Michigan State University > College of Education : JDSDE-Author-Corner : Parent's Views on Changing Communication After Cochlear Implantation - messages

Parent's Views on Changing Communication After Cochlear Implantation : Observation

sweetwavy — Thu, 03 Jul 2008 22:58:06 GMT

My most significant learning from this discussion is how differently each and every individual’s communication has or has not changed after implantation. It was interesting to see how the child’s approach to spoken language and/or sign language was dependent on their needs and preference. I was surprised to learn that younger children would be the most likely to be successful in communication skills after getting an implant. The reason why I was so surprised, because I got an implant when I was 4 years old and my communication didn’t change much after implantation. I used sign language a lot before I got an implant, and then continued to use it after I was implanted. My approach toward the spoken language didn’t work out because of my needs and preference of using sign language. I would also like to share my experience with the student I worked with. He is 8 years old and got an implant a few months ago. I have not yet seen any improvement in his communication approach of using spoken language or sign language. He used sign language a lot, and did not rely on his cochlear implant a whole lot. The parents felt that it would help change his communication after implantation, but unfortunately, that has not happened. I can understand now that Watson mentioned that older children were less likely to change. I was glad to have the opportunity to learn from other parents’ experiences with their deaf child. It was fascinating to hear about Mary’s experience with her daughter Hailey and the parent’s experience with his son, Michael. Hailey and Michael each have their own experiences with using an implant and how successful they are with it. Each illustrate their communication approach has or has not changed after getting an implant.

Parent's Views on Changing Communication After Cochlear Implantation : re: Educational Optiona

luckyday — Mon, 09 Jun 2008 01:26:48 GMT

I'm amazed at all the options available in other places. It seems like our town is at a critical point. An oral program may be starting in the fall. The TC program has been struggling with staffing issues, which have led to numbers issues in the student population. I really don't know what we're going to do in the fall.

I think there is a bias I haven't seen discussed in the study about CI kids using more speech. That the parents even got the CI shows that the family values the development of speech. It is like saying that of these children in sports programs, there is statistically significant level of competitiveness.

My son is right below the border for CI eligibility. If we really wanted to get one (and some days I do, honestly) I'm sure we could find a doctor to do it for us. So I struggle with this subject as an outsider.

Parent's Views on Changing Communication After Cochlear Implantation : re: CIs need support

ellen54 — Fri, 06 Jun 2008 23:44:32 GMT

I work as an Itinerant Hearing Impaired Intervention Specialist and you are right most teachers of the Deaf don't have expertise in CI's. I do because I've made it a huge priority to be knowledgable and I've been teaching 32 years. I find that it's not that difficult if you keep up with current trends with CI's and take advantage of "Hope" workshops online to be familiar with all aspects of CI"s and therapy used . I also make it a priority to have a good relationship with the CI Audiologists who see my kids. My kids use Signed Exact English, CASE as well as Oral Communication alone.

Parent's Views on Changing Communication After Cochlear Implantation : SimCom/SEE

SK17 — Fri, 06 Jun 2008 20:28:23 GMT

Dr. Watson, thank you for participating in this forum. Had we lived in the UK, my daughter would have been in your Group 3 (implanted at age 7) and she has indeed gone from SIMcom to being primarilly an oral communicator expressively, though she relies on our sign and speech combo for receptive understanding and has an interpreter at school. (with the cool exception of brief math review, for a chance to use her listening skills in a the classroom and still have a safety net)

We also found that our use of SEE helped her have a smooth transition to use of the implant without creating a gap in her development of comprehension. Matching signing with what she was beginning to understand through her implant seemed to help her greatly. We actually are a little sad that she is dropping sign use for her own expression, but that's what is happening here. (Plus her parents worked so hard to learn sign!)

Looking ahead, I think it might be a challenge to advocate for the interpreter as she continues to improve and is working at grade level, when she rarely signs for herself.

Very interesting topic, and it is indeed refreshing to see how many parents allow the child's personality and preferences to lead in the communication choice arena as evidenced in your research!

