Misconceptions about Cochlear Implant

[The following information is based primarily on my personal experience of working with children with hearing impairment at “Deaf & Blind School & College - IDA RIEU WELFARE.” This article should not be considered while making a decision of choosing between a hearing aid and a Cochlear implant. The aim here is only to inform and educate people and clear some of their misconceptions.]

1) Difference between a hearing aid and a Cochlear implant.

The most frequently asked question is related to the basic difference between a hearing aid and a Cochlear implant. Many people will consider both one and the same. To begin with, a hearing aid is a device which is used to amplify sound. It is small and fits inside the ear.

Cochlear implant, also known as a bionic ear, uses its own electrical signals to stimulate the auditory nerve (which is not being stimulated) and enables a person to hear. It requires a surgical procedure.

A person can be suffering from a mild, moderate or severe case of hearing loss. In case of mild and moderate cases of hearing lose, hearing aids are considered appropriate. But in case of severe hearing loss, doctor might recommend a cochlear implant. 

Cochlear implant has both, internal and external components. This is not the case with hearing aid. And it also, unlike a hearing aid, requires a surgical procedure.

2) If hearing is restored after the surgery then what is the problem?

The answer here is not that simple. Aside from being very expensive, the first question is of the child’s eligibility. And even after a successful surgical procedure, there are circumstances in which it might not work.

Madam Bilquis Bano, a senior teacher and a section in-charge of secondary school in IDA RIEU, has been working with children with hearing impairment for eight years and has worked with many audiologists, explained that the ideal age is of 12 months and eight years is the maximum age, if we wish to gain maximum benefits out of it.

She further explained that the decision of a hearing aid or Cochlear implant is only the first step. Speech therapy and parents training, which follows next, are often given less importance. Madam Bilquis herself considered parents training very important. Her son Hammad who is 16 years of age was born with hearing impairment but is learning in a regular school with normal-hearing children and scored 76% (Grade-A) in his matriculate examinations. He doesn’t know and need sign language because of his ability of impressive speech. She is the personal advocate of parents training and her son is the proof of it.  

3) Cochlear implant is much better than a hearing aid.

It is advertised these days that a Cochlear implant is better than a hearing aid and that two hearing aids are better than one. It is not true and it all depends upon the condition and severity of the deafness.

A child might not be considered as a proper candidate for the procedure of a Cochlear implant, if he/she is able to hear some sound and speech with the help of hearing aid. Another reason might be that the problem is not with the cochlea (a small curved tube inside the ear, which contains a small part that sends nerve signals to the brain when sounds cause it to vibrate) in the first place. Many people don’t even realize it but a child who has a profound hearing loss for a long period of time, a cochlear implant might be of no use to him/her. And if the hearing nerve is damaged or absent, then in that case, a Cochlear implant wouldn’t even be considered.

There have been many cases in which a child or a person has faced difficulties after switching from hearing aid to the Cochlear implant and vice versa.

4) Cochlear implant is the best available solution

This is mostly believed these days but it is not true. There can be many problems faced after a successful surgery of Cochlear implant. The issue of magnetism is one which will result in MRI restriction. It is advisable to avoid playing rough sports like football etc.   

Cochlear implant team, Mapper or an audiologist have a very important role in all this. The candidate must be thoroughly examined in order to decide whether the cochlear implant is the best or only option. And even after the surgery, the reprogramming session should be on the annual basis, especially if the child is very young. If there are no such personnel in nearby vicinity then it can be a serious problem but it too depends upon many other factors.

In case of Cochlear implant, batteries have low lives and the processor will not give any signal or warning before the batteries are dead. This is very uncomfortable especially in the middle of a conversation.

In case of any damage to the device or to its stimulator there is a possibility of another surgery which might lead to complications.

There are also advantages and disadvantages of hearing aids but the necessity, risk and all the other factors should be considered before opting for anyone of these. This idea of Cochlear implant being better than a hearing aid is not true. The final decision should be of an expert while keeping in consideration all the factors which are directly and indirectly affecting the child.

Dear Uncle Meher

Today, somewhere around seven o’clock, I got a surprised visit from Mr. Meher Deen. He had worked with my mother in the Sindh Juvenile Jail. But he was uncle Meher for me. During our talk, he told me that often on his way back home he would offer any boy on the streets a lift on his motorcycle. Then he would ask him that he would really love a cup of tea. This way he would have a nice chat with that little boy over a nice warm cup of tea.

Mr. Meher Deen

After all these years, he realised that every story would have one of the three factors common because of which the child would end up on a street. Firstly, he would have lost either one or both of his parents; secondly, the behaviour of stepmother; and lastly, the brutal clutches of poverty.

When he looses his father there is no financial hand to support the family anymore. He will abandon his toys, childhood and innocence for work to financially support his family. In case he has lost his mother then there is no loving hand for him. The source of unconditional love is gone along with his sense of self esteem and self respect. The loss of one is bound to upset the balance and the child might even end up in worse places (and conditions) than the streets. If the child has lost both of his parents at a very young age, he will eventually end up in an orphanage and is bound to be lost. As soon as he is out of the orphanage there are very low chances for him to have a normal life.

