9 ms·

The cochlear implant question

67 points by Tomte 2y ago

FollowingTheDao 2y ago
Saying this as someone who is hearing but close to the deaf community in college and knows ASL. By trying to give her the best of both worlds she is going to diminish both worlds. Not fully in the deaf community and not fully in the hearing community.
- Etheryte 2y ago
  An alternative framing would be that she gets to experience both to at least some extent, and isn't that better?
  - deleted 2y ago
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  - rincebrain 2y ago
    I think a lot of people who have their feet in multiple commonly "either/or" cultures have written quite a lot about the struggle to establish their own identity given those cultures framing many things in terms of, for lack of a better word, sole/primary membership. I'm not sure anyone can say better or worse, in a useful fashion, objectively - more options can also lead to more ambiguity and stress, as with anything in life. They're not wrong to say that by necessity, your experience is going to be different if it's defined in terms of choices made before you had agency, that are not mutable - your lived experiences are going to be very different if you cannot hear at all, and spent 10000 hours or w/e framing everything in your life around that, versus being able to hear. Unfortunately, I think absent something else, this will go the same way as most narratives of cultures where there are utilitarian reasons to not remain in it - people will often choose the route of most visible potential benefit, in these situations. Something more "ideal", in theory, would be if we could ignore critical periods, and just let people choose in adulthood to learn verbal language, but even that presents the problem that the majority dictates the "easy" option, and by nature, people who are not in that group will sometimes be the ones acting as sandpaper on rough edges in that interaction, as they're not as well-polished. (Look at all the government systems in the US that don't know how to handle more than the common "firstname lastname", for example.) So even that option presents the problems of utilitarian optimization resulting in rational actors just opting out of the more demanding route. e: Just to be clear, I'm not trying to say I think any of what I just described is "good" - I think homogeneity in human experience deprives everyone of enrichment in the variation of life. But I don't see a way to optimize for this where given the ability, a lot of people don't choose the lower-friction route in their lives.
    - FollowingTheDao 2y ago
      "Just to be clear, I'm not trying to say I think any of what I just described is "good"" Yes, this has been the problem. Many in the Deaf Community do not see being deaf as "bad", but that is the label society has put on them.
      - Etheryte 2y ago
        I mean, why would they? It would only create negative emotions, but it wouldn't have any positive impact on anything. Feeling bad about a condition can be useful if it can propel you to improve the situation, e.g. if you're an alcoholic and you feel bad about it, you might stop drinking. But for conditions where it's out of your control and there is no cure, framing it as bad does not do any good. No one needs to wallow in self pity thinking oh if only I was born different, especially if they can lead rich and fulfilling lives.
        bluGill 2y ago
        More importantly, by framing it as a thing (not good or bad just is) they can find ways around the issues. They can live their life just fine. Sure there are some things you cannot do without hearing, but there are more things to do in life than there is time anyway so there isn't a problem. You can't enjoy a symphony concert, but there are a lot of people who could do that yet don't. You can still enjoy a baseball game with those people, or if you don't like baseball - many others don't was well, just ...
- keiferski 2y ago
  Do you think bilingual kids have the same issue? I don’t.
  - robin_reala 2y ago
    The article talks about the capital-D Deaf community. It’s not just a different language, it’s a different culture.
    - keiferski 2y ago
      And people that speak say, Chinese and American English, don’t have two different cultures?
      - FollowingTheDao 2y ago
        Knowing ASL does not make me Deaf. And knowing Mandarin does not make me Chinese.
        keiferski 2y ago
        Obviously my example was for someone that grew up speaking Chinese and American English natively, as in a person of Chinese descent that grew up in America. There are millions of such people. I think you're missing the point entirely.
      - bluGill 2y ago
        Language does not make the culture. There are many deaf people who are not part of the Deaf culture. There are many people who have heard all their life but are also part of the Deaf culture. There are many different cultures in the US. Some are more similar than others. There is a Chinese culture in the US - as someone not part of it I'm content to call it one, but I'm sure those in it know of differences that I cannot see.
    - sarchertech 2y ago
      Language facilitate access to culture. You think that Deaf culture is the only culture you can’t fully participate in without speaking the language?
