Cochlear Implant - A New Study

[amiller]

At the risk of starting a war, I wanted to share this information because I thought it was interesting and that somebody here might appreciate it. For the record, I feel the "implant or no implant" decision is a personal one every family must make on their own - but this new study turned up some interesting information!

Cochlear implant clues
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Hearing study in cats born deaf helps show why the nerve-stimulating devices are 80 percent successful in children but rarely work in adults

SCRIPPS HOWARD NEWS SERVICE

December 5, 2005

A study in cats demonstrates how cochlear implants in very young animals allow them to develop normal nerve fibers to transmit sound and restore hearing by reversing damage to the brain's hearing network.

The findings by researchers at the Johns Hopkins University School of Medicine in Baltimore help explain why such implants are about 80 percent successful in restoring hearing to young children who are born deaf, but rarely work in adults who are congenitally deaf.

"What we think this study tells parents of deaf children is that if cochlear implants are being considered, the earlier they're done, the better," said David Ryugo, a professor of otolaryngology and neuroscience at Hopkins' Center for Hearing and Balance. He is the lead investigator for the study in Friday's issue of Science.

Cochlear implants are small devices designed to mimic the work of inner-ear structures that react to sound waves and convert tones to electrical nerve signals. Hair cells form a ribbon of vibration sensors along the cochlea,the organ of the inner ear that senses sound. After receiving sonic vibrations through the eardrum and bones of the middle ear, the hair cells
convert them to the signals carried to the brain via the auditory nerve.

Unlike hearing aids, which amplify sound through a nerve-to-brain system that may be damaged but still intact, cochlear implants bypass the ear entirely and link right to the nerve cells that interpret sound in the brain.

One part of the device is a microphone located behind the ear that picks up sound and converts it to electrical signals that are transmitted through the scalp to a receiver attached directly to the brain.

More than 10,000 children are born deaf each year in the United States, and an estimated 1.5 million people are believed to be good candidates for cochlear implants. But only a few thousand of the procedures are done each year, with about 10 percent going to children younger than 3.

For the study, Ryugo and colleagues compared the responses and brain tissue of cats born deaf that got coch-lear implants within four months of birth with deaf cats that did not get the implants.

Both groups were exposed to three months of sound stimulation, during which the researchers played music and let the animals roam the lab, with various everyday background noises. Along with three deaf cats with implants and
four deaf cats with no implants, they also included three otherwise similar cats with normal hearing as a control group.

To measure the animals' hearing development, all the deaf cats - with or without implants - were subjected to a unique sound, one for each animal, that measured its response to a cue, such as the clapping of hands or ringing of a bell, signifying that there was a food reward nearby.

Within a week, the deaf kittens with implants responded eagerly to the new sound cue, rushing to collect the food, while those without implants did not.

Later, brain-tissue analysis showed that those felines with implants developed regions called synaptic connections between connecting auditory nerve cells that closely resemble those seen in cats with normal hearing. Those connections included large numbers of synaptic vesicles, reservoirs
along nerve pathways that store chemicals needed to pass sound signals between nerve cells, and robust membranes that receive the signals.

The deaf cats without implants lacked the reservoirs, and the membrane regions were flat and withered in appearance.

Dr. John Niparko, another ear specialist at Hopkins who took part in the study and who has been studying the effects of hearing restoration on children for more than 20 years, said researchers now need to study the auditory system's development between birth and puberty. Specifically, the
research would seek to understand why the possibility of restoring hearing and language skills diminishes during that period.

Copyright (c) 2005, Newsday, Inc.

[MmaBasotho]

I have heard that people with CIs don't hear things the same way hearing people do, but hear something that is more like a computerized tone. Is this right?

And what does music sound like with a CI? Can a person with a CI still sing in tune?

We might think about this for our daughter down the road. Not yet, but if she doesn't take to her hearing aids, it could be a possibility.

[aligreat]

I have heard that people with CIs don't hear things the same way hearing people do, but hear something that is more like a computerized tone. Is this right?

And what does music sound like with a CI? Can a person with a CI still sing in tune?

We might think about this for our daughter down the road. Not yet, but if she doesn't take to her hearing aids, it could be a possibility.

