Cochlear Implants in Children: Ethics and Choices

CHAPTER 6. Adjusting to Life After the Implant

146 CHAPTER 6 Adjusting to Life After the Implant Parents of children with cochlear implants, as well as the children themselves, typically face several issues after the implant surgery. These include the time commitment parents need to make for their child to benefit as much as possible from a cochlear implant, and the mode or type of communication the children typically use after implantation.1 Some of the most important post-implant experiences of children with implants occur at school. Because education is so important, the following chapter will focus exclusively on that issue. Time Commitment Before implantation, virtually all of the parents we talked with were very much aware of the fact that it was unlikely that their child would demonstrably benefit from the implant immediately after the 1.“Children,” of course, in this chapter and elsewhere, is somewhat of a misnomer ; it is simply a category of convenience that includes a number of adolescents and young adults who are no longer children. ADJUSTING TO LIFE AFTER THE IMPLANT 147 device was activated.Rather, parents realized that they would probably have to put in a great deal of time to ensure that their child derived as much benefit as possible from the implant. [A speech therapist we see] . . . makes an analogy that receiving the implant is like receiving a load of building supplies on a lot. And in a couple of years you might have a beautiful new house on that lot if you do the work. But, if you don’t do the work, you’ll just have a load of building supplies on that lot. . . . Every moment with [our daughter] is a language opportunity. Mother of a 4-year-old girl implanted at 18 months A number of other parents we talked with commented on the amount of time they expected to have to put in with their child for implantation to “work.” A sampling of some of the comments from parents on this point follows: The implant is 5 percent. The 95 percent is what you do after the implant. . . . And we were very willing to make the commitment, and excited to make the commitment. Family of a 5-year-old girl implanted in the mid-1990s [My daughter] is not the only one who was implanted. I might not actually have something in my head, but it was a commitment . And it was a commitment to know that for this to succeed with [her] that I had just as much work to do as she did. And [the implant center was] very realistic about that. Don’t expect it to change overnight. Don’t expect her to be turned on and . . . to speak the next day. It’s not going to happen that way. Parent of a 7-year-old girl implanted in 1996 You’d never know how he would do. And that’s the hardest thing about deciding to do this is because they cannot tell you what the outcome will be. That was really hard, . . . and . . . if any parent asks me, I tell them the same thing.I say, Look, they cannot . . . promise that this is what’s going to happen with your child. So you have to know that going in. Don’t think it’s going to be like this miracle cure of your kid, . . . you still have to work. . . .You’re not going to turn it on and he’s going to hear like a normal hearing person. That’s not going to happen. Mother of a teenager implanted in the early 1990s We also asked parents if the amount of time they have actually devoted to the post-implant habilitation needs of their child was about what they expected. There was a good amount of variability in the responses to this question. A few parents said that they were surprised to find that, because the implant worked so well, they did not have to spend a great deal of time educating and socializing their implanted child, at least not any more time than they had to spend with their child’s hearing siblings (or what they thought their friends were spending with their hearing children). A more common response was that they did indeed have to put in a great deal of time, and that learning to use the implant is, as one parent whose daughter has used her implant consistently for 7 years, said, still...