- sarchertech 2y ago
  Who knows what the Deaf community is going to look like in 20 years when this kid is in college. Treatments for hearing loss are advancing and it’s likely that most of her peers will be in a similar position to her. 80% of deaf children born in developed countries receive cochlear implants.
- saalweachter 2y ago
  This isn't really a conflict unique to membership in the deaf/hearing communities. You can be the kid who stayed on the farm or the kid who left the farm for the big city, but you can't be both. You can be the kid who spends half the year on the farm and half in the city, or the kid who went to the big city for twenty years before returning to the farm, but those are different things. We all only get one life to live. All we can do is try to pick a good path and enjoy the stories from people who picked different paths. A person who picks a hybrid path doesn't get to fully enjoy either path, but they do get to enjoy some of each, and they get to be the storyteller who tells the city kids about the farm and the farm kids about the city.
- Almondsetat 2y ago
  The hearing... community?
- ttpphd 2y ago
  Have you met the undergrads at Gallaudet University? They live in both worlds.
paulryanrogers 2y ago
> it is unarguable that only signed languages are easily accessible in all situations Even in the dark? Or at a distance? Or not facing the signer? Or with arthritis? Differently abled folks are entitled to their own culture and beliefs. Yet claims like that seem to be trying too hard to find a silver lining.
- robin_reala 2y ago
  I’ve seen two signers on a train platform pause their conversation while one got on the train, then carry on through the window after they’d found a seat. While the article is hyperbolic, there are pros and cons to all modes of communication.
  - paulryanrogers 2y ago
    Right, I didn't mean to deny the advantages of signing. Rather point out some arguments are crossing over into absurdity.
  - cbsks 2y ago
    I went on a scuba dive trip with a couple of deaf people and I was definitely jealous.
    - mitthrowaway2 2y ago
      You don't have to be deaf to learn sign language!
- throw894389 2y ago
  My deaf coworker does not even know sign language, she uses phone for everything. She lives perfectly normal life. Entire office is not going to learn new language, just to speak with an odd deaf person. And communicating specialized stuff like technical programming is not possible, gestures only cover basic words.
  - techsupporter 2y ago
cen4 2y ago
Will just say, there are many different causes of Deafness. And therefore outcomes vary a lot depending on what the exact condition is. If the issue is with the auditory nerve for example, cochlear implants won't solve anything. And the whole debate can go in some other direction entirely.
poulpy123 2y ago
as a foreigner, the language used is baffling (for example: "rarely addressed in moderate, bipartisan terms" that comes out of nowhere)
- resoluteteeth 2y ago
  Bipartisan probably isn't quite the right word there
swalker326 2y ago
I have two deaf daughters, both have cochlear implants and I’m very happy with the decision. My wife and I both learned sign, and let our kids wear or not wear their cochlear’s as they see fit. The youngest is too young to really understand but the oldest understands and almost exclusively selects to wear them. She is in main stream school but does spend time with her dhh friends. She 100% prefers to be with other dhh folks and sign, but likes being able to hear. All in all the decision is yours to make and people can weigh in or tell you what to do. We got a lot of hate from Deaf community members for going down the road of implants, but we also got a lot of support. There are hatful people in all walks of life. Do what you think is best and love your kids.
- techsupporter 2y ago
  My niece was born deaf and her parents went the opposite direction: they chose not to have her get an implant because of the risk of surgery at such a young age and being fortunate to live in an area with a sizable deaf community. They took ASL classes (my spouse and I joined them) and she’s now enrolled in a mix of ASL and English interpreted classes. I agree that people can only make the decision with what they have at the time. After watching her grow up these last several years, her parents think they made the right choice.
- deleted 2y ago
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sheepscreek 2y ago
I like this pragmatism because it sheds light on the realities of life. People live their experience in a muddy grey world, which is far less crystal than any activist would like to imagine. Activism thrives on polarizing individuals and circumstances, more so off-late. We could call it politicization. Either way, I believe that it’s more harmful than helpful. That polarizing the PoVs of individuals makes them more apathetic for those that hold different views. The piece that was beautifully described by the author (paraphrasing) - “we can follow X while acknowledging that this isn’t how things should be, that it’s unfair - yet this is how the world is today”. On a similar level, but less consequential for sure, being left handed creates an additional step/mental block for individuals in a world that mostly defaults to right-handedness. I consciously nudged my own child towards being more right-handed for this reason, because I didn’t want them to have this additional piece to process on top of the already complex life they were going to have by likely inheriting my ASD.
