Language Choices for Deaf Infants: Advice for Parents Regarding Sign Languages
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The principle of respect for autonomy in modern medical ethics leads doctors to avoid persuasion and aim for neutrality when discussing language choices regarding deaf infants. However, at times persuasion to overcome biases is necessary and ethically mandatory. Many parents and health professionals have faith in the ability of cochlear implants (CIs) to allow deaf children to “hear” and achieve normal language and speech development. While it is good to encourage parents’ hope for their children’s future, to avoid bias, medical professionals must acknowledge the reality that CIs do not replace normal hearing. As of 2006, 80% of deaf infants in Northern Europe were receiving CIs, and as of December 2010, roughly 40% worldwide. Parents need to know that CI may not guarantee their child’s language acquisition. While a CI is usually given only to a child who will not benefit from a hearing aid, it is important to recognize that CIs are not “super hearing aids”; even hospitals that perform CI surgery make statements such as: “For most patients, a cochlear implant will not work as well as a hearing aid” and studies support that statement.
That’s because a hearing aid (HA) simply amplifies sound, whereas with CIs sound is transformed into electrical impulses delivered directly to the cochlear nerve. The CI-child must undergo long-term extensive training to interpret those electrical impulses. Unpredictable individual variation in outcomes is pervasive even with great effort and dedication from caregivers and the deaf child some deaf children receive little to no auditory benefit from CIs in acquiring language.