Parent's Views on Changing Communication After Cochlear Implantation : re: Educational Options

kpiraino — Wed, 04 Jun 2008 20:22:33 GMT

That's great! I love the analogy :) I agree :) and wish to that the professionals who specialize in different philosophies would come together and collaborate. What great comments!!

Parent's Views on Changing Communication After Cochlear Implantation : re: Educational Optiona

jdelkamiller — Wed, 04 Jun 2008 19:32:19 GMT

Thank you for the discussions. I agree with momrose in the other thread that having access to both visual and auditory languages is beneficial. I personally would like to see acceptance of both options instead of the extremes so that access to all forms of communication with others is possible.

We need to remember that the cochlear implant is a device-- a very good tool. I do not believe it should be the label we give students. Students with hearing loss will most likely function as deaf or hard of hearing regardless of the auditory device being used. Whether an implant, a hearing aid, a FM trainer or no devices at all, access to all forms of communication and relationship building benefits each person involved in the d/hh person's life.

:-) Maybe we can think of it as a buffet. Have everything prepared and ready to go. Sample it all and sometimes going back for more of one item. In some situations, d/hh might go back for more speech and in another situation would go back for more sign language and most often would go back for lots of socialization.

And someday, all people in deaf education will be able to sit at the table without a food fight. :-)

Parent's Views on Changing Communication After Cochlear Implantation : CIs need support

LGS — Tue, 03 Jun 2008 20:10:16 GMT

Thanks for sharing your research. Are the programs supporting these students readily available to them and their families? Often in the US, there is a lack of proficient staff in public schools who could provide the expertise necessary for kids with CIs.

Parent's Views on Changing Communication After Cochlear Implantation : re: Is your deaf child watching?

LindaWatson — Tue, 03 Jun 2008 11:44:41 GMT

Bilateral implantation is not common in UK. We are awaiting new guidelines from NICE, the UK body that regulates medicines etc. If they give the go ahead for bilateral implantation then it will become more common. It is good to hear that in your experience two are certainly better than one - it makes sense, doesn't it?

Parent's Views on Changing Communication After Cochlear Implantation : re: Is your deaf child watching?

goldbeck — Sun, 01 Jun 2008 23:00:17 GMT

Are there many bilaterally implanted children in the UK?

Parent's Views on Changing Communication After Cochlear Implantation : re: Is your deaf child watching?

LindaWatson — Sat, 31 May 2008 15:55:06 GMT

It's really exciting to me to hear of more and more deaf children who are able to communicate when convenient without the need to watch all the time. Obviously cochlear implants aren't the only option but they do have a lot to offer for many deaf kids. It's interesting that you spoke about bilateral implants. We are awaiting the latest guidance in UK to see whether bilateral implants become the recommended practice here.

Parent's Views on Changing Communication After Cochlear Implantation : re: Is your deaf child watching?

momrose — Thu, 29 May 2008 03:44:20 GMT

My 2 yrs old daughter seems like a very visual person but has been doing well in listening and speech skills after one year of using her CI. Sometimes I talk behind her back and she'd understand without having to look at me. I also notice that she isn't watching me anymore when I sit next to her and read her a book using my voice and signing. She'd look at the book for most of the time. She used to watch me signing all the time when reading a book to her before she received the CI.
She has been receiving intensive AVT therapy for nearly one year although I really don't practice it at home since her father and I are both deaf and use ASL. The AVT does benefit her immensely.
She also has been seeing an ASL deaf teacher regularly and is doing very well in ASL including a lot of facial expressions. I think it s very beneficial for her to use both visual and auditory languages (ASL and spoken English). So she would not fall through any cracks.

