Are Cochlear Implants Appropriate for Young Children?

"Aural Argument: Toddlers’ Implants Bring Upheaval To Deaf Education; Cochlear Devices Help Kids Join Mainstream Classes; Will Sign Language Die?; A Picket Against Dr. Green"
Author: Paul Davies
Publication: The Wall Street Journal
Date: March 29, 2005

Cochlear implants were originally approved for adults in 1985. In 2000, the FDA authorized their use in children as young as 12 months old, further inflaming the outraged deaf community. Members of the deaf community insist that deafness is not a disability and so perceive implants as an effort to fix what is not broken. Deafness, they argue, ought not be labeled as a pathological condition, but accepted as a natural state. Their more practical objection is that the invasive implant surgery destroys residual hearing such that patients are forever dependent on the device. Given the magnitude of the intervention, deaf advocates claim it is unethical for young healthy children to come under the knife before they are old enough to decide for themselves. However, proponents of the technology contend that the operation must be performed on very young children to maximize their likelihood of developing speech. It is the hearing world’s overriding preoccupation with speech that so concerns deaf advocates. They fear parents are forcing their deaf children down the auditory/oral communication route to the exclusion of sign language, even when the latter could prove beneficial. They reprove parents for taking the more convenient approach, instead of offering their children all the valuable tools at their disposal.

Davies’ article examines, in particular, how adjustments to deaf education have been necessitated by the rise in cochlear implant use among young children. Confronted by declining enrollment rates, schools for the deaf have begun introducing programs for children with cochlear implants. For instance, the South Dakota School for the Deaf was divided into two departments, one which focused on auditory and oral skills, and the other which focused on American Sign Language. Deaf advocates protested this new arrangement, claiming that the implant program would divert resources from the hearing aid program. This isolated dispute in deaf education is illustrative of the wider conflict between those who value normalization and those who want to preserve deaf culture.

With its own language and history, the deaf community has created for itself a unique culture; yet the threat of cultural extinction looms ever more ominously as larger numbers of children receive cochlear implants. It is reported that more than 90% of all deaf children are born to hearing parents. Not surprisingly, their training is focused on oral and auditory communication in preparation for life in the mainstream hearing world. So our preliminary question of the appropriateness of cochlear implants for young children takes us to a new question: To what extent can parents choose what is right for their children?