SoundliQlll

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Reopening A Doorway To
SoundliQlll
• A CBS. com Special Report On Cochlear Implants
• To Advocates: A Chance To Hear
• To Opponents: An Ethical And Cultural Assault
NEW YORK
Wednesday, April 28,1999 - 08:47 AM ET
(CBS) Sigrid Cerf became deaf at the age of three, after
suffering from spinal meningitis. As a deaf person, Cerf
remembers feeling left out, very insecure, and "like a
second-class
citizen." She learned to read lips and to speak,
but it wasn't until two years ago, when she turned 53, that she
was able to hear again with the help of a device called a
cochlear implant.
But there is a controversy over the device. To advocates, the
cochlear implant offers the profoundly deaf the opportunity to
hear again - or in the case of children, to hear for the first time.
To opponents, the device fixes something that doesn't need to
be fixed. Many in the deaf community feel that parents should
make the choice to get a CI for their children; alternatively,
some argue that by doing so parents actually preclude a child
from being part of a rich culture.
CBS.com took a look at how Cis have affected the lives of
deaf adults, parents of deaf children, and those who are a part
of the deaf community.
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Returning To A Hearing Worldj
Edit]
• Click On Images To Read And Hear Their Stories.
NEW YORK
Wednesday, April 28,1999 - 08:47 AM ET
(CBS) Donna Sorkin, Douglas Lynch and Sigrid Cerf were not
born deaf. Each lost their hearing post-lingually - after they
were exposed to sound and language. Each received cochlear
implants as adults, and have been found success with the
results.
Sigrid Cerf became deaf
when she was three
years old. She received
her cochlear implant two
years ago, at the age of
50.
Douglas Lynch lost his
hearing suddenly when
he was 26. Two years
later, he received his
implant.
Donna Sorkin gradually
lost her hearing through
her childhood, then more
noticeably in her 20s.
Sorkin received her CI at
age 40.
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How Cochlear Implants Work
Friday, June 12,1998 - 04:12 PM ET
(CBS) The ear processes sound through three main
mechanisms: the outer ear, the middle ear and the inner
ear.
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Sound waves traveling through the air enter the outer ear
- the visible outer part of the ear and the ear canal and
pass into the middle ear. The middle ear contains the
eardrum, and three tiny bones. When the sound waves
reach the eardrum, it vibrates and, in turn, causes the tiny
bones to move. The movement of the bones further
generates motion of fluid in the snail shell-shaped
cochlea in the inner ear.
The cochlea is lined with thousands of tiny sensory
receptors called hair cells. When the fluid in the cochlea
is set in motion, the hair cells convert the vibrations into
electrical impulses, which are then delivered by the
auditory nerve to the brain. The brain interprets these
electrical impulses as sound.
In the profoundly deaf, hair cells are usually damaged or
depleted so that they cannot generate the electrical
charges that bring sound vibrations to the brain.
However, despite the lack of hair cells, there are usually
some surviving hearing nerve fibers, which are the key to
how the cochlear implant works.
, Using a chip the size of a thumbnail and
an array of electrodes that fits into the
curve of the cochlea, the CI bypasses the
nonfunctioning hair cells by sending
electrical signals directly to the hearing
nerve.
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Hearing After Half A Centun
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NEW YORK
Friday, June 12,1998 - 04:12 PM ET
"The technology is
unbelievable for the
implants."
Mary Koch
Cochlear Implant Therapist
Sigrid Cerf (left), with her
husband, Vint.
---------meningitis.
(CBS) Sigrid Cerfbecame
deaf at the age of three, after
suffering from spinal
As a deaf person, Cerf remembers feeling left out, very
insecure, and "like a second-class citizen."
"It's similar to coming to another country, and you
think, 'OK, I've had two years of Spanish, I should be
able to do very well in Spain," Cerf says.
"You are able to get pretty much what general
conversation is about, but it takes maybe a year in
Spain before you understand subtleties, and you'll
never be able to understand other subleties like jokes
because you're never going to get the punchline."
She learned to read lips and to speak, but it wasn't until
two years ago, when she turned 53, that she was able to
hear again with the help of a device called a cochlear
implant.