I went to a lecture given by a deaf woman who had a CI implanted and then removed. The way she described it sounded as if she had a dial-up modem (you know, that noise you just hate) in her head. Although, this study makes me wonder if the experience of a small child might be different. If the woman couldn't form the pathways necessary to use the CI properly it wouldn't be as effective. Still, I personally wouldn't do that to my little one...just my own opinion.

[amiller]

I personally wouldn't do that to my little one...just my own opinion.

I am kind of with you - I feel funny about deciding for my child that a hole needs to be drilled in her head - still, if she wanted one at about 5 or 6, I would resect her decision. There are so many decisions that, as parents of special needs kids, we have to make FOR them, that I try to leave as many as possible for Anyka to make on her own. It is her body, and her life, and as long as something doesn't affect her ability to have a life, I feel she needs to make that decision herself when she is ready and able.

[MmaBasotho]

Honestly I've always been sympathetic to the anti-CI side of the debate - before I had Paula (she has severe SNHL). Now that I have my own hoh child, I realize that as her parent I'm responsible to make informed choices. There are times when communication is so NOT happening between us that I can really understand why some parents opt for the CI. I even think maybe that will be us, down the road.

The fact is that it was easy for me to form an opinion when the whole debate existed in the realm of theory. Now that it's very real, very present and literally in my lap, that opinion, like so many others, is up for review.

[aligreat]

Honestly I've always been sympathetic to the anti-CI side of the debate - before I had Paula (she has severe SNHL). Now that I have my own hoh child, I realize that as her parent I'm responsible to make informed choices. There are times when communication is so NOT happening between us that I can really understand why some parents opt for the CI. I even think maybe that will be us, down the road.

The fact is that it was easy for me to form an opinion when the whole debate existed in the realm of theory. Now that it's very real, very present and literally in my lap, that opinion, like so many others, is up for review.

Isn't it amazing how our little ones constantly update us on what we thought we "knew?" When Cassia was still in the hospital and having a hard time keeping any food down, a friend of mine told me that as a baby she had reflux and vomited all of the time. Her mom was constantly re-evaluating what was and was not clean enough to wear. I didn't understand this until I was changing Cassia's outfit 4 times a day. The decisions about clothing pale in comparison to decisions about surgeries. I'm so glad that I have you all to check in with when I'm deciding on such things. Be sure to weigh in on my post on ear tubes. Thanks!!

[amiller]

I realize that as her parent I'm responsible to make informed choices. The fact is that it was easy for me to form an opinion when the whole debate existed in the realm of theory. Now that it's very real, very present and literally in my lap, that opinion, like so many others, is up for review.

I completely agree. Informed choices are ours to make, as parents, all the time. And in the case where a parent feels it is the best decision they can make, then I say it is right for their family. Far be it from me to tell someone else what is right for them!

[KatnHunter's mom]

I'm new to this forum and just found the site. I think it's amazing. I wanted to tell my story from the perspective of a mom who decided against the CI when I learned my daughter was Deaf and then she helped me change my mind when she was 6 1/2. Kaitlyn was born 4 weeks early and Deaf because of the CMV Virus. I did some research on the implant and heard the same things you have posted here, how the quality of sound is not good and why should I drill holes in my child's head to make her hearing "like me". I felt that to implant her, I was not accepting the gift that I was given.

We learned Sign Language and we became pretty fluent in the language together. At the age of 6 1/2 Kaitlyn said to me that when she grows up, she'll be able to hear just like me. (Kaitlyn also has a little brother who is hearing) She started showing more interest in the presence of sound and wanted to know "what was that?" when she saw others reactiving to something that she just didn't see.

Kaitlyn was implanted in June of 2003 at the Mayo clinic in Rochester MN. She is now 9 years old and her audio grams test out as well as mine would. She knows most environmental sounds around her which I feel are important when it comes to safety. She's learning to talk, she can read out loud and she's slowly understanding more spoken words. She can be down stairs in her room and I call her from upstairs in the kitch to come and eat and she comes up the stairs and asks me "what?"

Each parent has to make that choice for their child, I made the choice when she was too young to make it for herself, but as she got older, she gave me her input and it then became her decision. We are very much a part of the Deaf community and we will always use Sign Language in our home, but I believe that I have opened her world up a little bit more.

