Hearing, speech and the joy of music are the three most central
forms of human communication and expression, and bringing them back to the deaf
community through the use of cochlear implants (CI) which are regarded by some
as the "Scientific Marvel of the Century" has been mixed with pros and cons.
The word "cochlea" is derived from the Greek word "kokhlias" which is the part of inner ear and looks like a snail. The word "implant" means a medical device that replaces a missing biological structure or supports a damaged biological structure.
A CI is a surgically-implanted electronic device that provides hearing sensation to a person who has severe or profound hearing loss usually caused by damage or a defect in the cochlea. The implants can directly stimulate the auditory nerve to send information to the brain. The brain learns to recognise this signal and the person experiences this as "hearing." CI is also referred as a Bionic Ear.
CI consists of three parts which are speech processor, transmitter and receiver. The speech processor looks like a long narrow calculator and is worn behind the ear which amplifies sound, converts it into digital signals, and sends these signals to the transmitter. The transmitter is a headphone and is also worn behind the ear which receives the electrical signals from the speech processor and transmits them through the skin to the receiver. The receiver is an implanted part and a magnetic disk, and is placed under the skin behind one ear. A wire that runs from the receiver to an electrode is placed in the cochlea where it stimulates acoustic nerve.
In the normal ear, sound moves through the ear and strikes the eardrum. Sound waves cause the eardrum to vibrate, sending the bones in the middle ear into motion. This motion causes the fluid inside the cochlea to move the hair cells. The hair cells change the movement into electric impulses which are sent to the hearing nerve into the brain. Thus we hear a sound.
In the cochlear implants, the external speech processor captures sound and converts it to digital signals. The processor sends digital signals to the internal implant which turns signals into electrical energy sending it to an array inside the cochlea. The electrodes stimulate the hearing nerve bypassing damaged hair cells, and the brain perceives signals. Thus severe or profound deaf individuals hear a sound.
Even though there are two types of hearing disorders namely, conductive and sensorial, most hearing loss results from the destruction of the sensory hair cells in the cochlea. When this happens, doctors say, "The cochlea died." It means the death of these cochlear sensory cells which is usually permanent.
CI does not provide the normal or natural hearing. It provides a digitalised computerised version of sounds to the persons with severe or profound hearing loss where they can understand speech. With the help of intensive speech, language and listening therapy many children and adults with CI have made remarkable progress in speech and language skills and they can ever communicate over the phone.
If CI technology continues to improve, then someday the world may be free from the problem of deafness.
At the very beginning, the deaf community in America did not welcome the use of CI. In 1980 through 1990, they protested against it and rejected the CI idea to cure for deafness and even they compared it to genocide because they viewed that deaf people are the members of minority cultural group and they should not be treated as a disabled organisation. As a result, the war between CI and the deaf community kicked off.
The deaf community was concerned that by using the CI technology deaf children will grow up like a spoken language rather than sign language. It was dating back the memories of two methods of deaf people, oralism and manualism (total communication), of the 18th century where deaf people can communicate and learn.
In oralism, lip reading, speech, the process of watching mouth movements, mastering breathing techniques and use of hearing technology are required where the sign language has been restricted. In the manualism, sign language is one of the means of total communication where manual alphabet, manual spell, handshapes, orientation, location movement and facial expressions have been emphasised.
The supporters of oralism view that the deaf who learn manualism will rely on it and never develop their potential for speech. On the other hand, the supporters of manualism claim that the method of total communication is the best answer for them and it is a gift from God.
In fact, sign language as well as total communication has been a global language used by the people with speech and hearing disability to communicate with each other and those who hear. It is both viable and visible language.
Perception is a sense of normal human bodies which have five elements viz. sight, hearing, taste, touch and smell.
The supporters of the CI view that lack of hearing as well as deafness is a disabling medical condition. That is why they focus on the normalisation of the deaf children for being key success. If deaf people are disabled for missing one of human capabilities, they may ask who are disabled between men and women? The answer is they both are able-bodied and have normal bodies but have different capabilities. If so, why not deaf people have different capabilities? It seems that this argument will remain forever.
