Why are Cochlear Implants Bad? A Primer

On The Horror of Cochlear Implants, Part 2, a Facebook acquaintance commented, “There must be some culture that I’m entirely outside of. Being able to make use of a sense that you otherwise could not is a bad thing somehow? Looks like I need to rethink my glasses…”

The traditional Deaf aversion to cochlear implants is baffling to most people. They can’t imagine why anyone wouldn’t jump at the chance to hear. Thing is, I understand that viewpoint. I don’t agree with it, but I understand it. The short answer is that it’s got a lot to do with the values that Deaf culture traditionally holds, most of which was shaped by events in the 20th century. The long answer… well, let’s dig right into the beginning.

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Deafness fundamentally shapes the way you approach the world. More so if you lost your hearing at a young age. In the absence of a sensory input, the brain and body will compensate in other ways. Not quite Daredevil-style, but deaf brains do tend to rewire for heightened visual and tactile input. There are also some real interesting questions on how our brains process language. And apparently we have better peripheral vision too, by having more neurons in our eyeballs. In other words, I guess we’re… glorified chameleons?

funny-chameleon-1254493-640x480

Kinda like this, but sexier.

That kind of thing also leaks out into how we think, talk, and behave. Instead of “I heard him say…” I’ll say, “I saw that he said…” We hug and touch more. We’re blunter, because communication is hard enough to begin with, and dancing around the topic just makes it worse. (That bluntness has gotten me into trouble more often than I care to admit, incidentally). We tend to use more animated gestures and expressions. Oh, and we gravitate to light.

Kinda like… no. Exactly like this.

When deaf and hard-of-hearing people get together– especially at residential schools for the deaf– and find these commonalities in how they live and think and get shit done, they basically create their own language and communities that don’t really factor in sound at all. Modern technology has made that even more possible: video calls, flashing alerts, text and video messaging, emails.

(Matter of fact, Nicaraguan sign language is a modern example of this phenomenon. Prior to the 1970s, Nicaragua didn’t have a deaf community, nor an unified sign language; d/hh kids grew up with mostly hearing families and home-grown signs. Then someone threw a bunch of those kids together, made it into a school, added more kids… and over time, the kids developed a pidgin/creolized mishmash of their home signs. Years after the school started, an ASL researcher found that the younger students had not only copied the older students’ creolized sign language, but also sophisticated it further. If you don’t mind the paywall, here’s a link to the study: http://www.ethnologue.com/language/ncs

However, some people disagreed on the benefits of this cultural and linguistic autonomy, at least in the US. And a lot of those people tried to steer their next generation of d/hh children toward integration into mainstream hearing society, particularly in the late 1800’s to mid-1900’s– often to poor results, both socially and academically. Turns out, educating and integrating d/hh children based on sound instead of sight is a tad counterintuitive, especially when effective hearing aids and cochlear implants aren’t a thing yet. (And I haven’t touched on the numerous attempts to “cure” hearing loss, a lot of which did more harm than help.)

The rise of oralism in the early 20th century–using spoken language to teach d/hh students– created a domino effect. Residential schools for the deaf were downsized or closed; d/hh staff lost their jobs to hearing people who couldn’t sign; d/hh students were banned from using sign language– some punished by having their knuckles rapped bloody with a ruler, or slammed into drawers; the focus on speech rehabilitation overshadowed traditional studies like math, science, and the trades– and often at the cost of language development. The end result was social, educational, and ultimately career retardation for a large segment of the signing d/hh people nationwide. (Pro tip: want to learn some really rude signs? Bring up Alexander Graham Bell with a mainstreamed Deaf person over 30.)

There are books and books of history on this, but for starters, I’d suggest A Place of Their Own: Creating the Deaf Community in America by John Vickery Van Cleve and Barry A. Crouch; and Never The Twain Shall Meet: The Communications Debate by  Richard Winefield.

Keep in mind, much of this was done in the name of “normalizing” d/hh children. Tell generations of signing d/hh people that they’re broken, threaten their nexus of social interaction and networking (i.e. residential schools), punish them for using an intuitive language, stunt their social and academic development by hyper-focusing on the one ability they collectively lack instead of their strengths… and you have the perfect recipe for resentment and a general mistrust of outsiders’ attempts to “fix” or “help” deafness.

Only in the past few decades has this trend started to reverse, particularly after the recognition of ASL as a language in the 1960s, and even then it’s often been an uphill struggle. Cue in the mass adoption of the first cochlear implant in the early 1980s– new, experimental, requiring surgery, and with a variable success rate that depended on many factors to boot– and hackles went straight back up. “Oh, great, yet another attempt to turn us into something we’re not, and you want to cut into our skulls to do it.”

