Opposition to Pediatric Cochlear Implantation Fading

CHICAGO - Opposition to cochlear implantation for children within the deaf community appears to be diminishing, according to an article in the May issue of The Archives of Otolaryngology - Head & Neck Surgery, a theme issue on pediatric cochlear implants and one of the JAMA/Archives journals.

Cochlear implants are small electronic devices that are surgically implanted in the ear that allow profoundly deaf people not helped by traditional hearing aids to hear better. According to information in the article, the topic of cochlear implants for children has been debated among deaf and hard-of-hearing persons, educators, and parents of deaf children and others. There has been disagreement over the appropriateness of cochlear implants for children, especially if they are too young to decide if they want the procedure for themselves. Additionally, approximately 90 percent of parents who have deaf children are not deaf, and generally have had little, if any, experience with deaf persons or understanding of deafness. However, perceptions may be changing, partially due to new research on the implants, the article states. John B. Christiansen, Ph.D., and Irene W. Leigh, Ph.D., of Gallaudet University, Washington, D.C., investigated the changing attitudes of parents of the deaf community and parents of deaf children regarding pediatric cochlear implantation.

The researchers combined the data from two studies: the first study (by the Gallaudet University Research Institute - the GRI survey) was conducted in the spring of 1999 and included the results of 439 questionnaires filled out by parents of children with cochlear implants. The second study consisted of 56 interviews with parents of 62 children with implants (and one without). The children represented by the studies ranged in age from two to 20 years old, and were between 15 months and 17 years when implanted.

Overall, the researchers found "While parents frequently receive conflicting information about educational and communication options for their child, they generally support signing [sign language] before and after implantation." About 50 percent of the children signed after getting their implant, both at home and at school.

According to the GRI survey, 62 percent of parents said they would have liked their child to receive an implant earlier because they believed it would have better facilitated the development of spoken language. One year after implantation, 54 percent of these parents were very satisfied with their child's progress.

Children with cochlear implants were educated in a variety of educational settings, with 34 percent of children represented in the questionnaire survey in mainstream classrooms for all activities with hearing children. Twenty-four percent were partially mainstreamed, and 13 percent were in classes for deaf or hard-of-hearing children. "Mainstreamed children with implants often continue to require classroom support services, and children with implants are frequently not isolated from deaf and hearing peers," the authors write.

"Opposition to pediatric cochlear implantation within the deaf community is giving way to the perception that it is one of a continuum of possibilities for parents to consider," the authors write. "To ensure optimal use of the cochlear implant, parents need to remain involved in their child's social and educational development."

(Arch Otolaryngol Head Neck Surg. 2004;130:673-677. Available post-embargo at archoto.com) Editor's Note: This study was supported by Gallaudet University, Washington, D.C.