In fact, deaf people have their own culture. They have sign language, clubs, meeting places, schools, colleges and even a university associated with sports and cultural programmes. These can be viewed as their cultural identity rather than a disability.
Deafness does not cause developmental delays. It is essential/important for deaf or hard of hearing (HOH) children to learn reading and writing competently at the very beginning of their lives. It would help them socially and academically grow, get their rewarding careers and, enjoy happier lives. There are many deaf and HOH individuals around the globe who have been successful without CI and with CI.
Deafness can be a source of spiritual growth to keep relation with God. Helen Keller (1880-1968), the deaf-blind American author, political activist and lecturer who wrote in her poem: "But I had talked with God when I was young/He would not let them take away my soul/Possessing that, I still possess the whole." Besides she remarkably said: "Blindness separates us from things, but deafness separates us from people."
The technological developments like close captioning, e-mail and the internet, two-way pagers, text telephones, telecommunications relay services, video interpreting services, visual alerting services, vibro-tactile devices, hearing aids, amplifications devices, audio loop and listening systems, fax machines and signaling devices have enriched the lives of deaf people.
Let deaf people be proud for being deaf because of genetic testing ensures that their children will be born deaf. They see deafness is their culture which allows them to thrive.
In the United States, 90% of deaf children have come from hearing parents. When hearing parents learn that their child will be deaf, then they often are at a loss what to do, and how to communicate with the child, and they often get involved with CI as a hope that their child will be their same hearing culture not thinking that there are other alternative options where deaf child can learn education through Cued Speech, American Sign Language (ASL) and Signed Exact English (SEE). If so, let the children of hearing parents learn education through CI as a member of hearing culture and the children of deaf parents learn education through sign language as a member of deaf culture. The fact is getting CI will not cure the deafness because despite using CI a deaf person will remain still deaf and always be deaf.
Like all technologies, CI has both advantages and disadvantages, despite many doctors saying that CI is a "revolutionary technology."
To implement CI's receiver a cut in the skin will be made behind the ear. A hole will be drilled through the bone behind the ear to the cochlea. A wire will be fed through the hole and into the cochlea. Then the receiver will be put against the bone behind the ear. The wire will be attached to the receiver. The incision will be closed with switches. After healing the skin, the incision is hardly noticeable and only a slight bump may remain over the implant which can be covered depending on the patient's hairstyle. Many patients are afraid of these because significant problems have been reported for children or adults. Most patients feel that their overall quality of life has improved after the CI.
CI surgery will cause the complete loss of all natural residual hearing in the implanted ear. A CI recipient is not able to receive Magnetic Resonance Imaging (MRI) because the implant contains a magnet.
Meningitis can be life-threatening because of the inflammation's proximity to the brain and spinal cord. That is why it has been classified as a medical emergency. The CI recipients can be at risk of meningitis because inner ear fluid leaks or other complications can result in medical treatment, surgery and removal of the device.
To participate in sports activities, an implantee needs to remove the external part of the implant that means the implantee will not hear while doing sports activities.
Technology advancement certainly has an effect on human nature and culture. What it will be, if the success in re-growing cochlea hair cell occurs with the use of embryonic stem cells? It will help the deaf community to become hearing community that does not apply aggressive surgical procedures or even potential risks. Then what will happen between the CI community and the deaf community?
After many years of work and research, Dr Stefan Heller, a leader in stem-cell based research on the cochlea and the professor of otolaryngology at the Stanford University School of Medicine, Oakland, USA now reported in the journal Cell, "It looks like something similar may be possible for replacing damaged human cochlear and vestibular hair cells." He focused on two paths for possible cures for deafness: drug therapy that could be as simple as an application of ear drops and stem cell transplantation into the cochlea. Both paths could be further advanced by the ability to develop hair-cell-like cells. He is optimistic that within a decade or so we could reap the benefits of this type of screening.
Thus we come to conclude that technological advancement is the source of potential benefits and also enormous harms. At this time, to make bridge between such gaps, the world needs transhumanist thinkers who can study on potential benefits and dangers of emerging technologies so that they can overcome fundamental human limitations as well as its ethical matters.
