Cochlear implants – 5 big lies

[Image: closeup of a mock US one dollar note which reads “IN GREED WE TRUST” instead of “IN GOD WE TRUST”]

This blog post is for parents deciding whether to teach Sign Language to their Deaf children. If your child doesn’t have Sign Language there is a 1/3 chance they will end up PLD.

Roses are red,
Violets are blue,
You learned language effortlessly,
Deaf kids should too.      Kimberly Sanzo

Please don’t misunderstand me. I’m not saying a cochlear implant program (CIP) is bad. I am saying that you don’t need to rush in. Don’t be pressured by lies. This is the most important decision you will ever make for your child. The research shows that all Deaf babies, including CIP babies, do best with Sign Language. Please don’t gamble with the decision. Don’t let the “experts” make the decision for you.

As Kimberly also says – As a parent, would you rather struggle to keep up with your child’s fluent language or watch them struggle their whole lives to keep up with yours?

When I spent 56 minutes watching a youtube lecture by psychologist Ann Geers  (transcript) many things fell into place for me. She’s at the Dallas Cochlear Implant Program in Texas USA. If you’re not a statistician it will be hard. But sit down with a pen and paper and take some notes. The other inspirational video is, of course, Rachel Coleman’s video about Leah.

In Ann’s video, count the number of times she says the word “deaf”. Count the number of times Ann says “We’re not sure what’s going on.” Especially listen to the questions at the end. The one from Debbie Moncrief of the University of Pittsburgh might point the way to new research. The other question from the Speech Therapist made my blood boil. Basically they are not really evaluating what they are doing.

In the meantime I think there are five big lies you may come across.

1. Big Lie Number One – babies with early implants do better

Ann’s own data shows that ONE THIRD of babies with cochlear implants are still behind their hearing peers by the age of 10. It makes no difference if this third has had early implants.

Anti Sign Language advocates spread the lie that Ann included Deaf babies with additional disabilities. The fact is that Ann’s study says her data is from “normal” Deaf babies who have no additional disabilities.

2. Big Lie Number Two – babies need to be implanted early to learn spoken language

Rachel Coleman’s daughter Leah proves this is wrong. Leah is deaf and she learned to read and write English BEFORE she got her implants. Ruth Campbell’s research says “we suggest that the best guarantee of good language outcome after CI is the establishment of a secure first language PRE-IMPLANT [my emphasis].”

3. Big Lie Number Three – Sign Language interferes with learning spoken language

Often people will say there’s not enough research about this. I think there is. Kathryn Davidson showed this lie was wrong. She studied bilingual bimodal deaf babies with cochlear implants (ie they grew up with native Sign Language with their Deaf parents and learnt English at the same time). She said the kids “exhibited strong and widespread success in spoken English language skills. .. bilingual CI participants performed at monolingual English age target, and not significantly different from their hearing bilingual KODA peers.” KODA means kids of deaf adults.

4. Big Lie Number Four – we can’t predict if cochlear implants won’t work

Ann’s own work, strangely, shows this is wrong. Check out the Lexical Neighborhood Test (LNT) values for the Persistent Language Delay (PLD) kids. LNTs are lists of words read out in spoken English. Compare the PLD kids’ LNT scores to the other kids – the NLE kids (normal language emergence) and LLE kids (late language emergence). What do you notice??? It hits me like a brick in the face. At 50 dB they fail more than 50% of the words. Their scores at 70 dB are also much worse than the other kids. So even with a CIP, these kids are DEAF. They cannot hear the softer sounds in spoken language. They miss out on more than 50% and have to guess what they are hearing.

Source: Ann E Geers,  Johanna G Nicholas, Emily A Tobey, Lisa Davidson, Journal of Speech Language and Hearing Research 59(1) October 2015
DOI: 10.1044/2015_JSLHR-H-14-0173
Persistent Language Delay Versus Late Language Emergence in Children With Early Cochlear Implantation

5. Big Lie Number Five – only a small number of cochlear implants fail

Lie Five is the biggest lie – only a few CIPs fail. What do we mean by “fail”? Even some Deaf people  misunderstand this. There are two meanings of fail.

1. The CIP industry says only 1-3% of CIs fail. They mean technical failure of the CI or an infection. They don’t mean when the CI operation fails. My Deaf friends tell me of deaf babies dying on the operating table [later edit: I haven’t found evidence of this and other Deaf friends say it’s an urban myth. I’ll leave it here to acknowledge the error] . The popular belief (again without evidence) is that only 5-10% of CIP babies never learn to speak adequately.

2. The second definition of fail is even more important. It should be the major thing that parents think about. The failure is when a child can’t properly communicate with a spoken language even with a CIP. As we’ve seen above from Ann’s work, this is about 33% – one third!

The other vital conclusion from Ann’s video is that if a kid is not speaking reasonably well by age 3, they are very likely to be in the group that doesn’t catch up. Ann calls them Persistent Language Delay (PLD) babies. I call them Deaf. If their audiogram is bad and they are far behind their peers, they are unlikely to catch up.

In answer to Ann’s constant statements of “We don’t know what’s going on”, my wife Joanna said: “These babies are DEAF. They need Sign Language.” Yep!!!

The  good academic overview in the British Medical Journal’s Journal of Medical Ethics is worth a read. The overview certainly belongs in an Ethics journal because it also exposes the lies. In particular the rubbishy “science” mixed with opinion in footnotes 2 and 3 stunned me.

Finally, don’t just take my word for it. Do your own research and listen to words of Ms Mairead MacSweeney of the Deafness Cognition and Language Research Centre in the UK. The science is clear: babies need strong sign language before they consider a CIP. This is exactly what Leah’s parents did. This is exactly what more and more parents in the Deaf community are doing.

Good luck with your decision.

BTW, the best place to get science research is Sci-hub. You can’t just enter words into sci-hub. Usually you have to know the exact title of the paper. Even better is to know the DOI number. People who don’t want you to use Sci-hub have forced them to change web addresses. So if the link doesn’t work, hunt around and check their twitter for the latest link @Sci_Hub