Desi

Kaitlyn and Hunter's mom

[MmaBasotho]

Kaitlyn was implanted in June of 2003 at the Mayo clinic in Rochester MN. She is now 9 years old and her audio grams test out as well as mine would. She knows most environmental sounds around her which I feel are important when it comes to safety. She's learning to talk, she can read out loud and she's slowly understanding more spoken words. She can be down stairs in her room and I call her from upstairs in the kitch to come and eat and she comes up the stairs and asks me "what?"

Hi, Desi,

I'm still curious about the ability to hear music with a CI. Maybe you can shed some light on it for me. My daughter has enough residual hearing that with her aids she is able to enjoy at least part of the melodies she hears. I was playing my flute for her yesterday and afterward she sang part of the melody I had played! I don't think I could take that away from her... We are a rather musical family.

I understand, though, about respecting your child's wishes in the matter once she's old enough to express them. I'm glad it is working well for all of you.

[Rachel]

From one musical family to another....

As "public" as our lives are with Signing Time and sharing our experiences with others, I have to say this- I do not feel that a cochlear implant is right for every deaf child. I do feel that exposure to sign language is beneficial for EVERY child, whether they have a hearing impairment or not.

I also do not believe that cochlear implants and American Sign Language are mutually exclusive. Some doctors and audiologists will recommend that you stop signing if you opt for an implant. (Ummm, what about when your kid is in the bath, in bed, at the beach, on a trampoline? How about when their implant batteries die, their implant gets lost or heaven forbid if the implant is unsuccessful or fails?) Don't leave your child without a means to communicate! Sign language is an important tool as well!

When we discovered that Leah was deaf she was 14 months old. We were told about implants and we looked into it, but it never felt right. I too thought, "I would never drill a hole into my child's head!" and "Who am I to decide for her that hearing is better than deafness?" I had heard that the sound generated by a CI was mechanical or robotic. I was also concerned with how quickly technology advances and if we implanted her now, technology could easily leave her behind in next few years. Once you implant an ear, in most cases you no longer have residual hearing in that ear.. meaning she could lose the little hearing she has. I was not willing to take that chance, especially since she was too young to tell us what she really could hear with her hearing aids.

So many things to weigh! We finally decided that Leah we would give Leah everything but an implant. She has an incredible education, she LOVES to read and she is an excellent writer. She is fluent in ASL. We have full communication and then some! She is so bright! Leah could decide for herself when she turns 18 whether or not an implant was something she wanted. But... then... over the years I met a number of adult implant recipients and most of them no longer used their implants. It seemed it was too hard after that many years of silence, to be bombarded with sound. Too much information to sort out.

I began to wonder, if we let her choose at age 18, is it giving her a choice at all? Or after 18 years will she be so comfortable with silence that we would only be setting her up for failure?

Leah had made the choice to stop wearing her hearing aids at age 5. They hurt, she couldn't hear anything and the wax build up was a continual problem. We let her make that choice and she went unaided for almost 2 years.

6 years had passed since Leah's original diagnosis and I had not given the implant a second thought. Suddenly a number of seemingly random things came together. My daughter Lucy, at age 3, needed a shunt put in her head to regulate the water on her brain. Hmmm... now I could no longer say I wouldn't drill a hole in my child's head!

I met a number of implanted children that I would NEVER have guessed were profoundly deaf. I looked into the latest implant technology and as I had suspected A LOT had changed in the past 5 years.

We sat down and talked to Leah. I said, "Leah, do you know what a cochlear implant is?"
Leah: "No."
Me: "Haven't you noticed the little circle that some deaf kids have on their heads?"
Leah: "No."
Me: "Well, it's like a hearing aid but they do surgery to put it in your ear. There is also a part that you wear on the outside to turn it on and control it. It might help you to improve your speech so that people who don't know sign can understand you when you talk. AND it might help you to improve your listening skills, so that you might be able to understand people when they talk to you."
Leah: (looking at us in complete shock) "Well, when can I get one?"
Me: "Leah, it's surgery. Do you understand, they would have to perform surgery on you."
Leah: "So, when can I have it?"

(I guess this is part 1 of a multi-part post! I have to run Leah to a drama performance.... so hang in there!)




(to be continued...)

[Aaron]

My opinions on what an implanted child actually hears...