- rangestransform 2y ago
  As a left hander, I highly recommend you don’t do this, I remember reading some article that forcibly switching handedness makes someone more stupid (severely paraphrasing here) I don’t find left handedness super disabling, I still learned to use right handed things where necessary (mouse and violin mostly), but for the most part left handedness is adequately accommodated
dghughes 2y ago
I'd certainly urge someone to get a cochlear implant. Deafness and even being hard of hearing carries a known increased risk of dementia. https://www.health.harvard.edu/blog/want-to-reduce-your-risk-of-dementia-get-your-hearing-checked-today-202302162891 https://www.health.harvard.edu/blog/want-to-reduce-your-risk...
- bkfunk 2y ago
  This is a study of people in their 70s. The vast majority of people with hearing loss in their 70s lost it late in life; they have no Deaf/HH community, they almost never learn to sign, and they often struggle to adjust for their loss of hearing. The study you linked talks about reduced stimulation, and in particular _social_ stimulation: > when an individual suffers from moderate to severe hearing loss, they are less likely to participate in social activities. Perhaps they are embarrassed about their hearing loss. Or they may simply find it unrewarding to attend a social event when they cannot hear what is going on. People who are born deaf/hh , or who lose their hearing early in life, if they are allowed to access and participate Deaf/HH communities and spaces, simply do not have any of these difficulties in social contexts within those communities. Martha’s Vineyard had an unusually high rate of congenital deafness for centuries [1]. It became a place where everybody, deaf and hearing alike, used sign language regularly. In such a society, being deaf was not a significant impediment to participating in social society at all; I am aware of no evidence that would suggest the dementia rates would be higher for the deaf residents just because of their deafness. A disability is only a disability in a given context; for some conditions (eg advanced ALS), they are disabling in almost all contexts, while for others (eg a food allergy), they are disabling in a relatively narrow set of contexts. The relationship to dementia is caused by the hearing loss mis-fitting the individual’s context; people with the same condition but different contexts would not be deprived of stimulation and therefore not susceptible to dementia in the same way. [1]: https://en.wikipedia.org/wiki/Martha's_Vineyard?wprov=sfti1#Hereditary_deafness_and_sign_language https://en.wikipedia.org/wiki/Martha's_Vineyard?wprov=sfti1#... (Martha’s Vineyard sign language is a major source for what became American Sign Language. The other was French Sign Language, which is why British Sign Language and ASL are quite different despite sharing the same local spoken language)
pmarreck 2y ago
I wrote a commandline app that takes a youtube URL (or path to any audio or video file that ffmpeg can read) and converts it into a transcript using the Whisper model and then optionally translates or summarizes it using OpenAI. It's been incredibly useful for chewing through my youtube backlog, but it might also be hugely useful for the deaf or hearing-impaired. It uses Nix to manage dependencies, although I got clever about making that not necessary (I don't like forcing Nix on people until they're ready for it) https://github.com/pmarreck/yt-transcriber https://github.com/pmarreck/yt-transcriber This is mainly useful for single-speaker videos that are conveying information. Most other solutions out there that claim to do this only download the closed-captioning and summarize that, but MANY YouTubes do not have a good closed-captioning track, in which case my method still works. (Note: Aiming for Linux/Mac compatibility but have only tested it on Mac so far) I next want to convert it into a simple web service and/or perhaps Docker image to democratize this out to everyone. (I don't know if I'd be able to afford to host since the CPU/GPU cost for running Whisper on spoken audio is not insignificant, but it should work fine on anyone's local machine assuming they have the hardware for it.) I also want to add speaker identification (something called "diarization"), possibly by going to WhisperX or other solutions out there, which would make this more useful for multi-party conversation audio. In other news, I'm looking for contract work (I'm just doing side projects like the above to keep myself busy and, ideally, useful). My last job was Director of Engineering for a startup, but due to having a toddler I wish to remain work-flexible for the time being. https://www.linkedin.com/in/petermarreck/ https://www.linkedin.com/in/petermarreck/
plondon514 2y ago
As the hearing brother of a deaf sister with hearing parents, what I usually tell people is to learn sign language and get the cochlear. Forcing only cochlear on the child means that the family does not live in the deaf world with their child, while only speaking SL might distance them and cause them to miss out on a lot in the hearing world. It reminds me of basque spain, where everyone speaks catalan and some people continue to speak euskera at home or with friends they know can speak.