Parent's Views on Changing Communication After Cochlear Implantation : re: Is your deaf child watching?

goldbeck — Thu, 29 May 2008 02:44:28 GMT

My son, Michael (now 11 years old), was diagnosed with a profound bilateral hearing loss at 18 months of age. After an unsuccessful hearing aid trial, he was implanted with a CI a few days after his 2nd birthday. He received intensive AVT at our local CI center and I worked religiously with him at home for many hours a day to ensure that he developed good hearing/listening and language skills.
He was able to enter Kindergarten in a public school, mainstream classroom on schedule and just completed the 5th grade with a stellar academic record. (This included being in the Gifted and Talented Program and making a perfect score in the Reading and Comprehension section of our state standardized test at the end of 3rd grade). At school, the teacher uses a classroom soundfield system and he has a personal FM which he is supposed to use also which patches into the classroom system.)
I think Michael does use visual/facial cues when he feels the situation warrants it (e.g he pays careful attention to the pronouncer during Spelling Bees - he won the school bee this year and competed in the regional bee - and Geography Bowls) and consistently uses closed-captioning when watching TV. However, he can carry on a conversation with me in the car without looking at me (he sits in the back) and I have seen him converse with others with a minimum amount of "watching."
This skill has improved exponentially since he went bilateral a day before he turned 8 years old. He himself says that he now under- stands what it means to "over-hear" and says that he is able to keep track of more than one conversation simultaneously. He was "down" for a month last year when the 2nd device failed due to a defective electrode and himself noted that it was very difficult for him to hear in the car and in noisy situations. He could hardly wait for his revision procedure even though he did not relish the idea of another surgery.
I am guessing that he is a poor lipreader - the swimming coaches use an eraseable board to communicate with him during swim practice when his equipment is off, and if it is early morning and he does not have his equipment on yet, he will ask you to write down what you are saying rather than try to read your lips. Maybe too lazy!
In summary, I think that Michael benefits from a combination of auditory and visual cues, but I also think that he is a fairly good user of auditory cues alone. Perhaps this is a benefit of having had intensive AVT therapy. In any event, I believe his ability to use auditory cues so well has been extremely useful to Michael in school and is definitely one of the reasons why he has done so well academically.

Parent's Views on Changing Communication After Cochlear Implantation : Is your deaf child watching?

LindaWatson — Wed, 28 May 2008 20:11:54 GMT

Some of the parents in our study said that their deaf child began to hear so well with their cochlear implant that they just stopped watching. This gave us a topic for discussion - how much do we need to get deaf children to watch our faces? We need their auditory attention but do we need their visual attention too? I am wondering what some of you have found with your children with CI? It's my turn to ask a question!!

Parent's Views on Changing Communication After Cochlear Implantation : re: Educational Optiona

LindaWatson — Mon, 26 May 2008 16:08:03 GMT

Here's another really interesting (and challenging) question! Most of the children in our study did have hearing parents, partly because as you know the majority of deaf children are born to hearing parents and also because in the early years of cochlear implants with children there was hesitation (both on the part of surgeons and deaf parents) to implant deaf children from deaf parents who were using sign. The children had all received their implant for more than 5 years and the data is a couple of years old now.

You raise the issue of the need to balance the deaf child's needs for lots of exposure to spoken language and their need for social and emotional well being. I note your phrase 'she seems very happy there', which I think is a really important consideration. I am sure that you will keep on reassessing all aspects of her educational placement, including her feelings. As she gets older, she will be able to join in the discussion with you. Some children in our study commenced their education in a mainstream school and then moved to a special school when they reached secondary stage (age 11+). In some cases deaf children with cochlear implants succeed well when they are young, but as they get older and experience a variety of teachers and teaching styles and the curriculum becomes more demanding they need more support. At this stage it is sometimes considered desirable to move them to a special school, either an oral school or bi-bi. In either case they can get more specialist support and greater access to deaf peers.

Each child is so individual that it is difficult to make generalized remarks. Some deaf children seem to regard themselves very much as part of the hearing community and feel comfortable there. You are clearly providing this little girl with access to deaf and hearing worlds already and have an open mind. Use your instincts, with knowledge of your little girl to guide you. I hope she continues to do really well and be happy - and do see if you can encourage the school to keep the background noise down as hearing children will benefit from that too.

