Cochlear Implants

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According to the U.S. Food and Drug Administration, about 13,000 adults and nearly 10,000 children have received cochlear implants in the United States (NIDCD, 2002). Children as young as 12 months are eligible for implantation, and many advocates are suggesting that children should receive the cochlear implant as early as 6 months of age.

A cochlear implant is a small, complex electronic device that can help provide a sense of sound to a person who is profoundly deaf or severely hard of hearing. An implant 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 receive signals from the speech processor and convert them into electric impulses
• Electrodes, which collect the impulses from the stimulator and send them to the brain

The electrodes are the portion of the implant that is inserted within the cochlea. The other portions are worn externally. Cochlear implants work differently from hearing aids. Hearing aids are designed to amplify sound. To a person with severe to profound hearing loss, amplification won't provide much hearing because sound is still being delivered through a damaged part of the ear. A cochlear implant doesn't make sounds louder; it bypasses the damaged part of the ear and sends sound directly to the auditory (hearing) nerve to provide a clearer understanding of sound and speech.

Even with this bypass system, an implant does not restore or create normal hearing. Instead, it can give individuals a useful auditory understanding of the environment and help them understand speech. For a simulation of what it sounds like to hear with a cochlear implant, visit http://www.isvr.soton.ac.uk/audiology/soecic/frameset.html.

Because cochlear implants are specifically designed for use with individuals who have severe to profound hearing loss, their use has been questioned by the Deaf community. Historically, individuals with this degree of hearing loss have been users of ASL, but children who receive implants are much more likely to use spoken language instead of signed language. Many representatives of the Deaf community have questioned the use of cochlear implants with young children. They have expressed concerns about the safety and reliability of the implants; the variability of results (not all individuals with cochlear implants develop understanding of spoken language); the misrepresentation of implants in the mainstream media as a cure for deafness; and certainly the possibility that, if all parents choose implantation, the cultural use of ASL will diminish. The National Association of the Deaf (2000) encourages parents considering implantation to "meet and get to know successful deaf and hard of hearing children and adults who are fluent in sign language and English, both with and without implants."

In 2001, a PBS documentary depicting the controversy over cochlear implantation was nominated for an Academy Award for Best Documentary Feature. Sound and Fury describes one family's struggle over whether or not to provide two deaf children with cochlear implants.