LINGUIST List 10.241

Tue Feb 16 1999

Disc: Sign Language and Cochlear Implants

Editor for this issue: Karen Milligan <karenlinguistlist.org>


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  1. Katy Beals, re: 10.174, Disc: Sign Language and Cochlear Implants

Message 1: re: 10.174, Disc: Sign Language and Cochlear Implants

Date: Tue, 9 Feb 99 20:12:52 EST
From: Katy Beals <bealsslu.tr.unisys.com>
Subject: re: 10.174, Disc: Sign Language and Cochlear Implants

	Unfortunately Frishberg's response rehashes some of the same flawed 
arguments one hears time and again from the most vocal opposition to cochlear 
implants. I am thus motivated to point out these flaws in the hopes giving
some of these people reason to be a little more sensitive and nuanced in their
thinking.
	Let me say first off that I am, on the one hand, a linguist who is
fully aware that ASL is a full-fledged language and that modality per se
doesn't matter for the acquisition of Language (though, importantly, it
DOES matter for the acquisition of literacy, since as yet no one has been able
to devise a workable writing system for signed languages).
	Secondly, I am a parent who made the decision to have her son
undergo cochlear implant surgery, and to raise him bilingually with ASL
and speech, because I believe that two things are unethical:

1. To deprive a deaf child of the language most naturally accessable to him
(in the case of deaf children, a visual language) at an age when he is most 
able to pick it up, and of linguistic access to the culture within which he 
may end up feeling most comfortable.

2. To deprive a child of a safe procudure that will give him greater access
to the language of his family (substantially increasing his language exposure 
within the home) and of his geographic community (improving his social life
within the neighborhood in which he grows up), and improve his educational 
and job opportunities, at an age when he is most likely to reap such benefits.

	The arguments put forth by Harlan Lane in his most recent book, (1997)
A Journey into the Deaf-World (co-authored with Ben Bahan and Richard
Hoffmeister), in a chapter entitled "The Hearing Agenda II: Eradicating the 
Deaf-World", repeat and elaborate the arguments Frishberg refers
to. "Long and complex" as they may be, they contain factual and logical
errors and highly questionable assumptions stated as truisms. Some time 
ago I wrote a several page critique detailing these, and I'm happy to 
send it along to anyone who is interested. In short, though, Lane's 
"scientific" argument is highly selective in his discussion of the statistics 
of word recognition abilities of post-implantees; his cultural argument is
based on a dubious comparison of hearing parents raising a deaf child to
white parents raising an adopted black child, on dubious and racist
assumptions about innate cultural characteristics, and on a failure to show
any distinction in cultural implications between coclear implants and
hearing aids; and his discussion of the practical issues surrounding the 
raising of deaf children and being deaf in a hearing world conflates the 
highly divergent circumstances of deaf children raised by hearing parents, 
on the one hand, and deaf children raised by deaf parents, on the other.
	Like Frishberg, Lane tries to buttress his arguments by invoking the 
supposed "bad guys"/straw men: the medical professionals, cynically 
distorting the picture so they can make money off of the naive and hopeful 
parents; and the "audists", who say that it is bad to be deaf, that deaf 
people are broken, that they should be made to conform to the dominant culture,
who slap their deaf children when they sign instead of speaking, etc, etc...
One hears about these bad guys so often in this debate that it's easy to
forget to question who they are, exactly, and whether they really behave this
badly. I have yet to encounter an audist who fits Frishberg's description, 
though I've met plenty of people who are concerned about deaf children's 
education and job opportunities and the difficulty that hearing parents have 
communicating with them.
	As for the medical professionals, please note that cochlear implant 
surgery is not the big money-making operation that Frishberg suggests: implant 
centers typically need to raise money from charitable donations to cover costs 
(and insurance companies foot the bill for most of what patients are charged, 
making cochlear implant surgery similar to hearing aids in cost to the 
patient). Our son's surgeon could make much more money doing other kinds of 
ear surgery if he wanted to. Why are doctors in the business of performing CI
 surgery, if not for the money, and why do charitable individuals and 
organizations support them? Our son's surgeon cites the average 3rd or 4th 
grade reading level of deaf high school graduates.
(As I indicated above, becoming literate, particularly in a phonologically
based writing system such as ours, is much more difficult for someone 
who lacks access to the spoken language on which the writing system is based: 
just imagine what "sounding out" words, or remembering spelling patterns
would be like, or, more fundamentally, what it's like to learn a language
primarily through its graphical symbols).