"I can now carry on a conversation on the phone, I
can use the television without having to lipread
anyone on the screen or even using closed
captioning," Cerf said. "I can carry on conversations
with a much greater degree of comfort and be
comfortable in practically any kind of listening
environment, even occasionally at a noisy party."
Although cochlear implants have been available in the
U.S. since the 1970s, many people are unfamiliar with
the technology. Cochlear implants, or CIs, are surgically
placed in the inner ear.
With the help of an external speech processor, CIs turn
sound waves into electrical signals that travel to the
hearing nerve, which sends the signals to the brain, where
they are interpreted as sound.
In the U.S., about 11,854 people have received cochlear
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implants. Worldwide, there are about 22,000 people with
CIs. The National Center for Health Statistics estimated
that from 1990-91, the number of hearing impaired
Americans was 20 million.
The FDA approved the use of cochlear implants for
adults in 1980 and for children as young as two-years-old
in 1990. Now, children as young as 18 months can get
the implant.
"The technology is unbelievable for the implants,"
says Mary Koch, who started the CI rehabilition program
for children at The Listening Center at Johns Hopkins
Medical Center. "If you saw the chip that is actually
implanted in the kids' heads, it's incredible. It's far
more complex than what we see on our pes. "
Koch says the technology allows for an amazing quality
of sound. When CI patients heal from their surgery, they
are "hooked up" to a microphone and to an external
processor the size of a pack of cards. Audiologists can
then fine-tune the device's sound levels.
Despite its effectiveness - and also because of it - the CI
has been a source of controversy within the deaf
community. Some deaf people feel that the CI is
designed to fix something that doesn't need to be fixed.
They condemn its use, especially on deaf children.
Grown-ups who have received CIs are not the target of
the debate, however, since candidates for the device
usually had lost their hearing post-lingually, or after they
were exposed to sound and language.
For some adults, the CI not only brings back sound, but
also provides the thrill of new discovery.
"It was unbelievably pleasant. It's been nothing but a
party since, in fact," says Cerf.
Naxt
How They Work II Implant Patients
The Controversy II More Information
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1998, CBS Worldwide
Inc., All Rights Reserved.
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Gathering language From Noise
NEW YORK
Friday, June 12,1998 - 04:12 PM ET
"I clapped behind her head
and she turned around. She
got a huge smile on her face,
and she clapped, because
suddenly she realized what
that was."
Pam Grugan,
Cecilia's
mother
(CBS) Although the
cochlear implant is
effective, experts warn that
there is no magic when it comes to the device, especially
for those who have not experienced hearing before they
learned to communicate. For those users - primarily
children - rigorous rehabilitation is needed.
Cecilia Grugan gets ready for
a bike ride.
But even rehabilitation may not succeed completely for
all CI users. Since aural nerve damage varies for every
person, the clarity of the CI's signal to the brain will also
vary.
"Some people will hear a very, very clear signal and
some people will hear a bit more compromised
signal," says Mary Koch, a therapist at The Listening
Center at Johns Hopkins Medical Center. "The
rehabilitation process has to be a very diagnostic
process. "
When Koch began the children's program four years ago,
she set out to mend the "weakest link" in CIs rehabilitation.
Koch devised a method to teach deaf children how to
interpret sound, which to their ears is like a foreign
language. She says that children first learn to be aware of
sound, then to understand, for example, that a siren
comes from a firetruck or that a bark comes from a dog.
Once this foundation of awareness is established, the
child is taught to use language effectively; to answer
questions and express how they feel.
Parents are a big part of that development and Koch
insists the commitment must be strong.
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"One of the things I tell
parents is that language
happens in the brain.
(Doctors) don't implant
gray matter," Koch says.
"The rehabilitation uses
the information that's
streaming into the brain
to start to make sense of
it. "
One of Koch's patients is four-year-old Cecilia Grugan.
Her parents, Pam and Scott Grugan, have been working
closely with Cecilia since she received her Cllast year.