As a parent of a child with a CI, I have accepted that I will never really know exactly what Leah hears. I have read that it is pretty darn close to what a normal person hears, and have also read that it is more like series of electronic noises, that they learn to interpret as "normal" sound. I guess the way to find out would be to ask an adult, who has lost their normal hearing, and has since been implanted (like Rush Limbaugh).

For me, I have lost the desire to find out, because it doesn't really matter. Leah can hear quite a bit while using her CI. She has developed her listening skills enough to LOVE music, including Hilary Duff, and her new-found favorite band, Jump 5.

For Leah's birthday this month, we gave her an mp3 player, with an attachment that goes direcly into her implant. We can barely pull it off of her, as she is constantly banging her head along with the beat to whatever she is listening to...in the car, around the house, and even when she goes to bed.

This month Leah has been perfoming (along with several other of her cousins) in one of the musical numbers during her Grandfathers Christmas concerts. She signs the song (and sings) as her other cousins sing. During the song she will glance over to another cousin to make sure she is in time with the song...and generally is.

Bottom line is...whatever sound she hears, she hears something, and understands more and more each day. Whatever she hears when listening to her music, she knows the words, and sings right along. She loves it, and often times will remind us how much she loves it.

BTW, we STILL use ASL all day/everyday with her, and I know we always will. I can honestly say that I don't know where we would be in this life without ASL...

I finally posted in the new forum! WooHoo!

Aaron

[aligreat]

My opinions on what an implanted child actually hears...

As a parent of a child with a CI, I have accepted that I will never really know exactly what Leah hears.
Aaron

At what point was Leah implanted? I ask because I was just floored by the improvement of her speech between 4-6 and the "chicken" preview on BST. Is she able to sing in tune? That mp3 player sounds great. Have you had any negative reactions to her having a CI within the Deaf Community? One of the reasons I wouldn't want to have Cassia implanted is because I perceive people with a CI as being placed in a sort of "not hearing but not deaf" limbo by their Deaf peers (not to mention the various horror stories from a medical stand point that I've heard.) This is the first really positive experience I've heard of with a CI, and I would love to hear more.

[amiller]

At what point was Leah implanted? Have you had any negative reactions to her having a CI within the Deaf Community?

I think Leah was about 6 years old when they implanted her, and I know Rachel posted about some "issues" some Deaf people had with their implant decision, on the Yahoo froum. I will look for those posts to see what I can find for you.

[Kei_as_in_K]

BTW, we STILL use ASL all day/everyday with her, and I know we always will. I can honestly say that I don't know where we would be in this life without ASL...

I finally posted in the new forum! WooHoo!

Aaron
Yay! It's about time you posted :p ;)
And I can honestly say... I'm so glad you do have ASL... because where would all the rest of us Signing Time fans be without you?

[amiller]

Isn't that the truth! What a blessing to all of us that your family made the decisions they did!

[eyeteachpreskool]

I'd like to add a little continuation to Rachel's post. We met Leah in Salt Lake this past summer while we were visiting family. I had heard about her implant, and had some questions for Rachel. Plus, I wanted to meet Leah and see what it was REALLY like for her.

I have to say I went home with an entirely new opinion of the implants. Rachel was the first person I'd ever met who felt like it was possible to have an implant AND sign. Finally! Someone who had managed to make it work and lived to tell about it.

I observed Leah for most of the time. She was no different from my hearing son, and was so much more aware of who she was than any hearing or deaf child I'd ever met. The stunning part was that she was also PROUD of who she was. I asked her point blank, "do other kids notice your implant and how do you feel about it?" She promptly shrugged her shoulders and said "Yeah, they notice. They think it's a little weird". From there, she dipped her fry into more ketchup and went back to teasing my five-year-old. Imagine my surprise at finding a DEAF child who was so comfortable with her implant.

When we came home from that trip, we made a greater effort at looking into the implant for my son, CJ, who is two now. He's kind of in a gray area because parts of his cochlea are missing, so his success rate may not be so great. We're kind of holding out to see how much more he loses of his hearing and how quickly it happens. But, we know we always have the option of giving him the implant if it turns out to be better than his hearing aids.

My husband is VERY musical. It's his life. I don't think he could breathe without music. So, it was like a bad scene from Mr. Holland's Opus when he found out about CJ's hearing loss. But, we've come a long way, baby. That kid loves music. He begs for it. I know he experiences it in a different way, but he enjoys what he gets. I think that is the whole point of music anyway.

