A question about cochlear implants and speech

I hope this is in the right place…I figured that this question doesn’t just have one factual answer, so it was more suited to here than GQ.

So, I’m writing a story in which there is a character who was born profoundly deaf, and got a cochlear implant on one side when he was an infant. I have read a little about cochlear implants and realize that they don’t “cure” the person’s deafness, and the hearing that is gained is not the same as a “normal” person’s hearing. So, I was wondering what would be a reasonable expectation would be as to how well he would be able to hear and understand speech, considering that he gets the implant when he’s very young? Would he have any difference in the sound of his voice, such as some deaf people (like Marlee Matlin, for example) have? I’m eager not to give offense with my story, as much as possible (I know that there are a lot of contentious issues involved in cochlear implants, and some people will be offended by the mere fact that he has one, but I want to at least get the descriptions of his hearing abilities right.)

I’ve heard of many implanted infants who go on to have a life just like any other hearing person’s life, with some maintenance here and there. No deaf accent, no need to watch TV with captions, etc. Perhaps a bit less likely to appreciate subtle music, or unable to hear very soft sounds clearly, or speech therapy to keep on track, but that’s it. Adults who have sudden onset deafness and who are implanted quickly function very well too (e.g., Rush Limbaugh).

The problems arises when a baby’s brain is robbed of the opportunity to train/develop the auditory cortex. That is why “prelinguistically deaf” is such an important label. If a deaf baby is implanted ASAP the resulting problems are minimal from what I understand.

/prelinguistically deaf, twice implanted

I had a student who had cochlear implants when she was about 2. She was VERY hard to understand. Interestingly enough, it was apparently only during her senior year that she, herself, discovered this: she was very shy, very private, and her best friend was her mom, who had no trouble at all understanding her (in the same way that mothers can understand their toddlers perfectly). It was only when she got a new speech therapist through the school her senior year that this came out–previous therapists had severely underserved her, I suspect because she seemed happy enough and was making great grades (2nd in her class). I know she put some serious work last summer into improving her speech before she left for school, but I don’t know how it turned out.

I have heard that other people with cochlear implants are easier to understand, so take this anecdote for what it’s worth.

Any amount of developmental time spent being deaf, even 2 years, is going to be detrimental. I was 2 when I lost my hearing and within a month I’d forgotten how to speak entirely and acquired a deaf accent.

I understand that. I was just sharing an anecdote to show that self-perception and the perception of people close to the person with the implant may be very different than the impression of strangers–rather like the way you quit hearing a distinctive accent when you live in a place for a while.

Yep… yours was a good point… :slight_smile: I didn’t realize I spoke funny till I was about 12, for many of the same reasons.

Thank you for your replies so far.

A further question, based on something dre2xl said…what would happen if the child needed speech therapy but was denied it until he was 5 or so? Would he possibly develop strange-sounding speech then?

To further explain the scenario of this story: Ezra, the boy in question, has a very cruel stepmother (his real mother is dead and his father is terrified of his stepmother, too much to help him.) So, until he is shipped off to boarding school at 5, she would not allow him to have speech therapy. (She got him the cochlear implant for a cruel reason, not to help him – she has knowledge that no one else, even Ezra’s doctors, has, and knows that his hearing would get better in time if they just waited…and she wants to destroy that potential, so he’ll never have normal hearing.)

Oooh, interesting scenario. Cochlear implants do require an external earpiece to work, and that earpiece does require batteries. How about tweaking it so that she keeps the earpiece that comes with the cochlear implant turned off? And if Dad sees somehow it’s not on, she goes, uh oh, the batteries in the earpiece must’ve ran out? That’d definitely screw Ezra up.

Oooh, interesting. I will probably use that a little…but she would leave it on most of the time. She wants him to be able to hear her when she barks orders at him or calls him names, and she certainly wouldn’t take the time to learn sign language or teach it to him…

Hmm… gonna be a bit tough… sounds like you want Ezra to display some negative long lasting effects of being deaf (e.g., poor speech) and yet have him be able to orally understand his stepmom. In my experience with the deaf community, speech ability is pretty closely tied to ability to comprehend sounds, but I’m sure an audiologist may correct me. If you can comprehend a strangers’ voice, then you can subconsciously self-correct your speech. Kind of a contradiction in there, it’s gonna be tough figuring out a realistic balance.