- jborichevskiy 2y ago
  This seems like a really thoughtful compromise, a meeting-in-the-middle that keeps optionality as open as possible for the child.
- plondon514 2y ago
  edit: castellano not catalan
- aslyes25 2y ago
  Hearing people always assume to make a good decision for any Deaf child by sharing the two worlds. Deaf child will always always be deprived with a lot of information. If parents learn sign language, it does not mean that they include a Deaf child in any kind of conversations. You chose not to listen to our life experience in the hearing world. We know what it is like to miss out a lot of information because you would not sign 24/7. If you sign, you would use voice at the same time. Simcom is not a language. Having a cochlear implant would not make him/her hearing. They will continue to struggle with all information
deleted 2y ago
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James_K 2y ago
I feel like the narrative around disabled people has advanced to the point where some now insist that they aren't disabled. In reality, it's a pretty objective fact that being disabled means being unable to do something. It is a net negative on someone's quality of life. I'd be jolly pissed off if my parent decided not to get me an implant that enabled me to hear just because someone had told them that being deaf was actually the same as being able to hear. Give the kid the hearing aid, and if they don't like it they can take it out later. There are plenty of things where this "different, not worse" narrative holds up. Children with autism or ADHD might struggle in some ways, but be better off in others. It seems clear that there is no objective reason they are worse than a neurotypical person, so if a "cure" to these conditions was developed, you would have some degree of moral quandary. But someone without hearing is just objectively worse off than someone with it, the same way someone without legs is worse off than someone with legs. The last part is what really gets me about this. The child values the hearing aid so highly that they literally hug it as they go to sleep, and this is somehow presented as a "both sides are right" outcome. To me at least, that's a pretty conclusive endorsement that kids should be given these things.
- exceptione 2y ago
  Children with autism or ADHD might struggle in some ways, but be better off in others. It seems clear that there is no objective reason they are worse than a neurotypical person, so if a "cure" to these conditions was developed, you would have some degree of moral quandary. Careful, you are most likely talking about someone spending their energy at masking their handicaps. *You only see the handicap you can see*. Someone with high intelligence but severely damaged executive functioning might look like the under performer in your team, but is giving all they have to work and still failing in silence, with their personal life being a giant mess.
  - James_K 2y ago
    No, I'm not talking about that.
- Workaccount2 2y ago
  A common thread across all the disability groups is an intrinsic desire to normalize it, a drive towards a world where everyone has the disability and therefore no one is disabled. Prune it down and it is simply "You can fix something by developing a fix, and if you can't do that you can fix something by redefining what "fixed" means".
zie 2y ago
“Blindness separates people from things; deafness separates people from people.” ― Helen Keller
ibejoeb 2y ago
Anyone here with SSHL have experience with CI? I've heard mixed things due to the rather different sound experience vs natural hearing.