We have another baby on the way (surprise!), and are sincerely hoping it's another Deaf one. We know what to do with our deaf child. We love him for what he's brought to us.

Whether or not a family chooses to implant is totally a personal decision (and I believe a matter of serious prayer and reflection), but I don't think there is really any right or wrong answer. I never would have guessed that someone so in tuned with the Deaf community would be able to successfully have an implanged child. I've seen it with my own eyes. Leah is an outstanding testament to the feats that can be achieved with a little will-power, an opened mind, and devoted, loving parents.

Okay, that's all. Rachel, you can continue with your story now.

-Aimee

[MmaBasotho]

We have another baby on the way (surprise!), and are sincerely hoping it's another Deaf one. We know what to do with our deaf child. We love him for what he's brought to us.

Congratulations! I have to say I relate.


My husband is VERY musical. It's his life. I don't think he could breathe without music. So, it was like a bad scene from Mr. Holland's Opus when he found out about CJ's hearing loss. But, we've come a long way, baby. That kid loves music. He begs for it. I know he experiences it in a different way, but he enjoys what he gets. I think that is the whole point of music anyway.

Ah! Mr. Holland's Opus :D My husband is actually a music teacher, though his true love is drums and percussion. So the parallels were inescapable, but fortunately we were already fans of a percussionist named Evelyn Glennie (http://www.evelyn.co.uk/). (Also see this article (http://www.drummerworld.com/drummers/Evelyn_Glennie.html)) She is the premier orchestral percussionist in the world! A true virtuoso. Long, wild brown hair and she plays barefoot. Why? She's deaf. She tunes her tympani by feeling the pitches in her feet. This is not a case of "wow, look what she can do even though she's deaf." It's a case of "wow, look what she can do, period."

So fortunately we knew that Paula doesn't need to hear the way we do to love and play music. Joel has gotten her a ukelele for Christmas. She is contstantly trying to play the tiny guitar on our (this is too corny) John Denver Christmas tree ornament. It plays "You Fill Up My Senses." (Well, now you all know my deepest, darkest secret!) Anyway, I know she'll be a drummer, though, too, because she just LOVES to listen to Daddy play his drums, grab a stick and play along.

Well this thread has wandered far astray, hasn't it? I'm still looking into CI's, but as my husband told me the other day, we won't really be in a position to make that choice until we've given her hearing aids another five or six months. There's no saying what things will look like then.

Off to rescue my mom's "Sol y Canto" CD from Paula and the VCR.

[Rachel]

At what point was Leah implanted? I ask because I was just floored by the improvement of her speech between 4-6 and the "chicken" preview on BST.
Leah was implanted in January 2004 and turned on in March 2004. In June 2004 we shot Volumes 4, 5 and 6 "Once I saw a rainbow..."

The weirdest thing is, Leah can hear how different she sounds on the earlier volumes of Signing Time. She'll be watching it and say, "I said Lello not Yellow!" Or "I said Orangee, it's really Orange!"

She loves to listen to Hilary Duff and Jump 5. Sometimes when I am singing Signing Time tunes in the car or in the kitchen, she will join in... to my complete surprise and shock.

[becnorris]

I had no idea that Leah had gotten an Implant! I had of course heard how her speach had changed but did not realize that was the reason.

I am a new observer of the Deaf community, as a hearing parent of 2 hearing kids but now am teaching ASL to them thanks to ST. I have a mom in my signing playgroup that takes care of a 2 yr old that is deaf but has an implant. I am learning more about them each time we meet and was also interested in how the Deaf community feels about it as well as how the kids and families feel about them.

It is wonderful to hear that Leah was able to make that decision for herself (with your help of course) after having the amazing experiences that she has already had in her life! The little girl in my group was implanted just after 1 yr old and is also learning SEE, but her parents don't sign to her at all (they are hearing). Her only signing experience is through her childcare provider (the mom that watches her a few days a week) who has been signing for 15 yrs with both ASL and now SEE. I just hope that she might have as good of an experience with the Deaf community as Leah and her whole wonderful family

You guys are great and like the others have said "we are so lucky that you did choose to teach Leah ASL or we would not have ST or you as our role models!"