The Cochlear Implant Controversy

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"People should know that
the cochlear implant is not
for everyone."
Laura Mayhall, Former CI User
Day
.June2ht
SendPlunts,
FII}'wel:'$
NEW YORK
Friday, June 12,1998 - 04:12 PM ET
(CBS) Laura Mayhall was born profoundly deaf and was
fitted with hearing aids in both ears when she was only
seven months old. When a series of ear infections
worsened the little residual hearing she had, an
audiologist suggested the cochlear implant.
In 1984, Mayhall's parents decided to try the device
designed for children, which at the time was still
undergoing clinical trials in the United States. Mayhall,
then seven, was accepted in a program at the House Ear
Institute in California for a single-channel implant.
But Mayhall had trouble with her implant. The internal
magnet that keeps the external microphone connected to
the implant did not work well, and because of that, the
headpiece was constantly falling off.
While attending the Portland State School for the Deaf,
she felt ostracized by the other students, who mostly used
hearing aids.
"From my experience, (the CI) affected me in my teen
years because my friends and other people did not
treat me as an equal. The reason for that was because
I was different from them," Mayhall explains.
As a teenager, Mayhall chose to stop using her CI. Her
parents honored her decision.
"I am not angry at my parents. I knew that they were
trying their best to help me," she says.
Laura does not take a side in the debate, but instead
encourages people to gather their information about CIs
carefully.
"People should
for everyone. It
the community,
make," Mayhall
know that the cochlear implant is not
can be successful for some people in
but it is each person's choice to
says.
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She adds that, "I would
maybe use it again in the
future. But now is not the
time."
From their own research
on the topic, parents Pam
and Scott Grugan feel that
after a certain age,
.
cochlear implants may not therapist Mary Koch.
be beneficial to a child's language development, and that
forcing an older child to get an implant is wrong.
But to Scott Grugan, both options are acceptable.
"If we had made the choice for Cecilia to be culturally
deaf, that wouldn't have been a bad decision. It's a
satisfactory decision, along with the cochlear implant.
I think they're pathways that are quite different, but
each have strong merits," Scott says.
Koch is sympathetic to the deaf culture's stance, but
insists that CIs are "an opportunity, not a cure."
For Koch, the success of the technology that she sees
"every single day" speaks louder than any argument.
"When we first hear their voices, it's like a flower
opening."
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'~---'-----'---------------HE~~
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A Question Of Ethics And Culture
~
( t;j»AUDIO.
Dr. Harlan
Lane
DISCusses
Ethical Issues
Concerning
Cochlear
"Deaf people achieve all
sorts of things in the United
States and around the world
despite all kinds of
handicaps ...You don't need
hearing to be an eminent
American."
Dr. Harlan Lane
Tiilj)i3n1S
NEW YORK
Friday, June 12,1998 - 04:12 PM ET
( ~»AUDIO.
Dr. Harlan
Lane
comments On
CI Controversy
(CBS) Many in the deaf community believe that adults
have no right to choose whether their child should be a
member of the hearing world. Since some children with
cochlear implants may struggle more than hearing
children to understand spoken language, many in the deaf
community see this as a form of child abuse.
Dr. Harlan Lane, a professor of
psychology at Northeastern
University, has written several books
that champion the deaf culture's
perspective. Although an advocate of
CIs for adults who lost their hearing
later in their lives, Lane is concerned
about children receiving cochlear implants.
(To hear portions ojCBS.com's interview with Dr.
Harlan Lane, click audio icons at upper left.)
Lane, who is not deaf, fears that children with CIs may
be stuck in a "no-man's land," shunned by both the
hearing and the deaf world. He says the problem with CIs
is also one of ethics.
"It's as if there were a procedure by genetic
engineering to make girl fetuses into boy fetuses. Or a
set of surgical and dermatological
procedures to help
some black people pass as white," Lane says.
"If parents come forward and say, 'We want our
child to be physically different because life is easier
for a boy, life is easier for a lighter-skinned African
American in the United States,' we rear back from
that and say, 'Wait a minute - something's seriously
wrong here.'"
Adding to the ethical problem, Lane says, is that the
surgery is still innovative, despite the FDA's approval.
Because results indicate that children develop language
skills better when they get the implant under the age of
five, Lane says that experimental - and unnecessary surgery is being done on very young children who have
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no say in the matter.
"Generally I think we want to avoid innovative
surgery with kids unless of course there's a lifesaving
issue," Lane says.
