Eternal Sunshine of the Cochlear Mind

Gazza, one of the Australian deaf bloggers who inhabits at The Rebuttal, posted a strong critique made by Michael Uniake, which examined the existing medical viewpoint of cochlear implants and highlighting their intransigence leads to an unhealthy legacy on the well-being of the deaf people, at large. One eminent doctor, Dr Bruce Shepherd, made a public statement that cochlear implants is the ONLY route to happiness and becoming a productive member of the society. I feel that insensitive statement will prove extremely unhelpful on the back of the hard work of Deaf professionals and campaigners, who have continously strived to improve the public perception of D/deaf people AND further compounded the fears of being Deaf amongst new parents of pre-implanted deaf children and potentially future parents of deaf children.

In that same statement, Dr Shepherd emphasized how important it is to communicate across the spectrum of society and not just being confined with the very few who are able to sign. While I recognise that communication is a core part of human’s essential life skills, it is tragic this doctor is naive/ignorance/arrogant (takes your pick) enough to say that happiness can only comes if you have this medical device – the cochlear implant. I was equally dismayed it was uttered on the same stage as the Australian Prime Minster, Kevin Rudd, which comes across as a Government’s endorsed viewpoint on this topic.

I’ve dug up an excellent article which provide an compelling account into the perils of relying too much on cochlear implants as the “miracle” cure for deafness. She also goes at great lengths that it is foolish to assume a CI will “fix” it for every deaf child in a mainstream settings – a position that the medical experts have been advocating for a long time. Essentially, having a CI alone is not the endgame or even a long term solution – something the medical profession have trumpeted with wanton disregard, but leaving the likes of Tricia to firefight in their wake.

The author is a person who have seen it all – as a mother of a deaf child and a coordinator for CI support group. I particularly author’s dissection of the the “inclusion” myth perpetuated by the mainstreaming policies of the UK government and CI experts around the world. I have no idea if this mainstreaming also applies to Australia. It does not works for everybody and CI is just a powerful hearing aid.

Further reading:

Hype-Mania (The final word on the cochlear implant hype)

This is a copy of the article taking from BATOD website – feel free to click on the link below.

One size fits all?

Tricia Kemp, Co-ordinator of CICS

Sixteen years ago when my profoundly deaf son was just six months old I was told that his first language would be BSL and that he would need special education – a sweeping statement. At that time, however, it has to be said that both predictions were likely to be true.

How different things are today! With the advent of cochlear implants things have swung the other way. Profoundly deaf children are having cochlear implants and parents are being told that normal speech and mainstream education are the expectation – another sweeping statement.

Yes, technology is a wonderful thing and clearly the benefits of cochlear implantation can be enormous but in advising parents of newly diagnosed deaf babies that implants are available and can make speech and mainstream education possible, some parents, obviously greatly relieved by this news, will never fully accept that their child is and will always be deaf. They are desperate for their child to be in mainstream education because that indicates ‘normality’ – whatever that means. Some are looking for what they want for their child rather than what that child actually needs.

As the parent of a deaf child and the Co-ordinator of CICS*, I would like to make not a sweeping but a common sense statement regarding education: it is not possible to compartmentalise any group of children, especially if they are deaf or have other special needs, into one type of educational provision.

Outcomes from paediatric cochlear implantation vary enormously and will continue to do so in the future especially as children are being implanted younger and younger before the existence of other difficulties has been identified. Cochlear implantation is not a miracle that immediately gives access to mainstream education for all children. Undoubtedly it provides this for some but even within this group the amount of support necessary will depend on the individual child. Other children will need more support and will be better suited to placement in a Hearing-Impaired Unit (‘Unit’) where more specialist help is available and others will need placement in a special school.

Amongst the population of deaf children, with or without cochlear implants, some will need sign support, others are oral (to varying degrees), some will need very little support, others will need a great deal; and some will have additional difficulties.

It is clear that the needs of deaf children are far too diverse to be met in any one type of educational placement.

Inclusion sounds like a great idea and for some deaf children it works well. Placement in a local school gives the opportunity for friends and social opportunities close to home and, for the child and the parents, avoids the stress of a journey to a Unit or school for the deaf which may be some distance from home. If a mainstream setting is a small class with good acoustics, a competent teacher and appropriate support available if needed, then obviously an able deaf child will stand a good chance of accessing the curriculum and keeping up. Unfortunately, however, in the real world, a class can be around thirty children, acoustics are poor and a good deal of a teacher’s energy is taken up in keeping control rather than teaching. In a class of thirty there will be a wide range of abilities to address. The last thing a mainstream teacher needs is to spend time making sure a deaf child has understood the content of a lesson and to deal with any equipment that the child may have.