Single Parents And The Rise of Crime Rates Among Children

Several studies show that children coming from single-parent households are more susceptible to destructive or rebellious behavior, not just because society imposes the need for a two-parent structure, but also, more often than not, the custodial parent is either too guilty that he or she smothers his child, or too busy to make ends meet to show how much he or she cares.

According to one study, about 90% of the change in crime rates between 1973 and 1995 had been accounted for by children born into single-family setups and those that had been born outside of marriage.

http://www.content4reprint.com/family/parenting/single-parents-and-the-rise-of-crime-rates-among-children.htm

The Facts About Russian Orphans

There are approximately 15,000 children that leave orphanages each year once they finish the 9th grade. They are usually 16-18 years old. Of these children:

50% - fall into a high-risk category (ie. prostitution)

40% - become drug users

40% - commit crimes

10% - commit suicide

Only 10% of Russian orphans adapt to somewhat “normal” lives in Russia. Source: Ministry of Education of the Russian Federation as shown on the website www.iOrphan.org.

http://www.russianorphanrescue.org/                                                                                                                               

I met him on my way back to Karachi from Multan at Multan Railway Station. He was involved in beggary and sex (forced and for fee) with mutilated body and it was apparent that he was mentally unsound. He had no memory of his family or abode except that he was beaten brutally by his father because of which he one day ran away. 

The second reason is the treatment of stepmother. Stepmother would blame, shout and sometimes even treat him inhumanly. The father would reach home form his job, tired and exhausted and is bombarded with complains and blames of how he (the child) has behaved. The child would be beaten up and one day, tired of the same routine, he would probably run away. 

Differences Found in Care with Stepmothers

Children raised in families with stepmothers are likely to have less health care, less education and less money spent on their food than children raised by their biological mothers, three studies by a Princeton economist have found. The studies examined the care and resources that parents said they gave to children and did not assess the quality of the relationships or the parents' feelings and motives.

New York Times, August 17, 2000

http://www.unl.edu/rhames/courses/social/step_parent.htm

Mr. Meher pointed out Child-Poverty as the last cause. Children will see and feel the deprivation as they come across the life, leisure and luxury of children who are financially well off. Child poverty can and will make a child vulnerable to negative outside influence which can result in an abuse or being taken advantage of. The only way they can even attempt to make their dreams come true is through crime. They will be used, abused and maltreated with sometimes no way of return.

The Geography of Child Poverty and Crime

         

Two reports recently published provide evidence of the distribution child poverty in the UK.

In most cases, the top twenty areas for child poverty are also in the top thirty areas for crime with the notable exceptions of Tower Hamlets, Liverpool, Enfield and Birmingham being 39th, joint 46th and joint 66th for crime.

http://crimematters.wordpress.com/2011/03/16/the-geography-of-child-poverty-and-crime/

    

The loss of one or both parents, behaviour of stepmother and Child-Poverty, all or any one of these may be responsible for the child to end up on streets. To be a parent and a guardian is a great responsibility. The uncertain future and the vulnerability of the child makes it even a more difficult job. It is unfortunate for any child to face any one of these factors but if we truly care, we may just be successful in managing if not avoiding the cause of the problem.

A technique to teach a deaf student

It is a difficult job to teach a student who is deaf by birth. But if his basics (or schooling) are strong, the impediments can be managed. Here we will consider a deaf child of age around 14. For instance, if you have to teach him that Mr. X was born in London, we can explain him through giving his own examples. Let us suppose the student name is Y.

We can say:

a)      You/Y are from Karachi which is a city.

b)      Similarly, Mr. X is from London which is also a city.

Now the student knows that London is a city.

We can further explain by saying:

a)      Karachi is a city of Pakistan which is Y’s hometown

b)      Similarly, London is a city of England which the hometown of Mr. X.

As explained earlier that the basics of the student should be strong. Here, we are considering a child of 14 years. So, chances are that he will know that Karachi is the name of his city and Pakistan is the name of his country.

We can also teach him something new by explaining him the difference. For instance, we know that our child goes to school. So, in order to explain him “Vice Chancellor of the University” we need to say:-

a)      You/Y studies in a school. College is bigger than a school. But University is even bigger than a college.

b)      Y has a teacher in his school. Principal is bigger then his teacher. But vice-chancellor is even bigger then the principal.

c)      Principal is to a school and vice-chancellor is to a university.

This can help in clearing the concepts and understanding the status and authority of a vice-chancellor of a university.

As a teacher, if you yourself are a student of some university then you can even use this fact to your advantage and say:

You (Y) are a student of school and I am a student of a university.

This will further clear his concepts.

The child may possibly confuse London with Lahore. The reason here is their ability to spell a word. We will later on discuss why they do get confuse while spelling a word. But this inability will result in confusing one word with another (like Lahore and London) and miss spelling (like writing Teet instead of Tree). These confusions with spellings should be corrected at once and the teacher should ask the student, and his parents to help him, practice. Practice is very important for learning because it is very difficult for these children to retain what was taught.