Lane also contends that there's not enough research data
to show that children who were born dei'f communicate
better with spoken language with the implant than
without. He says the FDA's approval was based primarily
on evidence that children who had a hearing memory and
who received the implant very young, had only
marginally improved learning skills than other deaf
children.
Scott Grugan, whose 4-year-old daughter Cecilia
received a cochlear implant last year, has heard
arguments like Lane's. Although he says he respects the
deaf community's view, he urges them to respect his.
"Being an African
American is not an
abnormality, but being
deaf is an abnormality of
the inner ear and I've
never heard anyone be
able to make a claim to
the contrary." Grugan
says.
"With culturally deaf adults, they insist that there is
nothing abnormal about them - they do not have a
disability, they're simply different," he says. "Our
record on this issue as a society is very bad. That is,
we tend to see difference as biological inferiority."
Researchers have found that children who receive
implants at a younger age have a better chance of
learning how to interpret sound. With children older than
five, their ability to catch up with their peers is greatly
diminished.
"It's believed that the pathways from the ear to the
inner recesses of the brain are atrophied and
incapable of acquiring language through speech and
hearing," Grugan, who himself is a radiologist, explains.
Grugan insists that for he and his wife, Pam, to choose
not to implant his daughter would be "robbing her of
the ability to choose. Because she can take the CI off,
and the moment she does she's deaf again."
Lane says that hearing is not vital to a person's success.
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"Deaf people achieve all sorts of things in the United
States and around the world despite all kinds of
handicaps ...You don't need hearing to be an eminent
American," Lane says.
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,··-··------·-·---·------------H-FA llH.__~_~~I:~J()_NEWS
The Cochlear Implant Controversy
~
"The (deaf community's)
perception is that there's
nothing wrong ...Our
perception is, there is
something that needs to be
fixed."
Mary Koch, Therapist
NEWYORK
Saturday, June 13,1998 - 03:40 PM ET
(CBS) The controversy over cochlear implants in
children has many sides. For some in the deaf
community, CIs are an affront to their culture, which as
they view it, is a minority threatened by the hearing
majority.
The deaf community feels that its way of life is fully
functional, and that using American Sign Language
instead of oral English gives them no disadvantage in
society.
Mary Koch, who started the children's rehabilitation
program at Johns Hopkins' Listening Center, says the
medical world and the deaf world were split at the outset.
"The (deaf community's) perception is that there's
nothing wrong. There's nothing that needs to be fixed.
Our perception is, there is something that needs to be
fixed. So from the very foundation, we're diverging in
our perspectives," Koch says.
The deaf revolution was spawned in the 1970's. The
culture rebelled against attempts by some educators in
the hearing world to teach deaf children to speak English.
The" oral" approach discouraged the use of sign
language, yet many children - even with the most
powerful hearing aids - had difficulty understanding what
was supposed to be their native language.
Sigrid Cerf became deaf at the age of three, but grew up
outside the deaf community, speaking English and
lipreading. She remembers the strain of trying to grasp
the subtleties of spoken English.
"It took a great deal of effort to put words together
because all I heard were those vowels and my brain
would be working and my whole body would be
tensed and stressed from trying to piece words
together," Cerf explains.
,
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Cerf received a cochlear implant when she was 53, but
says she understands the deaf perspective.
"The deaf community is a culture. They're much like
the culture of the Hispanic community, for example,
where parents who are Hispanic, or shall we say deaf,
would naturally want to retain their family ties by
their common language, their primary language,
which is either Spanish or in our case its American
Sign Language," Cerf says.
"It's difficult to accept something that would take
someone's entire culture into question."
Gallaudet University - considered the "Harvard" of the
deaf community - has been watched closely by all sides
in the debate for its position on CIs.
Mercy Coogan, Director of Public Relations at Gallaudet,
says the university doesn't have a stand on cochlear
implants.
"We try to be a forum where people can look at it
objectively," Coogan says. "A university is where you
debate issues, then make judgments based on that
debate. "
The school is organizing a conference on CIs slated to
open next year and plans to invite people from all sides
of the controversy: culturally deaf people, CI users,
doctors, and parents of children who are deaf. The event
is intended to provide an arena for information-sharing
and for airing opinions. But Coogan does expect sparks
to fly.
"Will it be controversial?" Coogan muses. "Sure it
will be. Because it's a very hot topic."
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