However, it’s entirely possible a real life Ezra would almost certainly understand his stepmom, and only his stepmom via lipreading, for similar reasons to Manda JO’s student being only able to understand her mom. Especially if their primary form of communication is in shouting a few simple insults and a few simple orders. Lip movements get exaggerated in yelling and that makes it a ton easier to lipread. There might also be interesting interactions where Ezra confuses his stepmom’s words with something else (e.g., cookie for turkey).

Oh, no, I don’t have any real attachment to him “sounding deaf”…I just want to know if he would, so people don’t read the story and be like “he wouldn’t sound ‘normal!’ She doesn’t know what she’s talking about!”

In the story, he actually understands another adult character, a friend of the family, the best, because the friend has actually taken the effort to learn how to communicate with him effectively.

The misunderstanding thing is something I might use, though. She will use any excuse to beat the heck out of him…

Pushing this up in case anyone else has anything to add…and also sharing this:

Courtesy of my best friend, my first picture of Ezra, the boy in question. (I know the braces on his legs are messed up and don’t look like they really would. I have to get my best friend some reference. :))

I have two nephews, both born deaf, one implanted sooner than the other. Nephew 2, who was implanted sooner (18 mos.?), has perfect speech. Nephew 1 garbles some of his words – does not enunciate – but doesn’t have a “deaf accent.”

Well…I’m actually a 13-year-old profoundly deaf girl who was born deaf and was implanted at 18 months. I was enrolled in hearing public schools and some people can’t tell that I have an accent whereas others assume that I’m from Boston, Massachusetts (What the heck, people?)… My accent has been described as “stuffy nose”, “food in mouth”, and so on.

I can basically understand people if I can read their lips, if the surrounding environment isn’t too loud, and so on. I have trouble with technology as cochlear implants (CIs) are made for human voices, not computer (the human voice gets warped if it’s entered through technology). I realize that this is over a year old but oh well. :stuck_out_tongue:

Oh, I can’t understand TV without captions, it’s just unfathomable. Maybe that’s just me but every other CI user I know needs captions and we all hate the radio with a passion (unless there’s a transcript/script available, but I very much doubt that.) I love music though…

That’s great about the music. I was under the impression that due to the relatively poor frequency resolution of CI, music was rather indecipherable for implantees.

I can’t find the site I was looking for, but here is one that simulates what hearing music and speech sounds like with varying numbers of frequency channels. The point being is that speech is very understandable even with limited frequency resolution. The clip of Music1 is particularly interesting because it includes singing and music.

. I can’t believe I missed this thread the first go round. From what I understand the effectiveness of CIs vary TREMENDOUSLY! There are quite a few “functionally” hoh prelingal implantees, but others may only get a small percentage of words on the spondee test, in the audilogical booth.
It’s basicly just like with hearing aids. Some people ( we’re talking severe profound) are functionally hoh with aids and others only get a small percentage of speech or even just enviormental sounds.
I actually think it might be due to a variety of factors, ranging from the fact that implant eligibilty has been loosened a bit. In previous years implant canidates were limited to kids who had little to no benifit from hearing aids. Now you can have 10% of speech perception (on the spondee) for kids, in order to be implanted. (for adults it’s MUCH higher…something like 60%) Also, only a small percentage of babies are born deaf. Most kids lose their hearing. It’s a fact that those who are the best users of implants, are those who lost their hearing. (aka late deafened) Many of the kids who are functionally or almost hoh with implants, may have had the advantage of hearing normally for a month or so.

A possibly relevant link (posted by Broomstick on another forum to give credit where it’s due): Audio Demos for Speech Perception. It has simulations of what speech and music sound like to people with different types of implants (and demonstrates why more channels are better).

Actually, I got that from **this thread **- see post #16, it’s the same link!

Cue up the closed caption version of “It’s a small world after all…”


Does this mean the internet will collapse in self referential paradox? Have I doomed us all?!

Probably not.