The cochlear implant isn’t a cure. But it was often marketed as such to hearing parents who didn’t know better, and more often than not, these parents weren’t made aware of American Sign Language or Deaf resources as an option. People being people, the controversy quickly devolved into an “us-vs-them” mentality– not entirely without cause, given recent history. And unfortunately, a lot of misconceptions on cochlear implants from those early days still persist.

Nowadays, while the Deaf view on cochlear implants has softened to accepting implants for adults, you’ll still see some resistance when discussing implantation for children. That’s a post for another time, but essentially, it boils down to the same central issue: stripping d/hh people of their cultural identity and linguistic access. While I don’t think implantation by itself results in that— quite the opposite, actually– I do consider it wise to evaluate the motivation behind advocating cochlear implantation. Giving the kid options? Sure. Expecting it to do the work for you, or make him “just like a hearing kid”? Not so hot.

So, there you have it. By nature, Deaf people have, for the most part, learned to adapt to a world using sight and touch, to the point that for many of us, sound is just not… a thing. It’s not in our mental landscape, at all. Some people choose to add sound to their toolbox through hearing aids and/or cochlear implants. Some don’t. The key element there is choice. When someone else tries to push that choice for us, whether that’s for or against implantation, that’s where things go awry. And it’s worse when that someone is perceived as an outsider pushing to eradicate the very thing that gave birth to your cultural and linguistic identity.

The Horror of Cochlear Implants, Part 2

While I was visiting family in Wisconsin last winter, I went to a Deaf gathering at a local pub to reconnect with an old Deaf professor. I wound up at a side table with 5-6 older d/hh people near the entrance. At some point, a family walked in with a young teenage girl who had a cochlear implant. And the table fell silent. I mean, emphasis on “fell”: signing hands went down, and eyes went to her head. One woman signed, “She has a cochlear implant.” Another woman put up her hands and looked to the side: “no comment.”

Traditionally, the Deaf community– at least the older generations, in my experience– has been pretty staunchly anti-cochlear implants. In the past 20-30 years, that overall view has softened to this: Cochlear implants are OK for adults who choose to get it, but don’t implant children before they’re old enough to decide for themselves– and certainly never implant infants. What about the health risks? What if the kid grows up to resent it? I’ve seen some Deaf publications go so far as to call it cultural genocide.

I won’t go into the risks, which are vanishingly minor, by the way– we’re talking a fraction of 1% rate of complications, period; not deaths, all complications. What I will discuss is the preconception that implanting a child before s/he’s old enough to consent (whatever age that is) will incur resentment against her parents and an identity crisis.

Sample size of one, but: I was implanted when I was ten. I was certainly old enough to ask if I wanted it, but for whatever reason, my parents never did. That wasn’t really the way things worked in our household; what Mom and Dad said was Law, and we kids went along.

I have never once regretted the implant, nor resented them for not discussing it with me first. Hell, ten-year-old me thought having a metal bit that mysteriously stuck on my head like magic was pretty cool. (I’m not sure how much I understood about magnets back then.)

The thing is, I knew my parents loved me and wanted the best for me. And I knew the implant was a result of that. I think that’s what made the difference, not some vague and ill-defined idea of consent. It’s a tiny bit of metal. It doesn’t change anything about who I am. How could it?

I have never, not once, heard another cochlear implantee speak negatively about her implant. I’m sure they’re out there, but I haven’t heard it yet– and believe me, I’ve asked. The worst feedback I’ve heard on cochlear implants has been neutral: “Oh yeah, I just don’t use it anymore.” Most has been positive. The criticism and concerns I hear almost always come from an unimplanted person. And damn near every one of them has a friend, or a friend of a friend, who got a cochlear implant and hated it. (After a while, I began to suspect that their “friends” were one person that everyone knew.)

More than that, though, I’d read accounts of cochlear implantees being rejected or teased by their d/hh peers as soon as they got the implant. And that was touted as an example of how implantation could cause an identity crisis, a reason to not implant your children.

Um, excuse me? If your friends ditch you over something like that, the cochlear implant isn’t the problem, and you need better friends.

Hearing Impaired = Broken?

Last week, I bought a giant canvas. It did not fit in my car. I spent the next hour or so texting local friends trying to find someone with a jeep or a truck, contemplating the logistics of strapping it to the top of my car, and snarking about it on Facebook.

Batman would not have made this mistake.

behold. my l33t planning skillz.

What on earth does any of this have to do with “hearing impaired”?

