Archive for April, 2009

“Audism” – Does It Exist?

Wednesday, April 29th, 2009

Melissa: I don’t think it does.  We believe that children born deaf who receive CIs and learn to hear and speak and live their lives fully in the mainstream will have a better life.  Does that make us audists?

Amy: I totally agree.  I don’t believe it does exist.  There ARE times when individuals are discriminated against based on disabilities, but that is not the same at all.  Yes, hearing is a good thing.  I don’t think that makes me anything which can end with -ist.  It’s not as if it is the same as being a racist, etc.  Human animals are meant to hear, and any time we can assist people toward that goal is good (which we have done)!  No doubt we would not think twice about loving our kids and whatever communication they used if we lived 200 or 1000 years ago… but we would always wish that they could hear, to make their lives easier.

Melissa: The issue is that easier and better doesn’t equal superior.  By that I mean that I believe that children born deaf who receive cochlear implants at a young age and learn to hear and speak will have easier lives and will have more opportunities open to them.  I don’t believe that they are superior to those who live their lives in the deaf culture, but I do believe that my girls’ lives are better than they would have been without the ability to hear and speak well.  Why else would I have put them through surgery?

I am glad that they can communicate with anyone without an interpreter by their side or without having to write back and forth.  I am glad that they could choose any school and socialize with the other students at those schools with ease.  I’m glad that I can speak to them on the phone when they are not home.  I’m glad that they can hear and enjoy music.  I’m glad that they are fully a part of family gatherings.  All of these things to me enhance their lives.

Amy: Yes, it’s easier and better.  And a recent study showed kids exhibiting greater psychological well being, even.  (Click here for the study abstract) Certainly we would wish that for our children.  I compare it to many other disabilities, both large and small… many parents would do what was necessary or possible to remove other hindrances to communication or physical freedom.  We would (and do) provide eyeglasses, wheelchairs or future biological aids for spinal cord injuries, speech therapy to allow less frustration during communication.  This list could go on and on.  We begin caring for our children in early life, and the fact that we cared enough to allow them to maximize what science allows today has nothing to do with audism!

There is a difference between thinking that someone is better/superior vs. having better opportunities or an easier life.  I do not think that a child born to more educated parents or who is living in a developed country is in any way “better” than a child born in poverty or in a country without educational opportunities.  But I do think that their lives will be easier.

These are two very different things.  And obviously, I would want to do anything humanly possible for my child to have opportunities.  I can’t personally make them a motivated individual– their achievement will be largely up to them– but I can give them the tools to make it possible.

Melissa: So then, coming back to the original question – Does Audism exist?  I do not think so, but there are those in the deaf culture who believe that it does.  I think that it is their own insecurities that cause them to believe the choice of others to value hearing and spoken language implies that they are inferior because they cannot hear and speak well.  Those of us who do value hearing and spoken language have never stated this.  We may believe that we have made choices to provide our children with a better life, but the idea that we, therefore, believe that those who cannot hear and speak are “inferior” is an idea of their own creation, not ours.

Amy: We have shown that parents do not exhibit audism by implanting kids, teaching them to speak, or by valuing hearing.  I have heard those in the deaf culture accuse random strangers of audism, too– people who are simply showing ignorance or general discrimination.  And, sometimes, it is neither of those, but practicality regarding ability to perform a job when one cannot hear.  Again, it’s not “audism” in either case.

Research Spurs Comments

Thursday, April 2nd, 2009

Amy: Recently, two studies came to our attention. They highlight why Auditory Verbal Therapy continues to be the best methodology for teaching deaf children to listen and speak, if those are the goals for that child. We parents are often accused of “audism,” or of being mean-spirited individuals who focus on speech to the detriment of brain development and the “natural” language of the deaf. We are accused of being overly focused on speech and the medical model of deafness.

We see the future, and we see how easily our children have learned to speak when we utilized IT as their natural language. Rather than seeing it as cruel, we see it as offering them what they deserve– the ability to do everything that their hearing peers and siblings can do. And we see them scoring very high in tests which indicate very normal development, whether it’s higher-level French language tests, state testing for Math, tests of reading ability, and so on. We posit that their development was far more normal that it ever would have been if they had been using a manual language in families which had previously never studied that language!

Below, we discuss the studies.

Web address:
Auditory Regions Of Brain Convert To Sense Of Touch, Hearing Loss Study Finds

ScienceDaily (Mar. 25, 2009) — Virginia Commonwealth University School of Medicine researchers have discovered that adult animals with hearing loss actually re-route the sense of touch into the hearing parts of the brain. (follow above link to read entire article)

Amy: This study is further proof that early implantation and use of the auditory pathways for auditory function is crucial in children (and adults!) with hearing loss! The rewiring, while assistive if there is no alternative, means that the auditory pathways will not utilize the new technology as well. The parents who take a “wait and see” approach with a child who is clearly profoundly deaf are allowing for this rewiring.

