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In recent times there has been a lift in the promotion of bilingualism for Cochlear Implant users. This is being driven from an ideological perspective from organisations like Deaf Aotearoa and the Deaf Education Centres in New Zealand. It is a fight back by the Deaf community who are seeing many of their number choose to become a Cochlear Implant user. The majority of these people find their Cochlear Implant so successful that they drift away from the Deaf community and become a successful part of everyday New Zealand society.

This article explores where the Deaf community draws its ideological position from and how it presents itself today. It looks at the evidence and the attempts to argue against this evidence. Finally, it comes back to the key ideology that must drive this debate – parental choice informed by research.

Deaf Culture

Deaf culture describes the social beliefs, behaviors, art, literary traditions, history, values, and shared institutions of communities that are affected by deafness and which use sign languages as the main means of communication. When used as a cultural label, the word deaf is often written with a capital D, and referred to as “big D Deaf” in speech and sign. Members of the Deaf community tend to view deafness as a difference in human experience rather than a disability.

Deaf culture seems to have grown, as many cultures do, out of persecution. Deaf education in times past has had a strong oral focus. Sign languages were driven underground, effectively banned in these institutions. Sign languages evolved and grew because they were the most effective means for people with hearing loss to communicate with each other. Lipreading and oralism were very much the poor cousins, in terms of effectiveness of communication.

Because society communicates verbally, people who found they could communicate most effectively with sign languages tended to cluster together. Community grew and so did culture. Eventually the Deaf education sector caught up with the reality that people with hearing loss, particularly at the severe to profound end of the scale, could communicate better through sign language. The Deaf schools and universities developed into their own hot beds of sign language and Deaf culture.

In this situation, when a family had a child who had hearing loss, it became natural for such families to gravitate to the Deaf community. Hearing parents would learn a new language. The family would “cross over” into the Deaf culture and re-orientate their lives and identity across two cultures – mainstream society and the Deaf community.

The Impact of Technology

In the 1970s advances in electronics and their miniturisation started to see the production of much more effective hearing aids. The first multi-channel Cochlear Implants also started to become available. Cochlear Implants in particular opened up a new world of effective hearing for those who have a profound hearing loss. Through the 1980s and 1990s these devices stepped up in effectiveness and significantly reduced in size. It became possible for a person with profound hearing loss to have their hearing effectively restored and for no one to ever know that they are hearing through an electronic device.

Suddenly an oral option that didn’t involve lipreading became viable. The vast majority of Cochlear Implant users  were able to recognise speech at a level very close to, if not the same as, one of their hearing peers.

As Cochlear Implants became available for young children, then infants, and as New Born Hearing Screening programmes rolled out allowing very early identification and implantation, families began to chose oral options for their children’s language development. This is perfectly understandable as over 90% of children with a profound hearing loss come from oral only families who have no connection with Deaf culture or sign language. Cochlear Implants allow the family and the child to stay within their natural existing social grouping.

The final pieces of the puzzle have come together with high quality auditory therapy and the widespread application of bilateral implants. Children now can catch their hearing peers in language development before their first birthday and maintain parity through their lives.

These developments have been devastating for the Deaf community. Effectively the ‘supply’ of new Deaf people has been switched off to just a trickle. Many Deaf people have got Cochlear Implants and have then chosen to move into their mainstream culture. Deaf culture has retrenched into academia and geographic small clusters. These clusters tend to be funded by government programmes but are on the decline. When ever the reality of the decline in numbers is raise there is a fierce defence of the ‘rights’ of this shrinking community.

Morphed into the Bi-Bi option

In recent years the Deaf community have responded with a new paradigm. Terms like Bi-lingualism and Bi-culturalism have evolved.

The term bi-culturalism has come out of the United Nations Convention on the Rights of Persons with Disabilities. The Deaf community have interpreted this convention to mean that all people with hearing loss are automatically culturally Deaf. There is no choice – you are ‘in’ by virtue of your medical condition, regardless of how it comes about. At the extreme end of the Deaf community are those who advocate that children with hearing loss be taken from their hearing parents and be placed with Deaf parents. At the less extreme end of things, this view would argue against early implantation of children. Rather children should be allowed to grow up and make this choice themselves. This is despite overwhelming evidence that early implantation directly leads to better speech production and learning outcomes.

Likewise the term bi-lingualism comes out of this same mindset that all children with hearing loss should learn sign language. By virtue of a medical diagnosis your language choice is dictated. Bi-lingualism however has become a slippery cousin to bi-culturalism. Deaf academia now argue that learning a visual language provides the grounding for learning an oral language latter. The advent of baby sign is part of this strategy.

