NAD Position
Statement on CIs
Part 2
Part 3
Reader Responses
Editor: The National Association of the Deaf (NAD) recently released
what I believe is their first official position statement on cochlear
implants (CIs). Although the statement ostensibly refers to CIs
generally, it really focuses on the implantation of children.
The culturally Deaf community has historically been vigorously
opposed to CIs in general, and the implantation of children in
particular. So I was extremely interested in their current position.
Our thanks to the NAD for their permission to share this information
with you. As you might expect, some of our readers had some pretty
strong opinions on this topic. Some of their responses follow the
statement.
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The National Association of the Deaf (NAD) is an education and
advocacy organization committed to promotion, protection, and
preservation of the rights and quality of life of deaf and hard of
hearing individuals in the United States of America. The targeted
audience for this paper includes parents of deaf children, deaf
individuals, medical professionals, and the media.
The NAD recognizes that diversity within the deaf community itself,
and within the deaf experience, has not been acknowledged or explained
very clearly in the public forum. Deafness is diverse in its origin and
history, in the adaptive responses made to it, and in the choices that
deaf adults and parents of deaf children continue to make about the
ever-increasing range of communication and assistive technology options.
Diversity requires mutual respect for individual and/or group
differences and choices.
The NAD welcomes all individuals regardless of race, religion, ethnic
background, socioeconomic status, cultural orientation, mode of
communication, preferred language use, hearing status, educational
background, and use of technologies. The NAD also welcomes deaf, hard of
hearing and hearing family members, educators, and other professionals
serving deaf and hard of hearing children and adults.
The NAD subscribes to the wellness model upon which the physical and
psychosocial integrity of deaf children and adults is based. The general
public needs information about the lives of the vast majority of deaf
and hard of hearing individuals who have achieved optimal adjustments in
all phases of life, have well-integrated and healthy personalities, and
have attained self-actualizing levels of functioning, all with or
without the benefits of hearing aids, cochlear implants, and other
assistive devices.
The NAD recognizes all technological advancements with the potential
to foster, enhance, and improve the quality of life of all deaf and hard
of hearing persons. During the past three decades, technological
developments such as closed captioning, email and the Internet, two-way
pagers, text telephones, telecommunications relay services, video
interpreting services, visual alerting devices, vibro-tactile devices,
hearing aids, amplification devices, audio loop and listening systems
have had an important role in leveling the playing field. The role of
the cochlear implant in this regard is evolving and will certainly
change in the future. Cochlear implants are not appropriate for all deaf
and hard of hearing children and adults. Cochlear implantation is a
technology that represents a tool to be used in some forms of
communication, and not a cure for deafness. Cochlear implants provide
sensitive hearing, but do not, by themselves, impart the ability to
understand spoken language through listening alone. In addition, they do
not guarantee the development of cognition or reduce the benefit of
emphasis on parallel visual language and literacy development.
The NAD recognizes the rights of parents to make informed choices for
their deaf and hard of hearing children, respects their choice to use
cochlear implants and all other assistive devices, and strongly supports
the development of the whole child and of language and literacy. Parents
have the right to know about and understand the various options
available, including all factors that might impact development. While
there are some successes with implants, success stories should not be
over-generalized to every individual.
Rationale
The focus of the 2000 NAD position statement on cochlear implants is
on preserving and promoting the psychosocial integrity of deaf and hard
of hearing children and adults. The adverse effects of inflammatory
statements about the deaf population of this country must be addressed.
Many within the medical profession continue to view deafness essentially
as a disability and an abnormality and believe that deaf and hard of
hearing individuals need to be "fixed" by cochlear implants.
This pathological view must be challenged and corrected by greater
exposure to and interaction with well-adjusted and successful deaf and
hard of hearing individuals.
The media often describe deafness in a negative light, portraying
deaf and hard of hearing children and adults as handicapped and
second-class citizens in need of being "fixed" with cochlear
implants. There is little or no portrayal of successful, well adjusted
deaf and hard of hearing children and adults without implants. A major
reason implantation and oral language training have been pursued so
aggressively by the media, the medical profession, and parents is not
simply because of the hoped-for benefits that come with being able to
hear in a predominantly hearing society but more because of the
perceived burdens associated with being deaf.
Because cochlear implant technology continues to evolve, to receive
mainstream acceptance, and to be acknowledged as part of todayıs
reality, it is urgent to be aware of and responsive to the historical
treatment of deaf persons. This perspective makes it possible to provide
more realistic guidelines for parents of deaf and hard of hearing
children and for pre-lingually and post-lingually deafened adults.
Wellness Model
Many deaf and hard of hearing people straddle the "deaf and
hearing worlds" and function successfully in both. There are many
people with implants who use sign language and continue to be active
members of the deaf community and who ascribe to deaf culture and
heritage. There are many deaf and hard of hearing individuals, with and
without implants, who are high-achieving professionals, talented in
every imaginable career field. They, too, are successfully effective
parents, raising well-adjusted deaf, hard of hearing and hearing
children. As citizens, they continue to make contributions to improve
the quality of life for society at large. Deaf and hard of hearing
individuals throughout the ages have demonstrated psychological strength
and social skills when surviving and overcoming societyıs
misconceptions, prejudices, and discriminatory attitudes and behaviors,
thus attesting to their resilience, intelligence, and integrity.
Given the general lack of awareness about the reality of the wellness
model, the NAD strongly urges physicians, audiologists, and allied
professionals to refer parents to qualified experts in deafness and to
other appropriate resources so that parents can make fully informed
decisions that is, decisions that incorporate far more than just the
medical-surgical. Such decisions involve language preferences and usage,
educational placement and training opportunities, psychological and
social development, and the use of technological devices and aids.
Part 2
Part 3
Reader Responses