Well, I ended up asking the store to hold the canvas until I could get someone with a bigger car. I came back the next day after work to ask the staff if there was a way we could take the canvas apart so it could fit. When we walked to the front of the store, where the canvas was sitting behind the counter, I spotted a note taped to it that read:

CUSTOMER WILL COME BACK LATER
HEARING/SPEECH IMPAIRED

My first thought: “Yay! They left a note so they know I’m the one who bought it!” I didn’t think to say anything until after a very nice and accommodating store representative helped me try to fit the Giant Canvas into my car. When both of us gave up and agreed that I needed a bigger car, I walked back inside, motioned for a pen and paper, and wrote:

“I saw that the note on the canvas [now gone] said ‘hearing impaired.’ I just wanted to warn your staff that many d/hh people find that term very offensive. I don’t personally care, but some people do, a lot.”

The very nice and accommodating store representative apologized– from her gestures, I could tell she knew a little sign and was familiar with Deaf culture– and explained that she had taken down the note for that very reason before we’d carried the canvas out to my car. I reassured her that it didn’t matter to me; I just didn’t want them to have a bad run-in with other d/hh people because of an innocent slip.


The term “hearing impaired” has never bothered me. I used it growing up because I saw it as an useful umbrella term that encompassed all varying degrees of hearing loss. It wasn’t until I took ASL classes in college that I learned its secondary implication for many d/hh people: the idea that we’re broken and/or need to be fixed.

I don’t quite agree with that definition of “impaired,” by the way; I interpret “impaired” as more like “lacking.” You just don’t have a particular thing– or you don’t have as much of it as others do– that doesn’t have to mean it’s broken, or that you are broken. There’s no value judgment in it for me.

I do understand why other d/hh people interpret it that way, though. And I understand the larger picture it can reinforce. What I don’t understand is the level of ire it seems to generate sometimes, particularly when the hearing person who uses that term has no reason to know that it’s offensive to some d/hh people, or why it would be offensive. The thing is, unless you’ve spent some time around the d/hh community (and even then, a somewhat specific segment of that community), you won’t know. And to add to that, to the uninitiated, often “hearing impaired” does sound like the more polite, PC term to use.

Basically, 99% of the time, when someone uses that term, it’s not meant to be hurtful or offensive. It’s generally other d/hh people who use it as a pejorative (“signing impaired,” anyone?), and who object to its use.

I’m not saying that we shouldn’t ask people not to refer to us as “hearing impaired,” or educate them about its implications. Words have power. We would do well to be aware of that, and to respect it. At the same time, should it be taken as an insult if the intent isn’t there, if you have to contrive meaning out of it to turn it into an insult? And how far do we want to go into policing the terms that others can use, especially if other d/hh people use “hearing impaired” to identify themselves?

Choosing Your Cultural & Linguistic Identity

Cherokee blood runs strong in my dad’s side of the family. Both my grandparents spoke Cherokee, and my grandfather won awards for his work teaching the Cherokee language. My siblings and I are registered members of the Cherokee Nation, with tribal cards to prove our ancestry. Yes, we have literal, honest-to-God race cards, and I’m playing mine here.

The thing is, I don’t speak nor read a lick of Cherokee, although I’d love to change that this year. I was just not exposed to it growing up. Hence, it’s not my natural nor native language. My physical makeup—other than the neurons in my brain that drive language development—had nothing to do with that. My dad tried to expose us to Cherokee history and culture as much as he could during our annual visits to Oklahoma, and we picked up on some Cherokee mannerisms from his side of the family, but for the most part, I was raised in working/middle-class settings, with predominantly German/Irish/Polish Americans. I live in the South now, and people here can often tell that I’m from the North; that’s closer to my cultural norm. So I think I can safely say that Cherokee is not my “natural” culture. I could learn a lot more about Cherokee, and grow to identify with the culture, but it would still be a learning curve, about as much as if I moved to China and tried to immerse with the natives there.

In that same strain, I am biologically deaf. But I don’t consider myself predisposed to ASL or Deaf Culture, especially Deaf Culture from those more than 2-3 generations before me. My native language is English, and I’m much more familiar with hearing culture than I am with Deaf culture. And I’m not the only one. Due to cochlear implantation and mainstreaming, the d/hh community (including the Deaf subset) has seen much more diversity in the past 20 or so years.

Another thing to consider is that, had the Cherokee Nation required that every one of its members speak Cherokee and live in Cherokee communities, regardless of any other considerations like the living standards of these communities, our access to resources, our interactions with non-Cherokee, our personal preferences, etc… I am quite certain they would have met with strong resistance, especially from my dad’s family. Not because their members don’t value Cherokee language and culture, but because people generally don’t like being told what to do.

I’m grateful that I learned ASL and studied Deaf history and culture. It helped me solidify an integral part of my identity in my early 20s, a time when I think pretty much everyone struggles with that kind of thing. I’m also grateful that Dad took us to Cherokee museums and re-enactments, and had us read books on our ancestors, and told us stories about his childhood in rural Oklahoma. But the thing is, it was all a gift. It wasn’t forced on me, and I didn’t have to trade off one culture for another.