The key question is whether this assertion that bi-lingualism actually enhances oral language uptake or whether it is merely means to ensure the survival of sign languages in society?

Research

There are small number of clinical studies that bi-lingual proponents point to in support of their arguments related to Cochlear Implant use. These studies are all small in sample size. Proponents will also point to particular individuals who have started with sign language and have done well once they received their Cochlear Implant. Presenting outliers does not prove a hypothesis however.

On the other side is a major clinical study by Ann E. Geers, Johanna G. Nicholas, and Allison L. Sedey entitled Language Skills of Children with Early Cochlear Implantation from 2003. This study looked at 181 children with Cochlear Implants. It is the single largest study on this topic to date. The study found:

Children educated without use of sign exhibited a significant advantage in their use of narratives, the breadth of their vocabulary, in their use of bound morphemes, in the length of their utterances and in the complexity of the syntax used in their spontaneous language. An oral educational focus provided a significant advantage for both spoken and total language skills.

In short the language outcomes for children with an oral focus are better. This is unsurprising. If a child focuses on developing a particular ability, it makes sense that they will be better at it.

This study is referenced in all the major literature reviews on the subject. Interestingly it is referenced in the literature reviews from proponents of bilingualism. However it is dismissed with no explanation. Ignoring the single biggest clinical studies findings on this matter seems disingenuous.

No published study has yet attempted to replicate this work. It is currently completely unchallenged. However there are at least two studies on outcomes for children with Cochlear Implants underway in Australia that should address this issue. They are due late 2013 and early 2014. Their preliminary findings concur with the findings of this 2003 study.

Geers’ study presents a major stumbling block for proponents of bilingualism. They are not able to show that bilingualism has a positive impact on a child’s language. This means that they have got little traction pushing bilingualism into mainstream school curricula. The Deaf community has failed to ‘normalise’ what is rapidly becoming a dying language.

Parental Choice

Perhaps the biggest stumbling block for the Deaf community’s advocacy of bi-culturalism and bi-lingualism is society’s recognition and elevation of parental choice and responsibility. The vast majority of therapy and language acquisition comes from parents in the home environment. With over 90% of children with profound hearing loss coming from parents with no connection to the Deaf community, it is not surprising that well over 90% of parents chose an oral only upbringing for their child.

Some in the Deaf community argue that parents do not have the right to chose the approach used for raising their child with a hearing loss (I was told this by a Deaf Cochlear Implant user!). Such arguments are now only put up by a small extreme as it tends to be particularly ineffective.

This leaves the Deaf community in a difficult position. The reality is that the numbers of people relying on sign language will continue to diminish. The vast majority of babies identified early with hearing loss are able to have their effective hearing restored. Older people who have had hearing and lost their hearing later in life are likewise able to have their effective hearing restored. Even a small number of older people who have never had hearing are now having their hearing restored. There are a small number of people who can not be helped with technologies like Cochlear Implants. They will need to rely on sign language – but that is a very small number.

The Future

In New Zealand there are less than 60 children receiving sign focused services. This number will decline. The number of Cochlear Implant users will grow from the 900ish currently to probably 3,000 over the next decade. Cochlear Implants have provided a way of restoring the effective hearing of people and allowing full participation in our oral based society.

So what should the Deaf community do? They should embrace choice.

There will be some people who will be interested in sign language. There will be a few Cochlear Implant children whom may benefit from sign language. For example children who lost their hearing to meningitis might be wise to have a backup to electronic hearing. Likewise children with cochlea abnormalities. It makes sense to have a fall back position. And of course children from families with a history of hearing loss and whom have family members who rely on sign language.

They should also embrace technology, rather than running from it. Online interpretation services and video social chat facilities will be needed as the numbers of sign language ‘speakers’ become less and less. The tyranny of distance can be lessened with such developments.

For parents who get presented with a diagnosis of their child having a hearing loss, they should know that in almost all cases, effective hearing can be restored (the exception being where there are multiple other developmental issues – then it becomes a bit iffy). They should make informed decisions based on the available research and their own circumstances. They should not be told they must chose a particular approach to raising their child. They should know what the research says and decide based on their own family’s circumstances.

SymAbout the author: Sym Gardiner has a six year old daughter who has profound bilateral hearing loss. She was simultaneously implanted just before she turned two years old. Sym is the editor of 2ears2hear. He is active in promoting the availability of bilateral implants for children in New Zealand. He is a contributor to the Cochlear Implant kids community in the Wellington region and the national Cochlear Implant community. 

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