- observationist 2y ago
  I don't have personal experience with CI, but have researched it extensively as a potential fix for my hearing loss. From what I understand, the number of electrodes or links to neural tissue is the limiting factor. With something like NeuraLink with 1024 electrodes, the resolution of the sound signal can be much higher. For something like early cochlear implants, with 8 or 12 channels, the signal is going to be very digitized and artificial sounding; you have to heavily optimize for a particular type or modality of sound, and that's usually speech. That means all sorts of nuance things like music and voices get lost in compression, or filtered out entirely. Cochlear implants are essentially BCI implants, taking the place of the cochlea in signaling via neural tissue. To completely replicate natural sound, you'd likely need somewhere between 15,000 to 30,000 electrodes. It's not linear, however, and 8-12 electrodes might get you to sound that is about 25% of normal, and 1024 will get you to 85-90% normal. Full fidelity of sound, or even better, will be possible once we get implants working with many tens of thousands of electrodes. People will have senses that far exceed biological human limitations. One neat thing with all of this is that due to plasticity, any connections on the neocortex can be trained to behave as if they're wired to any sensory organ; there aren't any hard limits on where an implant has to be connected. If you had an implant with 50k electrodes, half of them could be dedicated to sound, and the other half to sci-fi level possibilities like BCI mouse and keyboard control, simple virtual displays through modified sight, secondary audio channels, North sense, radar, electromagnetic signals, or immersion tweaks that modulate proprioceptive signaling. 1-500k would allow for convincing replication of normal sight, with the obvious advantage that with everything being digital, you'd be able to process your vision in software (Please watch this ad before waking! Skip in 10...). With a million electrodes, you could get into convincing totally immersive full sensory simulation. There would be some resolution issues, initially, but we're some materials science, software design, and engineering problems away from full Matrix style simulations. 1 sq cm of neocortex is all you'd need for access to 1 million neurons - things are pretty densely packed, and all the neurons we need to access live on the outer surface of the brain. Things are gonna start improving and the rate will accelerate, so hopefully we start seeing radical doublings of cochlear implant and other BCI capabilities in the near future. TLDR; as much of normal hearing as possible is compressed down to around 100hz over 8-12 electrodes in a cochlear implant. This results in significant quality degradation compared to normal hearing, but it can be a huge boon to someone who is totally or profoundly deaf. Implant technology is experiencing a boom, and we're going to see a period of Moore's law like scaling of electrodes until implants reach parity with the rest of our computing technology.
arjie 2y ago
My wife and I faced a similar situation and found it a simple decision. We both carry GJB-2 gene mutations that will likely result in profound non-syndromic hearing loss. We went through Orchid Health to get a whole genome sequence of our prospective embryos and then selected one that was not affected by the condition. We have 1 more carrier girl and 2 more unaffected girls to work with, and if we want boys later in life we will probably wait for Decibel Therapeutics / Regeneron to finish their GJB-2 gene therapy before we have that child. If there are constraints then we will have a cochlear implant or simply not implant that embryo. It was obvious to us how it should play out. My wife and I have an obligation to maximize the cone of possibility for our children and a duty to equip them best to experience the world so that they can choose the path through it that they wish. Just like I would not pierce the eardrums of my child after she is born, I shall not intentionally choose an embryo that carries a debilitating condition that I cannot remedy or mitigate if I can choose otherwise. I don’t think this is a dilemma in any way. There is an obvious choice for us. We will not deny her normative sense organs. My parents got me glasses and contact lenses. My life would have been much less vibrant if they had chosen to not provide me those prosthetics. Some parents are not so fortunate as us to have this choice. I hope modern therapeutics will enable all children and adults to have the full range of sensors that most humans carry.
- sssilver 2y ago
  How much money do things like this end up costing?
  - UltraSane 2y ago
    Must be nice to be rich.
    - nuancebydefault 2y ago
      The bringing up part of having children is much more expensive than that.
  - zonkerdonker 2y ago
    In the US, a full round of IVF plus transfer will be around 20k on the low end, up to maybe 40k on the high end, including all medication required if paid for fully out of pocket. Genome sequencing costs a few k per embryo.
Animats 2y ago
"Botticellian baby"[1] "Many perfections". "I had a stubborn sense that her deafness was not a pit she had fallen into, but just one of many extraordinary discoveries about her that I was making every day." This is coming across as denial. [1] https://en.wikipedia.org/wiki/File:Botticelli_04_Louvre.jpg https://en.wikipedia.org/wiki/File:Botticelli_04_Louvre.jpg
lemursage 2y ago
I'm "almost" a lifelong user of a cochlear implant. I got my first one when I was 9. Before I got it, I was communicating through lip reading and speaking, I never knew sign language. Lip reading I still use relatively often -- when I'm at a crowded restaurant, or at an unbearably noisy party, and there's many interlocutors at the table, I persistently stare at their lips. They take me for a great listener, when in fact, I can't hear shit, and I'm desperately switching back and forth between people's mouths to catch what they're saying. I'm out of shape and this takes so much of my brain power to understand people that I often cannot contribute my thoughts. Though my cochlear isn't perfect, I would never think of not getting it. In fact, I'd probably be rather angry at my parents for not helping me get one as soon as it was possible. During my childhood and up until late college, I've only ever met one person who was so severely hard of hearing and was about my age, and that was where I have been getting my speech lessons before I got my first cochlear implant.
