There’s a terrific story in today’s Wall Street Journal about the rapid increase in the number of children receiving implants before the age of three. To date approximately 10,000 children have received cochlear implants in the U.S., and the reported results are outstanding: kids who in the past would have found it very difficult to develop normal speech are able to start hearing early enough to learn spoken language at a normal developmental age.
A big reason for this success is a public health program funded by the federal government, which in 2003 screened 90 percent of newborns for hearing loss in hospitals across the country. (Unfortunately,the Early Hearing Detection and Intervention Program administered by the Maternal Child Health Bureau is on the chopping block in the Bush administration’s planned budget for the coming fiscal year. I will talk about the fate of EHDI in an upcoming post.) Early detection of hearing loss and immediate intervention can put a hearing-impaired child on the same critical developmental learning path that children with normal hearing are on. Given the success of cochlear implants, many are predicting the procedure ultimately will be done most often in the first year of a deaf child’s life.
But implants still aren’t a panacea. When I first suffered my hearing loss, friends asked me, “What about a cochlear implant?” They had heard about this seeming miracle cure for deafness and hoped perhaps I could just go into the hospital, plug in some new hardware, and come home good as new. I did some research and discovered what they didn’t know: the results vary tremendously, the norm is hearing and comprehension at levels below normal, and like any major surgery, there are not insignificant risks of complications. And then there’s the $60,000 price tag that insurance companies are very selective about covering. Even with 70 percent loss, I wasn’t a prime candidate for the procedure. So we’re still years away from a complete cure available to the masses. But the technology is improving on a daily basis and already is having a tremendous impact on peoples’ lives, especially children born deaf.
There is a downside, however. According to The Wall Street Journal story, giving kids some ability to hear with a cochlear implant makes it less likely they will go through the worthwhile effort to learn and use American Sign Language. Because signing gives deaf children the ability to learn a complete language with its own vocabulary and syntax, they proceed on the same developmental path as children who learn spoken language. Learning sign language and starting to communicate with peers and adults at an early age helps children develop socially and intellectually in ways that make them far more successful in society throughout their lives, even when they never learn spoken language. So a dramatic decrease in the number of children learning sign language would be a real threat to the thriving deaf culture which has helped hundreds of thousands of deaf people throughout the world. Ideally kids would be given both — an implant to help them hear, if even imperfectly, as well as complete immersion in sign language. But the question remains whether that’s a practical expectation, given the time, cost and energy required.