Melissa: This is proof of the fallacy in the argument used by many in the deaf culture that we should wait until the children are old enough to decide for themselves to get a cochlear implant. While we have known for many years now that those who were the early recipients of CIs, teens using ASL in schools for the deaf, did not succeed with them and gave them a bad reputation in the deaf community initially, this research now proves what we have seen. This combined with what research has shown for years, that the first three years of life are critical for language learning and establishing the auditory pathways, tells us that children need to be implanted as young as possible and then receive Auditory-Verbal therapy to take advantage of the implant. It also means that it is way past time for the FDA to lower the guidelines for age of implantation from 12 months to 6 months or at least 9 months.

Amy: It IS way past time. While I understand why certain babies would need to wait, based on prematurity, weight or inconclusive audiological testing, for those of us whose kids were clearly profoundly deaf (and even without residual hearing, in our cases!) and whose surgeons felt that they were headed for surgery, the FDA approval age being lowered would assist in insurance requests. Today, it is insurance more than anything which seems to be holding the process up. We were extremely lucky in implanting Oliver at 6 months of age.

This article is also more evidence to show that mixing methodologies, while hoping for audition and speech, is the wrong way to go. Visual and touch areas CAN and DO convert those regions of the brain. With the ability of kids today to hear well and use their auditory function appropriately, the Deaf Culture extremists who insist that we ought to be using sign along with speech are uninformed about the latest research. If we wanted a purely signing child, we would sign. Our point of speaking is to develop a child who is naturally good at using speech. The goals are very different, and the outcome of mixing methodologies serves to create the so-called “failures.”

Recently, another blogger was complaining that speaking people don’t use her language in the workplace (ASL) and wondered why that is fair. The reality is that any workplace will use the language most commonly learned in that area of the world. The sheer lack of numbers of ASL using persons in the world is the reason that people don’t use that language with her, and it is clearly the reason that I do not want it to be my child’s native language. We might expect safety officers to know Spanish, but would we expect them to know Cantonese? Deaf children can and have easily learned the language of their peers and family, which is the expected outcome of using that language on a daily basis. It has not been extraordinarily difficult. My were ready and ahead of peers by age 3, thanks to early implantation.

Melissa: We also saw the difference that earlier implantation makes. In 1996, the FDA guidelines still specified age 2, but our surgeon at NYU was willing to implant Jessica at age 15 months. She was 16 months younger than Rachel was when she received her CI, and yet the difference amounted to more than just 16 months. Rachel did not graduate from AV therapy until age 10, and even then she still had a slight language delay. Jessica, on the other hand, graduated from AV therapy at age 6 with language that was age level to above. I have since seen Amy’s sons. Again, Oliver was implanted at age 6 months, 9 months younger than Jessica was, and yet he completed AV therapy at an age 4 years younger than she did. The difference that early implantation combined with AV therapy makes is exponential.

Neuropsychologia. 2008 Sep 9. [Epub ahead of print]
Visual stimuli can impair auditory processing in cochlear implant users.
Champoux F, Lepore F, Gagné JP, Théoret H.

Centre de Recherche en Neuropsychologie et Cognition, Université
de Montréal, Montréal, Québec, Canada; Ecole d’Orthophonie et
d’Audiologie, Université de Montréal, Montréal, Québec, Canada.

It has been shown that visual stimulation can activate cortical regions normally devoted to auditory processing in deaf individuals.  This neural activity can persist even when audition is restored through the implantation of a cochlear implant, raising the possibility that cross-modal plasticity can be detrimental to auditory performance in cochlear implant users. To determine the influence of visual information on auditory performance after restoration of hearing in deaf individuals, the ability to segregate conflicting auditory and visual information was assessed in fourteen cochlear implant users with varied degree of expertise and an equal number of participants with normal-hearing matched for gender, age and hearing performance. An auditory speech recognition task was administered in the presence of three incongruent visual stimuli (color-shift, random-dot motion and lip movement). For proficient cochlear implant users,  auditory performance was equal to that of controls in the three experimental conditions where visual stimuli were presented simultaneously with auditory information. For non-proficient cochlear implant users, performance did not differ from that of matched controls when the auditory stimulus was paired with a visual stimulus that was color-shifted. However, significant differences were observed between the non-proficient cochlear implant users and their matched
controls when the accompanying visual stimuli consisted of a moving random-dot pattern or incongruent lip movements. These findings raise
several questions with regards to the rehabilitation of cochlear implant users.

Amy:  The cross-modal reorganization, while a coping mechanism of the body, is not good when a person’s goal is to continue hearing and speaking with a cochlear implant or hearing aid.  Hearing impairment is a neurological disorder. Treatment needs to occur as quickly as possible!