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Margaret
A. Kenna, MD, is an Associate Professor of Otology
and Laryngology at the Harvard Medical School
and a full-time pediatric otolaryngologist at
the Children's Hospital, Boston. She is Director
of the Pediatric Cochlear Implant Program at Children's
and Director of the hearing impaired program in
the Department of Otolaryngology and Communication
Disorders. She has published over 100 journal
articles, book chapters, and other types of publications
in the field of pediatric otolaryngology. Her
areas of research include sensorineural hearing
loss and otitis media in children.
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links to this scientist's home page and other related
infomation please see our resources
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Kenna
responds :
 11.13.01
Suzie
McCarthy asks:
I am a student at a deaf/hearing mixed school in
Los Angeles County and as part of the integration
program I am now in my third year of ASL. So I am
very interested in the deaf community and culture.
I have heard different views on the whole "Cochlear
Controversy" and the one thing that does concern
me is that it seems a small child given the implant
might socially end up in a type of no-man's land.
Not totally fitting into the deaf culture but not
being completely hearing either. Also, if the child
receives the implant at a young age he/she doesn't
really have a say in the whole procedure. Please
do not take me wrong. I am not anti- the implant
at all but every time I hear this subject debated
I wonder about the kid. Based on your experience
is this a problem?
Thank you so much for your work, care, and your
time, Suzie McCarthy, Granada Hills High School
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Kenna's
response:
If
a child undergoes a CI early in life and develops
normal or near normal speech and language, that
child will grow up in the "hearing world."
I agree that he/she would still be deaf, but since
the primary forma of communication is spoken language
that child will be in the spoken language world.
I agree, that the child does not get to participate
in the decision. Unfortunately, if you watied
until the child was old enough to have a definite
opinion about CI vs no CI, that child would very
possibly be too old to derive much benefit from
the implant. If the child grows up using ASL and
never uses his/her hearing, then an implant as
an adult will probably be doomed to failure (in
terms of that person developing usable spoken
language). If the person is oral deaf (ie, using
only spoken language already, or bilingual, speaking
and signing) then there is a greater possibility
that they will benefit, because they have been
using their residual usable (albeit very little)
hearing all along and will probably have both
speaking and signing friends.
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11.12.01
Pam
Tontodonato asks:
Dear Dr. Kenna,
My question concerns the policy of determining suitability
for a cochlear implant. Besides the cost issue,
why is an implant only considered appropriate for
a person who can't use hearing aids? I am asking
this because I have a four-year-old son with profound
hearing loss in the left ear, and moderate sloping
hearing loss in the right ear (of unknown etiology).
He wears a hearing aid for his right ear. Why is
he not considered a candidate for a CI for his left
ear? Thanks for your comments.
Pam Tontodonato Hudson, OH |
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Kenna's
response:
The
FDA has guidelines that are followed by most implant
teams, and these guidelines include auditory thresholds
as well as a number of other tests. Since the
implant can provide a lot of benefit, but not
normal hearing, many people are reluctant to implant
a child who still has usable hearing in one ear.
Having said that, there is a move to consider
implanting "less deaf adults" and there may be
certain circumstances in which this may apply
to a child as well. Also, the hearing from a hearing
aid is not the same as hearing from an implant.
If the hearing with a hearing aid in the better
ear is pretty good, the person actually might
prefer that ear to the implanted ear and not use
their implant.
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11.12.01:
Dear Dr. Kenna,
I 'played' the interactive cochlear implant game
on the SAF Web site. My question is: What does it
really sound like to the implantee? Does it ever
get any clearer? Thank you. |
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Kenna's
response:
Good
question. It does get clearer - or at least the
sounds start to make much more sense - to many
patients over time. But how clear and usable the
sound is depends a lot on the age at implant,
the reason for implant, how the device is programmed,
etc.
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