This document discusses cochlear implants, including their history, benefits, risks, and impact on deaf culture. Cochlear implants are electronic devices that bypass damaged parts of the ear to directly stimulate the auditory nerve for those with severe to profound hearing loss. While they allow many users to detect sounds and improve communication, success varies individually. Controversy arose as some in the deaf community view implants as threatening deaf culture. The document outlines educational approaches and communication options for children with implants.

1. Cochlear Implants Presented by: Marcia Tonya Outler

2. Cochlear Implants The purpose of this presentation is to discuss the medical and scientific aspects of cochlear implantation including: Possible benefits and risks History of cochlear implants Choices in deafness Deaf culture Ethics Educating children with cochlear implants

3. Cochlear Implantation: a Medical and Scientific Procedure A cochlear implant is a small electronic device that provides sound to children and adults who have a severe to profound hearing loss (70 to 90 dB) who do not benefit from hearing aids. Cochlear implants enable sound to reach the brain by effectively bypassing the part of the ear which is damaged, to directly stimulate the hearing nerve electronically.

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6. Hearing Loss, America’s Invisible Disability Affects approximately 10% of the population—28 million people Over 4,000 babies are born deaf each year Every day, 33 babies are born with a hearing loss in America (8-9 with a profound loss) Almost 1/3 of all cases are caused by loud noise Noise induced hearing loss is the most common work related disability Loy and Roland (2009)

8. Hearing loss effects every aspect of a person’s life and lives around them. Communication Childhood Marriages Parenting Friendship Dating Workplace Ability to acquire information

9. Hearing loss can also affect one: Physically Cognitively Behaviorally Socially

10. Cochlear Implant Three Parts: Receiver- surgically implanted beneath the skin above the ear. A small wire containing an array of electrodes is threaded through the cochlea. Microphone-part of the “headpiece” that rest on the outer side of the skin that covers the internal receiver. The microphone picks up sound and transmits it to the speech processor. Speech Processor-a microcomputer that can be worn behind the ear that transmits the signal to the receiver and electrodes, which then stimulates the auditory nerve fibers, which in transmits the signal to the brain where sound is interpreted.

13. Cochlear Implant Surgery Operation lasts about three hours Usually performed as outpatient Performed by Otolaryngologist

14. Pre-implantation Process Medical Evaluation. ENT examines the outer, middle and inner ear (otological examination) Physical examination Imagery Evaluation: x-ray, CT scans, MRI Audiological evaluation: Audiologist tests hearing. Speech and Language Testing Psychological examination Farley (2002)

16. Risks of Cochlear Implantation General Anethesia Risk Meningitis Cerebrospinal fluid leakage Infection of the skin wound Blood or fluid collection at the site of surgery Attacks of dizziness or vertigo Tinnitus Taste Disturbances Numbness around the ear Reparative granuloma FDA (2009)

17. Possible Positive Effects of CI Many CI users are able to detect medium to loud sounds including speech sounds and can learn to recognize familiar sounds. Many CI users find it easier to communicate. More than 50% are able to understand speech without visual cues. In clinical studies of adults who experienced hearing loss after they had developed speech, 90% reported improved communication without speech reading. 75% reported communicating more effectively when at a dinner party, when driving a car, with family members, with family and when ordering at a restaurant. Some can talk on a telephone and enjoy music. Olsen (2003)

18. Researchers Proposed List of Factors Thought to Influence CI Success Length of time the person was deaf before implantation Length of time the implant was utilized Language and Listening skills before implantation Cognitive and attention abilities Intensity of therapy after implantation Type of language programming Resources and involvement of patient’s family

19. No one can predict how much benefit any one person will receive from the implantation.

21. History of Cochlear Implants Two centuries ago Italian Count Alessandro Volta inserted metal rods in his ear canals and connected them to an electric circuit. 1957 in Paris Charles Eyries and A. Djourno 1961 William House and James Doyle 1970’s F. Blair Simmons and Robert White-Stanford University and Donald Eddington –University of California 1970’s Parallel developments in Vienna, Austria and Australia 1977 Professor Kurt Burian implanted the first multichannel cochlear implant. The device had been developed by Scientists Ingeborg and Darwin Hochmair.

22. 1989 Australian Cochlear implant was approved by the U.S. FDA for adults. 1990 FDA approved age for ages 2 and up 1998 FDA approved 18 mos. and up 2002 FDA approved 12 mos. and up 2005 First three recipients were implanted with Cochlear’s TIKI device, a totally implantable cochlear implant in Melbourne, Australia as part of a research project.

23. Deaf Culture and Conflicts as the 21st Century Turned Modern Language Association announced that American Sign Language was among the 15 most commonly taught languages. Doctors and scientist were approaching a time when they would be able to identify and “correct” genetic deafness. Human Genome Project. 1970’s Opposition to cochlear implants 1985 Deaf Position Paper-medical concerns and cultural genocide by doctors

25. Characteristic of Educational Programsto Support Children with CIs Display unconditional acceptance of a child with a CI Recognize the potential as assistive technology Respect the parent’s choice Acknowledge the contribution that audition makes in spoken language Places value on spoken language as an expressive communication tool

26. Provides aggressive auditory instruction Offers age-appropriate and challenging instruction Provides accommodations Considers the child’s communication needs Provides administrative support of professionals Chutes and Nevins (2008)

27. Communication Mode Options American Sign Language Signing Exact English Total Communication Cued Speech Auditory/Oral

29. My Reflection History Choices in Deafness Deaf Culture Technology and Medical Advances Acceptance

32. References Bahan, B., Hoffmeister, R. & Lane, H. (1996). A journey into the deaf world. San Diego, CA: Dawn Sign Press. Biderman, B (1998). Wired for sound, a journey into hearing. Ontario, Canada: Trifolium Books, Inc. Chute, P. & Nevins, M. School professionals working with children with cochlear implants. San Diego, CA: plural Publishing, Inc. Farley, C. (2002). Bridge to sound with a ‘bionic’ ear. MN: Periscope Press. Humphries, T. & Padden, C. (2005). Inside deaf culture. Cambridge, MA. Harvard Univ. Press. Loy, B. & Roland, P. (2009). Cochlear implants, what parents should know. San Diego, CA. Plural Publishing, Inc. Murray, N. (1992). Cochlear implants and children: a handbook for parents, teachers and speech and hearing professionals. Washington DC: Alexander Graham Bell. Olsen, W. (ed.) (2003). Mayo clinic on hear. Rochester, MN.: Mayo Clinic Health (ed.). Information & Kensington Publishing Corp., New York, NY. Schwartz, S. (Ed.). (1996). Choices in deafness: a parents guide to communication options. Bethesda, MD: Woodbine House, Inc. United States Food and Drug Administration. 2009 Center for devices and radiological health. Retrieved February 9, 2009, from http://www.fdagov/cdrh/cochlear/whatare.html. Retrieved February 9, 2009, from http:www.fdagov/cdrh/riskbeneft.html. Retrieved from http:www.fdagov/cdrh/faq.html. Wikipedia. 2009. Retrieved February 9, 2009, from http://en.wikipedia.org/wiki/Cochlearimplants.