Hearing but still Deaf?

Cochlear implants arouse strong feelings. Some people talk of them as miracle machines. So why do others think they're potentially disastrous, both for the individual and for the Deaf community?

For a start, implants aren't for everyone. They're generally thought suitable for people who have severe to profound deafness in both ears and who aren't helped by conventional hearing aids. In these people it is generally the hairs in the cochlea or inner ear (which pick up vibrations caused by sound) which are damaged, not the auditory nerve (which sends the signals to the brain). Plus there's concern that implants will discourage children from learning to sign, cutting them off from the Deaf community and Deaf culture. It's argued that people with implants may fit into neither the hearing nor the Deaf worlds.

Some experts believe implantation works best when performed on young children, so that a child can learn to recognise sounds from an early age. But this puts parents in the extremely difficult position of having to make a decision on their child's behalf. Others think that the decision should only be made by individuals when they are old enough to decide for themselves and when they can already sign, so that they will not be isolated from the Deaf community.

How does an implant work?

A small microphone inside a headpiece, worn behind the ear like a hearing aid, picks up sound and sends it down a wire to a speech processor or microcomputer, also worn externally. The processor converts the sound into coded electrical signals and sends them back to a transmitter in the headpiece. These signals are then picked up by a tiny radio receiver under the skin, which is connected by a wire to minute electrodes implanted in the cochlear, which in turn stimulate the auditory nerve, sending messages to the brain that are interpreted as sound.

So what is this 'sound' like? The answer is that it's different for different people. Sometimes, at first, it's just squeaks. Speech therapy and training are vital to help people recognise what they are 'hearing'.

Unchanged identity

Last week VEE-TV talked to Piers Kittel, who asked for an implant when he was 13, overcoming his parents' doubts. He says it is still possible to identify with the Deaf world. 'After I had my implant, my Deaf identity became stronger, even though deaf people were against it,' he says. 'I'll always be part of the Deaf world. There's no way I'd lose it. I'll still sign. I love the Deaf world. If somebody held a gun to my head and said, "Choose the implant or Deaf identity," I would choose Deaf identity without hesitating.'

The debate

This week the VEE-TV debate was about cochlear implants. Taking part were Yoav Felberbaum, who had a cochlear implant when he was 17; Paul Welton, who at the age of 27 has recently been assessed for an implant; and Alex Redpath, who says he would never have an implant.

Yoav argues that a cochlear implant is 'just a better version of a hearing aid' and, like Piers, says he's 'still Deaf'.

'But that's not what other people will call you,' Alex says. 'They'll call you the one with the cochlear implant.' However, Alex agrees that people should be able to decide for themselves, when they are old enough.

Paul is thinking about having an implant 'just to help communicate with hearing people'. But he is worried that the device won't work and about the attitude of other deaf people.

Internet forums are busy with people discussing the same subject. If you've got something to say on the subject, go to our message board. Here are a sample of comments from other sites:

'Each child should be viewed as an individual. Some children will benefit from a cochlear implant and some will not. First and foremost, TOTAL COMMUNICATION is a priority.'

'With deafness, you will lean toward the Deaf culture. If that is taken away at an early age, then the child is not likely to be able to stay in that culture comfortably at a later age.'

'I believe it is wrong to implant children. Hearing parents often do not know about the Deaf culture. They want their child to be hearing just like them. There is a beautiful Deaf world out there, and contrary to popular hearing belief, deaf people do lead rich and rewarding lives without the ability to hear. Please do not be so quick to "fix" a problem … it isn't a problem.'

'I once went to a meeting for deaf people, and there were two speakers that had implants. Their stories were very compelling. [One of them] explained the sounds of rain hitting the window-sill … I mean wow!!!'

Implant facts

• To receive an implant, you have to be referred by your GP to a consultant, who may in turn refer you to one of the UK's cochlear implant centres. You will have to undertake a series of tests to assess your suitability.
• If a decision to go ahead is taken, the waiting time is usually between one and five months.
• The operation itself takes about three hours. The usual hospital stay is two to three days.
• The device is usually actually switched on about four weeks after the operation.
• The world’s first cochlear implant operation was carried out in France in 1957.
• More than 30,000 individuals have been implanted worldwide (1999).
• More than 200 children a year are currently receiving implants in the UK.
• The most common age of children at implantation is three years.
• On the NHS, the cost of one type of multi-channel implant, with surgery and a rehabilitation programme, is currently £22,000-£30,000.

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