- lcnPylGDnU4H9OF 2y ago
  > They take me for a great listener, when in fact, I can't hear shit, and I'm desperately switching back and forth between people's mouths to catch what they're saying. FWIW you sound like a good listener. It’s more about understanding than hearing and the dedication to understand what people are saying is the hallmark of a good listener. That said, I’m sure it helps that perception that you have to stare so attentively at whomever is talking.
snakeyjake 2y ago
Three years ago I paid $47k for my deaf nephew to get implants because his fully-insured deaf parents wouldn't pay for them. Not $47k just the out of pocket ($2k-3k-ish). I paid $47k and I got a deal because it was cash. They wanted him to live in and embrace the "deaf world". He wanted to live in the actual real world. They ended up nearly irreparably fucking up his life and denying him the only thing that he wanted so when he turned 18 instead of buying a new car I bought a surgery because crying children piss me off. There is no deaf world. There is only the world. This entire debate is insane. Nobody is going around telling pediatric biliary atresia patients to not get a liver transplant because of "not having a functioning liver" culture. There are an infinite multitude of analogous situations where an "x" culture or "x" world would be considered direct evidence of mental illness or cult behavior but due to the inertia of history here we are. edit: Maybe I should have not gotten a spinal fusion because of the rich tapestry and long history of "living in constant excruciating pain due to degenerative disc disease" culture?
- adammarples 2y ago
  While I agree with you, the culture is coming from the sign language. Liver disease doesn't come with a shared language.
- lcnPylGDnU4H9OF 2y ago
  > Maybe I should have not gotten a spinal fusion because of the rich tapestry and long history of "living in constant excruciating pain due to degenerative disc disease" culture? Surely you can argue better than to provide such a clear and obvious false equivalence. It is a matter of fact that there is a distinct culture among those who communicate via sign language and not so that there is a distinct culture among those who... what? They don’t like surgery in general? They don’t like that specific surgery? Why would you even bring that up as a comparison to Deaf culture?
  - snakeyjake 2y ago
    Coming up with unique cuss words using ASL isn't culture but let's suppose it is. Not only do member of that culture have no right to attempt to persuade or bully or pressure people into remaining in their culture in order to keep it alive, people who do that should be harassed and ridiculed until they stop out of shame and/or risk to their position in society. It is irrefutable, unquestionable cult-like behavior to criticize someone who doesn't want to be like you for not wanting to be like you. Warning sign #5 you're in a cult: "There is no legitimate reason to leave, former followers are always wrong in leaving, negative or even evil."
GianFabien 2y ago
I can't see anywhere any mention of the fact that the implant portion of the Cochlear implant has been improving. It might be prudent to consider that in the future more capable implants might be available. AFAIK implants can't be removed and upgraded. So it might be a consideration that a child could have a superior implant by waiting a couple of years. Of course the external portion of CI are being upgraded over time. But they will always be constrained by the implanted portion.
- 2dvisio 2y ago
  The internal part can be replaced too. The gain you get from implanting as soon as possible is massive compared to waiting it off. No one truly considering it should be waiting and instead actually pushing for an implant as soon as possible. For our son, in the UK in 2019, they asked us to wait until our son was one year old. We insisted to have him implanted as soon as possible and us being ready to do it at 6 months (possible already in US). We managed to do at 7 months only switching surgeon to a much younger and keen surgeon that was pushing to lower the implantable age in children on the back of the massive benefits gained and very similar complication rate as close age brackets. Our son is currently in mainstream school and doing brilliantly.
  - shawabawa3 2y ago
    Hi, I have an 8 week old deaf daughter in the UK and id love to talk to you about your experience getting the cochlear implant, particularly how you were able to get it so early If you're happy to could you get in touch via my email in bio? Thanks
    - 2dvisio 2y ago
      Sure. Thanks for having contacted me.
jpcom 2y ago
Is there such thing as an extensible or upgradeable cochlear implant? My understanding as a layman in audiology is that the silia or tiny hairs are essentially emulated or designed manually at specific frequence-reverberations and this results in some quantifiable Resolution of Hearing. My question is, is there a way or maybe a hardware technique where we could, as equipment improves and nano-scale is reached, add more "hairs" to the board? If not, can someone please make?
