Today's cochlear implant myths and facts post has been challenging to write. An important distinction must be made clearly. People with different perspectives might say that "CIs work!" or "CIs don't work!" Which is correct? The answer depends upon how you define "work". Image description: pale blue background with circles and sca
CIs provide access to sound. They are highly effective for this, and almost every person who uses a CI hears more than they would with a hearing aid.
If you are a CI candidate and your expectation is better hearing than you would have with a hearing aid, that is realistic in most cases. But if your expectation is "normal" hearing and no difficulties with listening, that is not realistic.
For most deaf and hard of hearing (DHH) people who are CI recipients, CIs work for providing better auditory access than hearing aids. Whether they work for other purposes (like language development) depends on the individual. But outcomes are not just a matter of luck.
Some factors that influence outcomes are language skills prior to implantation, age at implantation (for children in particular), how long the person has been deaf, cause of deafness, medical conditions and additional disabilities, ...
... residual hearing before and after surgery, having/not having a strong support system, aural (re)habilitation, and previous hearing aid use. Future research may reveal more factors that affect CI outcomes.
Good outcomes can never be guaranteed, even for people who are ideal CI candidates. What "good" means also depends upon a person's goals and whether they are realistic.
Many DHH children develop spoken language with CIs, but this is not guaranteed. No audiologist or other professional can predict an outcome with certainty. For any CI candidate, expecting freedom from all listening struggles is not realistic.
Will you be able to watch TV without captions? Understand speech on the phone Understand spoken language without speechreading Enjoy music? Maybe, or maybe not. No two CI users have the same experience.
The short version of all of this: the claim that "CIs don't work" is misleading. But the claim that "CIs work" can be misleading too if realistic expectations aren't part of the discussion.

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More from @AudOTB

13 Jan
Cochlear implant fact of the day: there is no credible evidence that sign language causes poor spoken language outcomes in children with CIs. Read this one carefully! Image description: pale blu...
Little research exists on early sign language access in children with CIs specifically.
Some research has reported better spoken language outcomes for DHH children who communicate primarily in spoken language compared to those who communicate primarily in sign language. In some cases, study authors have suggested that sign language itself causes poorer outcomes.
Read 24 tweets
13 Jan
Listening fatigue is a common experience for deaf and hard of hearing (DHH) people who communicate in spoken language. Understanding what another person has said requires cognitive effort. Image description: dark blu...
Even more of that effort is required when a person does not hear all of the sounds clearly due to background noise or another reason. When a person is experiencing listening fatigue, they may feel tired, frustrated, and stressed, even after the listening situation is over.
They will probably have more difficulty maintaining attention and energy. This picture lists other examples too. Another person's listening fatigue might not be obvious. You might not always know that the DHH person in your life is experiencing listening fatigue.
Read 7 tweets
11 Jan
Cochlear implant fact of the day: those inspirational CI activation videos that you see on the internet do not tell the whole story. Image description: pale blue background with circles and sca
When you see those videos, you see only the reaction from the CI user and/or their parents. What you don't see is how the CI user is hearing in that moment and all of the work that lies ahead of them in learning how to hear through their CI.
You might be wondering, "What's wrong with celebrating when a person has a good CI outcome?" Nothing at all! But whether an outcome is "good" isn't apparent from a CI activation video. Activation day is only the beginning of a long process.
Read 6 tweets
16 Nov 20
Dr. Sarah Sparks, Au.D. is pleased to announced the formation of Audiology Outside the Box, an online practice serving clients in Maryland, Massachusetts, Virginia, and Washington, DC. Practice and website opening on November 30, 2020!
Audiology Outside the Box offers a different mindset about audiology services. The focus is on supporting your communication and hearing-related goals, whether those involve spoken language or not. All services can be provided in American Sign Language (ASL), English, or both.
What happens during your appointment? You share about your needs and preferences, and your audiologist will listen. Together, we will create a plan that suits your individuality and does not force you into a box.
Read 7 tweets

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