Cochlear implants (CI) seem nothing short of a miracle, especially in light of the famous video of a young woman hearing her voice for the first time. For parents of babies who are diagnosed with hearing loss, the initial shock of the news and little understanding about what it is actually like to be deaf leaves them struggling to decide whether to have doctors fit their child with a CI, or have their child grow up deaf to make the decision for himself down the road. For many parents, the initial response is to give their child the gift of sound.

The decision isn't that simple.

Quality of Life

As with any advancement in medical science, CIs have benefits for those who receive them. A 2010 study published in Otolaryngology — Head and Neck Surgery, children with a CI ranked their quality of life equal to that of their normal hearing peers.

This may be because deaf children who attend "mainstream" public schools often report feeling isolated and have a difficult time making friends. In these cases, cochlear implants seem to help ease that loneliness and give these children a more "normal" life. However, children with deafness who attend schools for the deaf don't have these same socialization concerns. For these children, cochlear implants may actually separate them from the deaf community they have become a part of.

Language Skills

The National Institutes of Health (NIH) reports that profoundly deaf children who received a CI at a young age developed language skills comparable to their normal-hearing peers. In the past, children with hearing loss were not often diagnosed until age two. According to the NIH, these children often fell behind in language, cognitive, and social skills, and were limited in their career opportunities.

According to the National Association of the Deaf, it is important to remember that despite the findings by the NIH,

"Cochlear implantation is a technology that represents a tool to be used in some forms of communication, and not a cure for deafness. Cochlear implants provide sensitive hearing, but do not impart the ability to understand spoken language through listening alone. In addition, they do not guarantee the development of cognition or reduce the benefit of emphasis on parallel visual language and literacy development."

Risks and Side Effects

As with any surgery, implanting a CI carries the usual risks. In addition, it also carries the dangers of injury to the facial nerve, meningitis, fluid leakage, infection, dizziness/vertigo, tinnitus (buzzing sound in the ear), disturbance to taste, and inflammation. In addition, patients may need to have the implant removed if it malfunctions or an infection occurs. They will also deal with lifestyle changes and may lose their residual hearing.

"Many deaf children are born with residual hearing and with the aid of a hearing aid are able to pick up certain speech sounds, and also identify certain sound frequencies that can aid in survival such as a fire alarm, or siren," explains Jennifer Diggans, student sign language interpreter and child of deaf parents. "Once a child has a CI their residual hearing may be wiped out completely. When they don't have their implant turned on they are 'stone deaf,' unable to hear anything at all."

Additional side effects can occur, but major problems with a CI in children have proven to be rare.

Additional Diagnoses

If a child has an additional diagnosis, than she may not be considered a good candidate for a CI. Children with complex diagnoses already face challenges and adding a CI may not benefit them. For example, children with autism already face communication obstacles and sensory issues. A child with autism who is deaf will therefore face even further challenges to the extent that wearing the device may be unbearably irritating. On the other hand, deaf children with developmental disabilities who received a CI have made gains in speech intelligibility and perception skills, proving that CI can make a big impact.

Community

The deaf community is a strong and proud. Many do not feel deafness is a condition that needs a cure. For them, a CI makes the statement that despite everything they have accomplished, all that matters to the world was they are unable to hear. Because of this, adults who choose to receive a CI have often faced scrutiny from the deaf community, and have even been shunned.

According to Diggans, a deaf person who chooses a CI should make an effort to remain a part of the deaf community and continue using sign language. They should live in both the hearing and deaf communities because they are, in fact, still deaf. When it comes to young children who are deaf, the deaf community strongly agrees that these children should not be fitted for a CI, but rather receive hearing aids to help them hear as naturally as possible for as long as possible.

"My only advice to parents who are faced with the challenges of raising a deaf child is to embrace it! Be open to all forms of communication," says Diggans, "Sign language is a wonderful gift that allows deaf children to communicate fully using a natural language — a language that comes easy to them. Contact deaf people within your community… Contact a residential school for the deaf, a teacher of the deaf, a sign language interpreter, but most importantly, ask deaf people within the deaf community how they feel about growing up without a CI. Ultimately, whether or not a parent implants their deaf child is their decision, but be savvy, do research, make an informed decision, and in the meantime… learn sign language! Expose your deaf child to a language that they will quickly understand. Don't wait!"