Click video icons at left to view portions of 'Sound To
Life, ' an educational series on cochlear implants
developed by The Listening Center at Johns Hopkins
Medical Center. The segments follow Cecilia Grugan's
progress with her implant. Video courtesy the Advisory
Board Foundation of Washington, D.C
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Surgery
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Success
Cecilia went through a long evaluation
process to see whether the CI was a good
solution for her hearing loss. After
physical, psychological and audiological
tests, she was considered a good candidate
for the implant.
) Her surgery took about three hours. During
cochlear implant surgery, an incision was
made behind Cecilia's ear, and an array of
electrodes was placed inside the cochlea.
The microchip, or receiver-stimulator, was
placed under the skin behind the ear. Like
Cecilia, patients are usually released the
same day.
) Three months later, with the incision
healed, Cecilia was ready for her implant to
be activated. When she was first connected
to her speech processor, although she could
hear sound, she could not yet make sense
of it.
The moment of mental connection tends to come later,
once the child has learned what sound means. For
Cecilia, it came after two weeks of doing sound
awareness excercises with her parents.
"I would clap behind her, so that ...she couldn't see
what I was doing. And finally, one evening I was in
the bedroom with her, and I clapped behind her head
and she turned around," Pam Grugan says.
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"She got a huge smile on her face, and she clapped,
because suddenly she realized what that was. She
realized, 'That sound came from you, Mom.'"
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How They Work II Implant Patients
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The Future Of Cochlear
Imp Iants il.illll
NEW YORK
Wednesday, April 28, 1999 - 08:47 AM ET
(CBS) For adult cochlear
implant users like Douglas
Lynch, who went deaf at the
age of 26, the CI returns them
to the sound they had lost.
"It was the most profound
experience I could ever
imagine ... 1went from just
Douglas Lynch (left) with
complete and total silence
Advanced Bionics
and isolation to, in an
co-worker Tom Walsh.
instant, being just turned
back onto life in all the
vibrance of sound," Lynch says.
Lynch received his implant when he was 28. His enthusiasm
for the device lead him to work for the company that made his
CI, Advanced Bionics, where he is now a spokesman.
Many CI users stress that the device has been invaluable in
their day-to-day work life. One remarkable result of the implant
is the user's ability to use the telephone, which people with
hearing take for granted.
"Being able to use the telephone has been a marvelous
benefit of an implant," says CI user Donna Sorkin, Executive
Director of Self Help For Hard Of Hearing People, Inc., a
consumer, educational organization for the hearing-impaired.
"I don't think there's really anything that replaces the
ability to have a conversation with somebody and hear
their voice, and converse in that way."
In addition, Sorkin is able to use the technology in combination
with other hearing-assisted devices. For example, she can
watch a play at the Kennedy Center in WaShington, D.C., and
listen to the actors using the theater's infrared 'Listening
Enhancement System.'
"Sometimes
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I can hear the dialogue
better than my
10/4/994: 16 PM
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husband, who is having to rely on the sound sytem in the
theater," Sorkin says.
Sorkin's hearing loss was gradual, though the telltale signs
began in her childhood. During hearing tests, she had a
difficult time detecting the high-pitched tones. But it wasn't until
her late twenties that the sound began to fade noticeably.
Finally, at the age of forty, she became profoundly deaf. That
year, she received a cochlear implant, and the return of sound
changed her life.
Sorkin recalls a recent day when the batteries in her speech
processor died. She was jogging in her neighborhood at the
time, but instead of going back home, Sorkin decided to
reacquaint herself with silence.
She noticed that the birds stopped singing, and that she could
no longer detect whether a car was coming up behind her on
the street. Then she worried that she would see one of her
neighbors.
"I would have to talk to them without any sound, and I
was nervous about doing that because I knew I would
have difficulty, so at that point I became so frustrated, I
turned around and went home to get a battery," Sorkin
says.
According to Lynch, the latest device is sixty times faster than
the last generation. And he expects the technology to improve.
In ten years, Lynch predicts that the implant will be entirely
internal.
But today's implant, as Lynch notes, is still very effective.
"I know in my own heart that the quality of sound today is
exactly what I remember it from when I heard normally.
When my wife yells at me to take out the garbage, it's the
same voice that yelled at me before I lost my hearing."
e
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