stoical1 2y ago
To dismiss deafness as merely a "disability to fix" shows a lack of understanding about Deaf culture and identity. Saying, “Deaf people are worse off because they can’t hear” is like claiming left-handed people are “worse off” because most tools are designed for right-handers. It’s not the person that’s deficient—it’s society failing to accommodate diversity. Another frequent comment, “Give them an implant and let them choose later,” oversimplifies a complex issue. Cochlear implants don’t restore “normal” hearing—they produce robotic, limited sounds, which don’t work for everyone. Choosing implants without teaching sign language cuts children off from the Deaf community and a rich cultural identity, leaving them stranded between worlds. Claiming that Deaf culture is “something to decommission” as if it’s outdated is not only ignorant but deeply offensive. Deaf culture is rooted in a shared language, history, and identity, much like any ethnic or linguistic community. Would you advocate for erasing small languages because they’re “less useful”? Of course not—diversity enriches us all. The idea that “the world is designed for hearing, so fix deafness” ignores a simple truth: the world is designed by hearing people, for hearing people. With accessible design—visual alerts, captions, and sign language inclusion—Deaf individuals thrive without needing to be “fixed.” Instead of framing deafness as a deficiency, let’s respect Deaf individuals and their right to choose how they navigate the world—whether through implants, sign language, or both. Empathy means listening, not dictating.
elzbardico 2y ago
Leftism and its consequences have been a disaster for the human race.
mrangle 2y ago
Ethically speaking, there's no choice. ASAP cochlear implants will allow the child to have the normal audio language input that is absolutely required for normal cognitive development. Deaf people, without implants and no audio language input in childhood, will have curtailed IQ from what they would have had. The "deaf is perfect" subculture was inevitable and has precise parallels across disabled populations. That doesn't mean that it is logical, strictly speaking, and that parents are required to respect it. I'd argue that parents are ethically obligated to help their child avoid a massive disadvantage and have absolutely no obligation to deafness as a wider culture.
akoboldfrying 2y ago
The outright selfishness of Lane, Humphries et al. is mind blowing, and publicly advocating for it would (in the modern world) rightly lead to ostracism in any other context. It is nothing more and nothing less than "I suffered, so you should suffer, too" -- the same attitude that keeps the "culture" of female genital mutilation alive.

67 points by Tomte 2y ago

Saying this as someone who is hearing but close to the deaf community in college and knows ASL. By trying to give her the best of both worlds she is going to diminish both worlds. Not fully in the deaf community and not fully in the hearing community.

Etheryte 2y ago
An alternative framing would be that she gets to experience both to at least some extent, and isn't that better?
- deleted 2y ago
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- rincebrain 2y ago
  I think a lot of people who have their feet in multiple commonly "either/or" cultures have written quite a lot about the struggle to establish their own identity given those cultures framing many things in terms of, for lack of a better word, sole/primary membership. I'm not sure anyone can say better or worse, in a useful fashion, objectively - more options can also lead to more ambiguity and stress, as with anything in life. They're not wrong to say that by necessity, your experience is going to be different if it's defined in terms of choices made before you had agency, that are not mutable - your lived experiences are going to be very different if you cannot hear at all, and spent 10000 hours or w/e framing everything in your life around that, versus being able to hear. Unfortunately, I think absent something else, this will go the same way as most narratives of cultures where there are utilitarian reasons to not remain in it - people will often choose the route of most visible potential benefit, in these situations. Something more "ideal", in theory, would be if we could ignore critical periods, and just let people choose in adulthood to learn verbal language, but even that presents the problem that the majority dictates the "easy" option, and by nature, people who are not in that group will sometimes be the ones acting as sandpaper on rough edges in that interaction, as they're not as well-polished. (Look at all the government systems in the US that don't know how to handle more than the common "firstname lastname", for example.) So even that option presents the problems of utilitarian optimization resulting in rational actors just opting out of the more demanding route. e: Just to be clear, I'm not trying to say I think any of what I just described is "good" - I think homogeneity in human experience deprives everyone of enrichment in the variation of life. But I don't see a way to optimize for this where given the ability, a lot of people don't choose the lower-friction route in their lives.
