On the occasion of International Cochlear Implant Day, we celebrate the invention of cochlear implants and the ongoing research that allows thousands of children who are deaf and hard of hearing access sound to listen and speak. A cochlear implant done at the right time, with the right follow-up and intervention has the potential to dramatically change a child’s trajectory and quality of life. But by itself the cochlear implant itself is not the “cure” or the “fix”.
Consider this – a cochlear implant is a tool, like a pencil.
A pencil is a tool. It provides a way to write and draw – to express oneself, to create, to imagine without barriers of language. A pencil can be used to write the script of any language in the whole wide world.
Similarly, a cochlear implant is a tool. It creates the conditions that facilitate development of listening and spoken language – any language in the whole wide world!
But a few things to keep in mind as we help children use cochlear implants as a tool to communicate their needs, wants, thoughts, opinions, and questions –
Having a pencil doesn’t mean you now know how to write and express yourself. You need someone to teach you how to hold the pencil, how to form letters and words, what those letters and words mean, and how to put them together in sentences. The appropriate writing instruction / intervention is required to learn to write. Followed by consistent practice with writing correctly, neatly, and with confidence.
Similarly, getting a cochlear implant does not mean that now a child knows how to listen and speak. The child will need appropriate instruction / intervention to learn to listen, speak, and communicate. Followed by consistent device usage and during all waking hours, practicing learning to listen, learning through listening, and then listening for life!
When a child can practice using a pencil to develop pre-writing skills and learn to write at the appropriate age, learning to write is easier. Children do and can learn to write later in life, but it might take more time and there might be limitations on how far they can go.
Similarly, a child who receives a cochlear implant at the earliest possible age and receives intervention that keeps in mind brain development and follows a developmental approach will have an easier time learning to listen and speak than a child who has limited or delayed access to sound and intervention.
There are many types of pencils – plain, fancy, mechanical – they all write. The type that works best for you is what you should get.
Similarly, there has been a lot of innovation in cochlear implants and different brands offer different features. We have come a long way from the single channel implants. The brand and model that is best suited for a particular child, is familiar to and well understood by the otology and audiology teams should be chosen.
A pencil has to be maintained – a dull pencil might not be the best tool to write quickly and clearly.
Similarly a cochlear implant has to be maintained through regular mapping and consistent care of batteries and parts. Understanding the benefit from the hearing technology through speech perception testing is crucial to optimal use of this tool.
Finally, a pencil is a tool that creates endless possibilities. You might use it to draw, answer multiple choice questions, fill in the blanks, write an essay, or even a novel.
Similarly, a cochlear implant is a tool that creates opportunities for listening and speaking. Each individual, child or adult, uses it with different goals and desired outcomes in mind. Some might use it for sound awareness paired with communication using a visual language, while others might rely solely on the auditory access through a cochlear implant for spoken communication, and everything in between. Endless possibilities – all these are good, acceptable, and appropriate use of this amazing tool.
I started my career just as cochlear implants were being used with young children. The impact they have made in the lives of so many children has been incredible to watch. At the same time, many continue to struggle to access this tool, receive the follow up and high-quality, family-centered, developmentally appropriate intervention that is needed. The global community has to recognize the disparities and act on those, so that all children can benefit from this tool that creates endless opportunities.
With gratitude for the researchers, professionals, families, adults and children who have shown us the possibilities, with hope that many more, around the world have the same opportunities, we wish you a Happy International Cochlear Implant Day!