parents accomplish an enormous amount when they are fitted with a CI. After all, they grow up under very different conditions.”
The two studies show that, for CI recipients whose parents are deaf, both spoken language and sign language are important. This is an area in which parents would like to have more guidance. It is also an issue that concerns those who are in daily contact with these children in kindergarten and at school, as well as the health professionals who care for them. “Deaf parents often feel pressured by doctors to have their children fitted with CIs as soon as possible, and this can leave them with the impression that their lives as members of the deaf community are being devalued,” says Kirstin Busch. Provision of more nursery and kindergarten schools that cater for the needs of children with hearing loss would also help these families.
How parents decide
Deaf parents who decide to have their child fitted with a CI are motivated primarily by concerns for the child’s future career prospects. In some cases, this decision may be met with skepticism or provoke a critical reaction on the part of deaf relatives and friends. However, in many families, it is the child who takes the first step, and expresses the wish to have the CI.
“The degree of acceptance of the cochlear implant in the deaf community is growing, but reservations remain, especially with regard to its use in children,” says Annette Leonhardt. Another project now underway at her Institute for the Education of the Deaf and Hard of Hearing at LMU is devoted to young adults who were fitted with an implant as hearing-impaired children, and whose parents are deaf. In this study, the participants are asked to describe their own experiences with the implant (“One has to learn to hear all over again”) and the reactions of people around them. The early results indicate that all those interviewed are quite satisfied with the implants.
In Germany the frequency of hearing loss among newborns is 2-3 per 1000 live births and, in around 90% of cases, the parents of these children have normal hearing. It is estimated that between 100 and 150 children whose parents are deaf are referred to CI centers. nh