Times are changing, as they always have and always will. I think most of us would like the freedom to determine our own cultural identities, not according to someone else’s cultural ideal.

“Deaf Person Hears for the First Time” Videos

You know those emotional YouTube videos of someone’s cochlear implant activation, usually ending in happy exclaims and tears of joy. Friends have shared a few of these on my Facebook wall because I have a cochlear implant too, and really, I don’t mind. Joy is a good thing to spread, and I generally applaud more additions to our bionic army.

If you have any familiarity with the d/hh community, though, you know there are mixed reactions. Some of them get pretty heated. (And the Titanic sprung a leak.) In fact, there was an article on Wired a while back titled, “Why You Shouldn’t Share Those Emotional ‘Deaf Person Hears for the First Time’ Videos.” I disagree somewhat with that article, by the way. So, here’s some middle-ground perspective.

The thing to remember is that these videos are usually of late-deafened individuals who want to hear again, or babies who have no clue what’s going on. The impact will be somewhat different for those who, for whatever reason, don’t regard hearing as a big part of their lives.

I became deaf at eighteen months, so I have always relied far more heavily on sight than sound. When I got my implant at ten years old, my reaction was, “Oh, I can hear more now. Cool.” That was it. I can’t miss what I’ve never had. I’ve also known several late-deafened people who found that they just didn’t really miss their hearing that much.

These videos also don’t show the time and effort that goes into post-surgery recalibration, because you often have some neurolinguistic programming to overcome. It’s not an instantaneous process.[*] As a result, they can give off the mistaken impression that the cochlear implant is a “cure” for deafness. It’s not. It’s an incredibly useful tool, but it doesn’t restore hearing as most people know it.

[*] However, it’s also not the burden that some anti-cochlear implant detractors have made it out to be; I spent one night in the hospital and went back to school after three days, and that was in 2000. CI surgeries have advanced immensely since then, to the point that it’s usually now performed as an outpatient procedure. I also resumed speech therapy as usual, just with a different focus.

ALL THAT SAID. Don’t let anyone guilt you into not sharing or liking these videos. Usually they’re intended to share the original poster’s happiness with the world, not to be hurtful or malicious, and that happiness alone is worth celebrating. The important thing is to keep them in perspective.

Addendum to Changing Perspectives: A New World

Another cuer contacted me to share that her experiences with the Deaf community did not quite match up with what I’d shared in my last post, Changing Perspectives: A New World. I had written that “[the d/Deaf community at University of Wisconsin Milwaukee] wasn’t this cloistered community that I’d expected. People had no problem with the fact that I used a cochlear implant or Cued Speech (most were quite curious about Cued Speech, actually) and could just get by with a smattering of Signed English at first.”

Now, I should clarify that these experiences took place mostly within UWM. Outside of UWM, I got more varied responses, although still overwhelmingly accepting. I think it depended on several factors, which I’ll outline soon.

Truth be told, I will probably not post much about the positive interactions here, because although “everybody got along, got what they needed, and is happy” is generally the desired outcome, it isn’t really much of a post. The few negative parts are where we still need improvement, likely through education and awareness. All that said, I will always, always shoot for balanced, constructive discussion. We really don’t have anything to gain by making enemies out of each other.

For me, I think several factors helped at UWM:

1) Diversity. UWM has/had a quite diverse community of d/hh students. Many came from a mainstreamed background, but we had several students and teachers who attended or graduated from residential schools for the deaf. We also represented a wide range of communication styles, from pure ASL to Signed Exact English to Cued Speech, and many of us used hearing aids and cochlear implants too.

I think a big part of this is our (in my opinion) excellent accessibility services program; they were truly committed to meeting each student’s individual needs and preferences. ASL, Signed English, Cued Speech, captioning– whatever you requested, they made sure their staff were equipped to meet that demand.

The size may also have played a part in it; compared to schools like RIT, Gallaudet, and CSUN, we had a fairly small d/hh community, so it may have been a bit harder to form cliques.

2) Age. I do notice a generational gap, starting around 1990, between what I think of as the “old school deaf”– raised in residential schools, used ASL as their primary language, had bad experiences with the auditory-verbal approach– and younger deaf people, more of whom tend to be mainstreamed and/or implanted, and with much better educational approaches too. The latter tended to be much more open-minded and accepting.

3) Mutual Respect. Pretty much right away, I took up ASL– I got many compliments about how fast I’d improved– and started learning about Deaf Culture. I always tried to show respect and appreciation for others’ perspectives, even when we disagreed. I think that made it much easier for others to show me the same respect and appreciation in return.