	Nor do the implant centers tell parents that the surgery will "make
their children hearing". In fact, if Frishberg were to listen in on
a pre-surgery evaluation session or to read the literature that one must
sign before surgery occurs, she would see that the centers go out of their
way not to raise expectations. Nothing is guaranteed; one is told that
the implant may help your child with spoken language, and one is given
names and phone numbers of parents with implanted children in order to
get first-hand accounts.
	Some of the supposed good guys, on the other hand, may not
have the purest of motives. I'm told that Harlan Lane charges hefty
honoraria for his inflamatory speeches on cochlear implants, speeches in
which, among other things, he accuses medical professionals of trying to
commit cultural genocide.

	In addition to Frishberg's simplistic characterization of the good and
bad players, she fails to distinguish different circumstances of childhood
implantation. In general, the later the implantation occurs, the worse
the outcome is, as neurons atrophe and brain plasticity declines. There
is, thus, a big difference between a prelingually deaf child who gets the 
implant before age 2, as my son did, and one who gets the implant after, say,
age 10. Indeed, I would argue against implanting anyone this old, as do many 
implant centers. The late implantee will have much more trouble learning to 
extract meaning and beauty from the sound signals he receives, will need many 
hours of auditory and speech therapy, and is quite likely to eventually stop 
using the implant and to resent its ever having been implanted in him. One
finds lots of these people at Gallaudet (I've corresponded with some of them), 
and if that's Fishberb's only source of anecdotes about implant outcomes, we 
have an explanation for her distorted impression.
	On the other hand there is the (prelingually deaf) child who gets
the implant before age 2. Unlike the late implantee, and, indeed, unlike
the typical unimplated deaf child, this child does not undergo hours of tedious
therapy every week, and, to the extent that there is any deliberate "therapy", 
it is done in the form of play that the child enjoys. Few two-year-olds
would put up with anything else! And after the first year or two, unlike
with other deaf children, there is typically little perceived need for 
auditory and speech therapy. For someone unfamiliar with the cochlear
implant centers and their patients, these successful implantees are much more
difficult to find then the unsucessful ones because they tend to be much
more integrated into the larger society, and not, for the most part, 
attending schools specifically for deaf children. Yet they are out
there, and among young implantees, far outnumber their unsucessfully-implanted
counterparts.
	A few words about Jonah, our deaf son. He was implanted at age
1 1/2, the earliest age when cochlear implant surgery is currently allowed
in this country, and is now one year, one month post implant. He is
NOT one of those implant whiz kids one might hear about on TV magazine
shows; in fact, though a bright child, he has consistently been somewhat below 
average in his reception of spoken language, and is not yet talking, and we 
have some reason to believe that he may have social/communicative issues 
unrelated to his deafness. On the other hand, he understands, without 
lipreading, most of the key words he hears frequently and that are most 
important to him (at last count, over 70), he makes a variety of speech 
sounds and has been babbling for the last 6 months, he enjoys music and can 
distinguish different environmental sounds even in cacophonous environments, 
and he likes his implant so much that he doesn't want it off at night and is 
upset when the battery runs out, even though he is not linguistically 
dependent on it when at home with us, where we all sign. His sign language 
has followed a relatively normal course, though it, too, is somewhat 
below average for his age (at least compared to deaf children whose 
parents sign at least as well and as much as we do). For us, the implant 
has been a way for us not only to improve his access to language and social 
activities, but also to draw him out of the private world he so often inhabits,
and we're very happy with his progress.
	Finally let me correct one of Frishberg's medical claims. She says 
that implant surgery destroys the "physical structure of the cochlea and other
parts of the ear", so that "these CIs would not be candidates for any other
surgical procedure". The only part of the ear vulnerable to implant surgery 
are the hair cells (scillia) of the cochlea (which in the deaf ear are already 
dysfunctional) and not its physical structure. Since only one ear is 
implanted, the other ear is available for whatever new procedure might come 
along. And researchers are optimistic about developing the technology to 
regenerate those damaged hair cells-- in fact, this is currently thought to
be the most promising new area in hearing-enhancing technology.


Katharine Beals, PhD
Computational Linguist
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