Benefits and Risks of Cochlear Implants

As an electrical device surgically implanted to assist recipients, especially who are suffering from profound hearing impairment, to access sound and achieve near-to-normal speech understanding by providing a sensation of sound in a relatively quiet acoustic environment, cochlear implants have always been controversial among the deaf as well as hearing parents with deaf kids. Because first, although increasingly advanced technology has been applied in the development and upgrading of this device, still in no way can it be considered a cure for deafness. By stimulating the auditory nerve directly rather than amplifying sound as much as possible with residual hearing, the implant processes digital signals through to a wire equipped with far less electrodes corresponding to different signal frequencies than that of a functional cochlea, resulting in inevitable hearing limitation and sound distortion. Nonetheless, it surely is a groundbreaking improvement compared to the old-school hearing aid. There’s no denying that implants do produce the facsimile of sound for those with severe hearing loss, hence providing a chance for the deaf, especially the early-deafened children who apparently have a much more promising chance of mastering spoken language, to flourish in both the deaf community and the world of sound, which, as the main advantage, has already got more reason to outmatch other potential drawbacks.

According to the criteria set by the FDA, children aged one year and older who are in need of such devices are eligible for a cochlear implant. Robert Ruben, former chairman of the Unified Department of Otolaryngology at Montefiore Medical, Center, advised. "Language of any kind, no matter what kind, must somehow be got into the head of the child soon enough". When you think about it, implanting at a young age actually makes a lot of sense since being exposed to sound during such a critical period of learning would greatly improve their odds of language acquisition and smoother assimilation to the hearing world when they grow up. And also, earlier as they start, sooner they would get through the intense post-surgery speech and language therapy to get used to the implant without the entanglement of substantial sunk cost mostly present on implanted adults who’s taken years of detour by wearing hearing aids. Despite the fact that a cochlear implant can only provide 1%, give or take, of the aural acuity of a well-function hearing system, basic comprehension and communication with the outside world is still desired for the vast majority living in soundlessness. Thus, to conclude, as long as the candidates pass all the tests mandated by their audiologists and surgeons, they ought to get implanted as early as possible.

With the necessity to receive cochlear implant for a kid with severely-impaired hearing established, is there an optimal timing for surgery or better on a case-by-case basis figured out later when the recipients step into adulthood or adolescence? There are potential problems that come with. For one, how does one draw the line of timing when a child is fully capable of making his/her own decisions? If legal definition is the way to go, then besides missing the perfect window of language use, inevitably the certain young man/woman would have already got used to living in the deaf community and reluctant to leave his/her comfort zone to deal with the hassle of picking up a brand-new oral language at the risk of getting sideways glances each time he/she speaks. As Rome is not built in one day, cochlear implant training is no easy job either. Extensive practices are required for a recipient to achieve the most optimized comprehension from the device, fine-tuning and adjustments from the audiologists during the training are quite time-consuming as well since sounds processed via the device might be unnatural at first, hence it would twice or even more troublesome for the recipient who’s probably a full-time student or has a day job. Furthermore, even though it’s not the main concern for the person undergoing the trouble himself/herself, the whole argument that the surgery should wait until the child can decide whether to go through or not sounds much like a disingenuous false statement that is not in the child’s best interest for the simple reason that the standpoint from someone who has spent more than 10 years of committing to the deaf community due to the incapability to communicate smoothly with others must have gone through a seismic shift and swayed from neutrality.

As a matter of fact, the advantages of cochlear implant are countless, first and foremost, the chance of mastering oral language for a prelingually deaf child is astoundingly promising, at the very least, to a degree where they can be well-functioning individuals in the hearing world at a comfortable level. The intensity and difficulty of auditory therapy and training would also be mitigated for young learners. If instead, the parents decide to wait until consent from their children is in place, then they’re surrendering their child to an arduous regimen of auditory therapy that is much less likely to result in successful oral language skills, rendering the adoption of cochlear implant ineffective, to begin with. With cochlear implanted, the recipient is able to bridge the culture between the deaf as well as the hearing world rather than left with no choice but confined to the deaf community regardless of their willingness. Not that there’s anything wrong with any one of the communities, but it’s always ideal to have an alternative. Some kids actually long for an active social life with family, friends, schoolmates, and co-workers. Courtesy of cochlear implant, a better speech perception to expand career opportunities and participate in a learning environment more independently to experience a boost in confidence in life is available for them now. And the list of benefits goes on, for instance, awareness enhancing on the occasion of imminent dangers, such as being more alert to car horns, sirens, fire alarms, etc.

Of course, the technology behind the device is hardly perfect at this point, inerasable background noise that constantly annoys the wearers, destruction of their residual hearing and relatively high cost of surgery and therapy that comes after, but what’s really the hot-button issue lying around stirring up ongoing controversy is primarily the discontentment from the deaf community targeting the public’s discrimination of defining deafness as a disability. The cochlear implant debate is really a holding mechanism for a larger debate about assimilation versus alienation, about the extent to which standardizing human populations is a laudable mark of progress and the extent to which it is a poorly whitewashed eugenics. Instead of being passively labeled as disabled or a patient, they prefer to be addressed as members of a minority cultural group, using the American Sign Language they’re fiercely proud of, because from their perspectives, being deaf is part of their identity and getting a cochlear implant would destroy their identity, a disrespectful betrayal to the cultural values preserved by generations of predecessors to some extent. By all means, that’s honorable, but changes are simply inevitable with social and technological evolvement in progress. It’s one thing to defend one’s own belief, but a totally different thing to intervene other’s with one-size-fits-all criteria. However, there’s no reason why this ethical conundrum could not be moderated by a little nudging from responsible parents to provide bilingual upbringing to their children with a cochlear implant, with both sign and oral language. It’s a safe bet to raise children with more than one string to their bow to secure them a future available to more possibilities.