The word "cochlea" is derived from the Greek word "kokhlias" which is the part of inner ear and looks like a snail. The word "implant" means a medical device that replaces a missing biological structure or supports a damaged biological structure.
A CI is a surgically-implanted electronic device that provides hearing sensation to a person who has severe or profound hearing loss usually caused by damage or a defect in the cochlea. The implants can directly stimulate the auditory nerve to send information to the brain. The brain learns to recognise this signal and the person experiences this as "hearing." CI is also referred as a Bionic Ear.
CI consists of three parts which are speech processor, transmitter and receiver. The speech processor looks like a long narrow calculator and is worn behind the ear which amplifies sound, converts it into digital signals, and sends these signals to the transmitter. The transmitter is a headphone and is also worn behind the ear which receives the electrical signals from the speech processor and transmits them through the skin to the receiver. The receiver is an implanted part and a magnetic disk, and is placed under the skin behind one ear. A wire that runs from the receiver to an electrode is placed in the cochlea where it stimulates acoustic nerve.
In the normal ear, sound moves through the ear and strikes the eardrum. Sound waves cause the eardrum to vibrate, sending the bones in the middle ear into motion. This motion causes the fluid inside the cochlea to move the hair cells. The hair cells change the movement into electric impulses which are sent to the hearing nerve into the brain. Thus we hear a sound.
In the cochlear implants, the external speech processor captures sound and converts it to digital signals. The processor sends digital signals to the internal implant which turns signals into electrical energy sending it to an array inside the cochlea. The electrodes stimulate the hearing nerve bypassing damaged hair cells, and the brain perceives signals. Thus severe or profound deaf individuals hear a sound.
Even though there are two types of hearing disorders namely, conductive and sensorial, most hearing loss results from the destruction of the sensory hair cells in the cochlea. When this happens, doctors say, "The cochlea died." It means the death of these cochlear sensory cells which is usually permanent.
CI does not provide the normal or natural hearing. It provides a digitalised computerised version of sounds to the persons with severe or profound hearing loss where they can understand speech. With the help of intensive speech, language and listening therapy many children and adults with CI have made remarkable progress in speech and language skills and they can ever communicate over the phone.
If CI technology continues to improve, then someday the world may be free from the problem of deafness.
At the very beginning, the deaf community in America did not welcome the use of CI. In 1980 through 1990, they protested against it and rejected the CI idea to cure for deafness and even they compared it to genocide because they viewed that deaf people are the members of minority cultural group and they should not be treated as a disabled organisation. As a result, the war between CI and the deaf community kicked off.
The deaf community was concerned that by using the CI technology deaf children will grow up like a spoken language rather than sign language. It was dating back the memories of two methods of deaf people, oralism and manualism (total communication), of the 18th century where deaf people can communicate and learn.
In oralism, lip reading, speech, the process of watching mouth movements, mastering breathing techniques and use of hearing technology are required where the sign language has been restricted. In the manualism, sign language is one of the means of total communication where manual alphabet, manual spell, handshapes, orientation, location movement and facial expressions have been emphasised.
The supporters of oralism view that the deaf who learn manualism will rely on it and never develop their potential for speech. On the other hand, the supporters of manualism claim that the method of total communication is the best answer for them and it is a gift from God.
In fact, sign language as well as total communication has been a global language used by the people with speech and hearing disability to communicate with each other and those who hear. It is both viable and visible language.
Perception is a sense of normal human bodies which have five elements viz. sight, hearing, taste, touch and smell.
The supporters of the CI view that lack of hearing as well as deafness is a disabling medical condition. That is why they focus on the normalisation of the deaf children for being key success. If deaf people are disabled for missing one of human capabilities, they may ask who are disabled between men and women? The answer is they both are able-bodied and have normal bodies but have different capabilities. If so, why not deaf people have different capabilities? It seems that this argument will remain forever.
In fact, deaf people have their own culture. They have sign language, clubs, meeting places, schools, colleges and even a university associated with sports and cultural programmes. These can be viewed as their cultural identity rather than a disability.