Parent's Views on Changing Communication After Cochlear Implantation : re: Educational Optiona

momrose — Sun, 25 May 2008 05:03:32 GMT

Linda,

Do all the deaf children in your study have hearing parents? Any of them have deaf parents who use sign language as a primary communication mode? Have you observed the children's emotional and social well being when they are mainstreamed as the only deaf child at a regular school? Especially those who use spoken language with success like their hearing peers. That is what concerns me a little. My 2 yrs old child received a cochlear implant over a year ago and has progressed very well in spoken language. She is only a few months delayed in spoken language at her age . She is also bilingual in ASL and spoken English. She has been using ASL since she was an infant since her both parents are deaf and use ASL. She has been mainstreamed at a regular school with hearing children and has been receiving therapy after she received the implant. I was told that my child has been interacting well with her classmates and participating well in all the activities except that the background noise that can make it difficult for her to hear sometimes. She seems very happy there. I had planned to send her to a deaf school with a bi-bi approach but there is lack of spoken language. So it is more likely she will remain mainstreamed as she needs to get a lot of spoken language exposure but I am concerned about her social life and identity when she gets older. Is it important for deaf children who do well with the implants to have deaf peers or friends at their school so that they wouldn't feel alone?

Parent's Views on Changing Communication After Cochlear Implantation : re: Cochlear Implants

kpiraino — Fri, 23 May 2008 16:42:29 GMT

Thank you to all of the parents who have been willing to share their perspective and personal experiences. It is wonderful to see so many of the parents using a variety of methods when working with their child's language and communication. I think that the emphasis on the individual child has been a common theme and wonderfully refreshing!

Parent's Views on Changing Communication After Cochlear Implantation : re: Educational Options

kpiraino — Fri, 23 May 2008 16:28:45 GMT

That's wonderful! I love to hear about success stories where everyone is working together towards a common goal of meeting the child’s needs. I think that most programs are working towards the implementation of a program that offers both languages fully (English/ASL). Many ESL "English as a Second Language" programs highlight the importance of teaching the whole language. Much can be learned from these approaches. Educating professionals on the technology is also vital as it continues to change and become more and more complex and versatile. My husband is an audiologist who happens to have hearing loss himself. He has a CI and it has been amazing to see how this device has made him less reliant on his speech reading abilities. I have noticed that many professionals who have been in a bilingual setting for many years have not had the opportunity to see what the new technology provides and how it can be successful. The devices have changed so much and with the use of FM systems we have also seen increased success among children's spoken language abilities. I would love to see more collaboration among professionals who specialize in different philosophies :)

Parent's Views on Changing Communication After Cochlear Implantation : re: Cochlear Implants

LindaWatson — Fri, 23 May 2008 15:50:47 GMT

Dear Lisa
Thanks for your message. There are many possible answers to your question. I am sure you will not be surprised to say that a lot depends on the individual child and their progress. So if you are asking in relation to your own child then you will need to use your judgement, taking account of the advice of your AVT therapist.

A more general response is to say that AVT is only one way of working with children who have received a CI. It is not widely used in UK, although I am aware some implant centres provide it. To my knowledge, none of the children in our study received AVT. They did of course have support for the development of their communication and language skills from teachers of the deaf and speech and language therapists working with parents. We tend to use an approach that tries to mimic the way that typically developing (hearing) children learn language, through informal conversation and play.

Parent's Views on Changing Communication After Cochlear Implantation : re: Educational Optiona

LindaWatson — Fri, 23 May 2008 15:28:06 GMT

You are right that it is more of a challenge in this setting, but as you and other participants have rightly pointed out, cooperation between everyone (parents and professionals) involved with a deaf child and an environment that supports the development of listening skills and spoken language, whether exclusively or alongside the use of sign language seem to be key factors for success.

Parent's Views on Changing Communication After Cochlear Implantation : re: Cochlear Implants

Lisa — Fri, 23 May 2008 13:06:31 GMT

Dear Dr. Watson,

Please advise: What is the number of years a child should receive AVT after implantation?

Thank you,

Lisa