There are about 40% of deaf children with additional difficulties and of the other 60% there will be many who will only thrive in a mainstream setting with a significant amount of support but will they get it and, if they do, will the Classroom Assistant have had appropriate and sufficient training to work effectively with deaf pupils? In many cases this scenario is merely an excuse for cost-cutting. Placing a deaf child in a mainstream school with limited support is the cheap option; but if there is little, or no support, it requires immense concentration and is exhausting for the child to understand and keep up with the teacher, let alone catch the incidental comments of their hearing peers throughout the school day. Inclusion? Perhaps, but at what cost to the deaf pupil?

If, in the other extreme, a child has and is totally reliant upon full-time, one-to-one support in order to access the curriculum this will exclude that pupil from learning from the class teacher with the hearing pupils. A full-time Classroom Assistant is unlikely to be a qualified teacher and faces the difficult task of effectively translating a lesson into language that can be understood by a deaf pupil who may be functioning at a lower linguistic level than hearing peers in the class. How can this be described as inclusion?

The danger of blanket inclusion is that it actually leads to total exclusion, leaving some deaf children unable to manage socially with hearing peers and unable to keep up with the pace of learning, thus falling behind and failing to reach their potential. Some Hearing-Impaired Units are able to provide an appropriate mixture of specialist teaching in small groups for specific subjects and support during integration into mainstream classes but more and more of these provisions are becoming mainstream based rather than Unit based, resulting in children struggling to keep up in a setting that is not specifically designed to meet their needs, ie mainstream with support, as opposed to the more structured and supportive environment provided by a Unit.

It is vital to have good early intervention to enable deaf children to build the foundations for learning at a later stage. At secondary school the pace of learning picks up enormously. A deaf child may already have a language delay and will simply not manage to keep up with the vast amount of new vocabulary presented to pupils at this stage of the curriculum, resulting in an ever-increasing language gap making it extremely difficult, if not impossible for the child to access the curriculum at an age appropriate level.

Delayed communication causes problems outside of, as well as inside, the classroom. Good communication skills are vital if a deaf child is to develop real friendships with hearing peers. If they don’t possess these skills at a young age and the problem is not addressed by appropriate input at an early stage, they will simply not catch up, especially those who have additional difficulties; and without good communication skills, deafness leads to isolation. Poor communication can lead deaf children to be left out of games at a young age and to be excluded from social chit-chat as they get older. In a mainstream setting there may only be one deaf child in the school and unless s/he can fully integrate s/he is likely to feel isolated and may even be a target for bullying just because s/he is different. In the short term this may lead to poor self-esteem and even behaviour difficulties and to mental health issues in later life.

The standard and choices of educational provision for deaf children need to be improved. Whilst it is clear that the Government’s policy for inclusion works well for some children, it certainly does not work for all of them and it is important to ensure that there is a choice of high quality provision in all areas. Mainstream education with support, which is sometimes inadequate, is merely a cheap option for the local authority and one cannot help wondering how much this is a factor in what they offer to parents as an appropriate provision for their child. It is no good having a child in mainstream education if that child’s needs are not being fully met. This merely represents a short-term saving for the Local Authority with long-term adverse consequences for the child.

The role of a Teacher of the Deaf, whether in a special school or as a support in mainstream, remains vital for deaf children. More needs to be done to encourage teachers to enter this specialised field, perhaps by changing the structure of the existing lengthy training. There will always be a need for special schools but the number of these has been reduced to a dangerously low level. It is time for a re-think. More, not less special schools are required, spread appropriately across the country and research must be carried out to look at ways in which these schools can work effectively with mainstream schools to provide pupils with the best of both worlds. (A role model for this is already in existence in Hertfordshire.)

There is a real danger that the current generation of deaf children will be let down by a lack of investment in their education. In the right setting they will achieve but, without enough support and specialist teaching, many of them don’t stand a chance.

The system’ must be made to work for, rather than against deaf children.

Even with the tremendous benefits that technology can provide, life will be hard enough for deaf children as they become young adults. If they are to become independent, well adjusted members of society able to take their place and compete in the hearing world they need an individually tailored educational programme to ensure that they reach their potential.

The danger of a blanket inclusion policy is that many deaf children will simply not be able to meet their potential because the system has let them down by looking at cost rather than individual needs.

`One size fits all’ simply isn’t good enough.

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