Deafness does not cause developmental delays. It is essential/important for deaf or hard of hearing (HOH) children to learn reading and writing competently at the very beginning of their lives. It would help them socially and academically grow, get their rewarding careers and, enjoy happier lives. There are many deaf and HOH individuals around the globe who have been successful without CI and with CI.
Deafness can be a source of spiritual growth to keep relation with God. Helen Keller (1880-1968), the deaf-blind American author, political activist and lecturer who wrote in her poem: "But I had talked with God when I was young/He would not let them take away my soul/Possessing that, I still possess the whole." Besides she remarkably said: "Blindness separates us from things, but deafness separates us from people."
The technological developments like close captioning, e-mail and the internet, two-way pagers, text telephones, telecommunications relay services, video interpreting services, visual alerting services, vibro-tactile devices, hearing aids, amplifications devices, audio loop and listening systems, fax machines and signaling devices have enriched the lives of deaf people.
Let deaf people be proud for being deaf because of genetic testing ensures that their children will be born deaf. They see deafness is their culture which allows them to thrive.
In the United States, 90% of deaf children have come from hearing parents. When hearing parents learn that their child will be deaf, then they often are at a loss what to do, and how to communicate with the child, and they often get involved with CI as a hope that their child will be their same hearing culture not thinking that there are other alternative options where deaf child can learn education through Cued Speech, American Sign Language (ASL) and Signed Exact English (SEE). If so, let the children of hearing parents learn education through CI as a member of hearing culture and the children of deaf parents learn education through sign language as a member of deaf culture. The fact is getting CI will not cure the deafness because despite using CI a deaf person will remain still deaf and always be deaf.
Like all technologies, CI has both advantages and disadvantages, despite many doctors saying that CI is a "revolutionary technology."
To implement CI's receiver a cut in the skin will be made behind the ear. A hole will be drilled through the bone behind the ear to the cochlea. A wire will be fed through the hole and into the cochlea. Then the receiver will be put against the bone behind the ear. The wire will be attached to the receiver. The incision will be closed with switches. After healing the skin, the incision is hardly noticeable and only a slight bump may remain over the implant which can be covered depending on the patient's hairstyle. Many patients are afraid of these because significant problems have been reported for children or adults. Most patients feel that their overall quality of life has improved after the CI.
CI surgery will cause the complete loss of all natural residual hearing in the implanted ear. A CI recipient is not able to receive Magnetic Resonance Imaging (MRI) because the implant contains a magnet.
Meningitis can be life-threatening because of the inflammation's proximity to the brain and spinal cord. That is why it has been classified as a medical emergency. The CI recipients can be at risk of meningitis because inner ear fluid leaks or other complications can result in medical treatment, surgery and removal of the device.
To participate in sports activities, an implantee needs to remove the external part of the implant that means the implantee will not hear while doing sports activities.
Technology advancement certainly has an effect on human nature and culture. What it will be, if the success in re-growing cochlea hair cell occurs with the use of embryonic stem cells? It will help the deaf community to become hearing community that does not apply aggressive surgical procedures or even potential risks. Then what will happen between the CI community and the deaf community?
After many years of work and research, Dr Stefan Heller, a leader in stem-cell based research on the cochlea and the professor of otolaryngology at the Stanford University School of Medicine, Oakland, USA now reported in the journal Cell, "It looks like something similar may be possible for replacing damaged human cochlear and vestibular hair cells." He focused on two paths for possible cures for deafness: drug therapy that could be as simple as an application of ear drops and stem cell transplantation into the cochlea. Both paths could be further advanced by the ability to develop hair-cell-like cells. He is optimistic that within a decade or so we could reap the benefits of this type of screening.
Thus we come to conclude that technological advancement is the source of potential benefits and also enormous harms. At this time, to make bridge between such gaps, the world needs transhumanist thinkers who can study on potential benefits and dangers of emerging technologies so that they can overcome fundamental human limitations as well as its ethical matters.
Published in the Financial Express, Dhaka, Bangladesh, June 30, 2012
No comments:
Post a Comment