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3 1 ImPaCt of CoChLEaR ImPLants on thE DEaf CommUnIty Raylene Paludneviciene and Raychelle L. harris Due to recent improvements in cochlear implant (CI) technology and the trend toward early implantation in infants as young as 6 months of age, how deaf children acquire spoken language has changed significantly. Recent research has demonstrated the dramatic improvement in spoken language for many of these children, essentially because of increased auditory access to spoken language (e.g., Sorkin, 2010). This in turn has created a generation of deaf children with CIs who in some ways are markedly different from previous generations in terms of educational and social experiences. The rapid changes in CI technology have resulted in evolving perspectives of CIs by professionals and members of the Deaf community. Even though deaf people have long used hearing assistance technology, no specific technology has caused the type of repercussions within the Deaf1 community and professionals the way the development of the CI has. funCtIons and BenefIts of CoChLear ImPLants Many members of the Deaf community wear hearing aids, which provide a wide range of benefit ranging from access to spoken language to environmental sound awareness. Since CIs also result in similar benefits, depending on individual attributes such as age at implantation and ability to learn the meaning of sound input among others, some may wonder why CIs have become the recommended hearing assistive technology for many deaf children and adults. The way sound is accessed differs based on the different technological functions of hearing aids and CIs. The main difference between CIs and hearing aids is in how sound is conveyed to the brain. Hearing aids are designed to amplify sound, although digital hearing aids can be programmed to dampen specific sounds (e.g., very loud For clarity, we use lowercase “d” to include all deaf people, regardless of level of involvement in the deaf community or fluency in a signed language. 4 rayLene PaLudnevICIene and rayCheLLe L. harrIs background noise) while amplifying another kind of sound (e.g., human voices). Their effectiveness depends on the nature of the user’s residual hearing. In contrast , the surgically implanted internal part of the CI converts sound to electrical impulses, which are then sent to the auditory nerve and from there to the auditory centers of the brain. These impulses can be manipulated through the use of a computer program capable of translating sounds that the user can learn to recognize. This is a process technically known as “mapping.” CIs do not amplify sound nor do they depend on the residual hearing of the individual since the electrodes inserted in the cochlea send impulses directly to the auditory nerve. CIs do not make a child or adult hard of hearing, contrary to assumptions that some may have, although they may be viewed as functioning like hard of hearing persons. These individuals are still deaf and still have to learn what the sounds they hear mean. Profoundly deaf individuals typically are candidates for cochlear implantation , given that the auditory nerve is still functioning. The possibility that they will derive significant benefits from CIs is a real one, especially if they are implanted at a young age. Changes in surgical procedures and improvement in the equipment (e.g., making the inner coil less rigid, causing less damage during insertion into the cochlea) have made it possible to preserve residual hearing in some patients (Niparko, 2009). The practical aspects of preserving residual hearing in this case include providing CI users with the option of utilizing their residual hearing in certain situations (e.g., listening to music). Age of implantation is the single most important factor affecting the success rate of acquisition of spoken English (Sorkin, 2010), although multiple other factors also come into play. For example, in one study, deaf children who received a CI at 13 months of age had similar vocabulary levels as hearing peers of the same age, whereas deaf children who received their CIs later performed more poorly (Indiana University School of Medicine, 2010). The recent increase in the prevalence of bilateral CIs, meaning that each ear is implanted with a CI, has resulted in an increase in positive benefits for deaf children. Tait et al. (2010) compared 42 unilaterally implanted and 27 bilaterally implanted children and found that bilaterally implanted children were significantly more likely to vocalize and to use audition when interacting vocally without looking while conversing with an adult. For children, the path to cochlear implantation starts shortly after birth. To...

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