If you are losing your hearing as you age, you may have been wondering about use of devices such as hearing aids or the new cochlear implant. What is the difference between these two devices? Who are they for? Are there any downsides? In this article, we will answer these questions and explain the controversy surrounding cochlear implants. Read on to learn more.
Which device cures hearing loss?
You may be surprised to learn that neither hearing aids or cochlear implants can cure hearing loss. A hearing aid acts in much the same way as a pair of eyeglasses. It makes sound louder and clearer so you can hear it. When you take the hearing aid off, your hearing is still impaired.
Cochlear implants do not amplify sound. Instead, they deliver sound impulses directly to auditory nerve which delivers them to the brain. The implant is worn continuously and can be turned off and on. When it is off, or if it is removed, the wearer still has hearing loss.
Which is better?
Your choice depends upon a number of factors, such as the type of hearing loss you have, your health and your age. A hearing aid is typically a better choice for a person who has some level of hearing ability. A cochlear implant is a better choice for a person who is profoundly deaf because of problems with the structure of the ear.
Who are the best cochlear implant candidates?
Because cochlear implants must be surgically installed, good candidates for this option must be in good health. People who do not have the ability to hear at all are good candidates for cochlear implantation. Adults or children may benefit from these devices.
Typically, babies as young as a year old, who were born deaf to hearing parents may benefit the most because cochlear implantation can help them develop spoken language skills at a relatively “normal” pace.
Adults who have lost hearing through injury or deterioration of the structures of the ear may also benefit from this procedure.
Cochlear implants are made up of two parts. There is a microphone or processor that is placed behind the ear (much like a hearing aid). There is also an implant that is inserted under the scalp, proximal to the ear. The implant is actually a miniature computer. It digitises sound signals and delivers them to the auditory nerve to be carried to the brain. The implant is visible, but it is said not to interfere with activities of daily living (even swimming!)
Who are the best hearing aid candidates?
Hearing aids are the correct choice for children and adults who have the ability to hear somewhat. A hearing aid enhances these existing hearing abilities, but a cochlear implant would bypass them.
For this reason, most seniors experiencing a decline in hearing ability are better off seeking assistance through hearing aids than cochlear implantation.
For seniors, a hearing aid is much less intrusive than a cochlear implant, and it allows the user complete control. You can choose to wear your hearing aids or not, and you don’t have to undergo surgery to be fitted with them.
Hearing aids are worn externally. Today some are so small as to be almost undetectable. Once you get use to them, you can wear your hearing aids for most activities but must remove them for swimming or any water sports.
Can you hear right away?
When you put on a hearing aid, if you have some hearing you will notice immediate improvement. When you get a cochlear implant, this may not be the case. In fact, you may hear loud, obtrusive, confusing noises instead of welcome sound.
Even if you are an adult who was formerly able to hear and speak, you may not be able to understand the sound signals being delivered to your brain via your cochlear implant. You may need to undergo speech therapy and training to be able to make good use of this device. Babies and children who receive cochlear implants can count of years of speech therapy and training, as well.
Training and speech therapy are necessary to help users get the most benefit from cochlear implants because the sounds conveyed by a cochlear implant are not like those heard naturally or amplified by a hearing aid. Many people say that voices heard via cochlear implant sound robotic.
This video provides a good demonstration of the difference between natural sound and that heard via cochlear implant.
In many instances, cochlear implant users continue to rely on lip-reading, context, closed-captions and other assistance to comprehend speech; however, a cochlear implant can help these individuals hear warning signals and maintain greater awareness of the world around them.
Deaf people don’t always like cochlear implants
Many hearing people are surprised to learn that deaf people are not all for this technology. It is important to understand that the prevalence of cochlear implantation plays a role in perpetuating the idea that deaf people must be “fixed”. Many deaf are opposed to that notion.
For people who are culturally deaf (e.g. deaf children of deaf parents or those who are immersed in the deaf community) deafness is a point of identity. As with all cultures, Deaf Culture has values, traditions, history, heroes, forms of art and a complete and rich language. The idea that deaf people must be repaired and made to be like hearing people is seen as an affront and a threat to that culture.
While cochlear implantation can be very helpful to deaf children of hearing parents, it can be a real detriment to a deaf child with deaf parents. In the United States, children who receive cochlear implants are often discouraged from learning American Sign Language (ASL). This interferes with communication at home and within the family’s community which may include deaf church, deaf theater, deaf college and many more institutions and traditions that are vital to the Deaf.
Still, some deaf people are interested in exploring the possibilities of cochlear implantation, and this has given rise to quite a bit of debate in the deaf community. Many believe that the push to outfit deaf people with implants is a form of oppression. The technology is actively protested by those who express Deaf Pride. Some who have received implants are shunned by others; however, the National Association for the Deaf in the US has made it clear that this is against policy and that all deaf should be welcomed within the community.
In the US, ASL is considered the cornerstone of deaf culture. Attempts to turn deaf children into hearing children are often seen as attempts to eradicate ASL and are compared to the wiping out of Native American language by separating indigenous children from their parents and forcing them to learn English instead of their native languages.
While doctors and administrators and others who hold the purse-strings may see deafness as a disability to be overcome, those within the Deaf Community often see their efforts as discrimination and oppression.
It can be hard for hearing people to understand this point of view, but for people who have descended from many generations of deaf, the sense of loss of language and cultural identity is profound.
What’s the solution?
If you are looking for hearing enhancement for yourself, think about the circumstances which caused or led to your hearing loss. If you are still able to hear a bit and just need a boost, a hearing aid is an easy and convenient choice.
If you are a hearing person who has suffered injury or damage to your hearing and cannot hear at all, you may wish to talk with your audiologist to find out if you are a good candidate for cochlear implantation.
If you are a profoundly deaf adult and you truly want to hear, discuss the matter with your doctor and your audiologist. You may also find it helpful to discuss this important decision with a counselor. Understand that many people who are profoundly deaf find themselves profoundly disappointed with cochlear implantation. Many report headaches, confusion, regret and little or no improvement in quality of life.
If you are the parent of a child who was born deaf or has become deaf early in life, talk with your pediatrician to see if your child would benefit from cochlear implantation. If your child is merely hard-of-hearing, hearing aids are probably more appropriate.
Technology is constantly improving
As with any other technology, both hearing aids and cochlear implants are getting better and better by the day. Technology that may not be appropriate for you today, may literally become “just what the doctor ordered” tomorrow!