  - FollowingTheDao 2y ago
    "Just to be clear, I'm not trying to say I think any of what I just described is "good"" Yes, this has been the problem. Many in the Deaf Community do not see being deaf as "bad", but that is the label society has put on them.
    - Etheryte 2y ago
      I mean, why would they? It would only create negative emotions, but it wouldn't have any positive impact on anything. Feeling bad about a condition can be useful if it can propel you to improve the situation, e.g. if you're an alcoholic and you feel bad about it, you might stop drinking. But for conditions where it's out of your control and there is no cure, framing it as bad does not do any good. No one needs to wallow in self pity thinking oh if only I was born different, especially if they can lead rich and fulfilling lives.
      - bluGill 2y ago
        More importantly, by framing it as a thing (not good or bad just is) they can find ways around the issues. They can live their life just fine. Sure there are some things you cannot do without hearing, but there are more things to do in life than there is time anyway so there isn't a problem. You can't enjoy a symphony concert, but there are a lot of people who could do that yet don't. You can still enjoy a baseball game with those people, or if you don't like baseball - many others don't was well, just ...
keiferski 2y ago
Do you think bilingual kids have the same issue? I don’t.
- robin_reala 2y ago
  The article talks about the capital-D Deaf community. It’s not just a different language, it’s a different culture.
  - keiferski 2y ago
    And people that speak say, Chinese and American English, don’t have two different cultures?
    - FollowingTheDao 2y ago
      Knowing ASL does not make me Deaf. And knowing Mandarin does not make me Chinese.
      - keiferski 2y ago
        Obviously my example was for someone that grew up speaking Chinese and American English natively, as in a person of Chinese descent that grew up in America. There are millions of such people. I think you're missing the point entirely.
    - bluGill 2y ago
      Language does not make the culture. There are many deaf people who are not part of the Deaf culture. There are many people who have heard all their life but are also part of the Deaf culture. There are many different cultures in the US. Some are more similar than others. There is a Chinese culture in the US - as someone not part of it I'm content to call it one, but I'm sure those in it know of differences that I cannot see.
  - sarchertech 2y ago
    Language facilitate access to culture. You think that Deaf culture is the only culture you can’t fully participate in without speaking the language?
sarchertech 2y ago
Who knows what the Deaf community is going to look like in 20 years when this kid is in college. Treatments for hearing loss are advancing and it’s likely that most of her peers will be in a similar position to her. 80% of deaf children born in developed countries receive cochlear implants.
saalweachter 2y ago
This isn't really a conflict unique to membership in the deaf/hearing communities. You can be the kid who stayed on the farm or the kid who left the farm for the big city, but you can't be both. You can be the kid who spends half the year on the farm and half in the city, or the kid who went to the big city for twenty years before returning to the farm, but those are different things. We all only get one life to live. All we can do is try to pick a good path and enjoy the stories from people who picked different paths. A person who picks a hybrid path doesn't get to fully enjoy either path, but they do get to enjoy some of each, and they get to be the storyteller who tells the city kids about the farm and the farm kids about the city.
Almondsetat 2y ago
The hearing... community?
ttpphd 2y ago
Have you met the undergrads at Gallaudet University? They live in both worlds.

paulryanrogers 2y ago

> it is unarguable that only signed languages are easily accessible in all situations Even in the dark? Or at a distance? Or not facing the signer? Or with arthritis? Differently abled folks are entitled to their own culture and beliefs. Yet claims like that seem to be trying too hard to find a silver lining.

robin_reala 2y ago
I’ve seen two signers on a train platform pause their conversation while one got on the train, then carry on through the window after they’d found a seat. While the article is hyperbolic, there are pros and cons to all modes of communication.
- paulryanrogers 2y ago
  Right, I didn't mean to deny the advantages of signing. Rather point out some arguments are crossing over into absurdity.
- cbsks 2y ago
  I went on a scuba dive trip with a couple of deaf people and I was definitely jealous.
  - mitthrowaway2 2y ago
    You don't have to be deaf to learn sign language!
throw894389 2y ago
My deaf coworker does not even know sign language, she uses phone for everything. She lives perfectly normal life. Entire office is not going to learn new language, just to speak with an odd deaf person. And communicating specialized stuff like technical programming is not possible, gestures only cover basic words.
- techsupporter 2y ago

cen4 2y ago

Will just say, there are many different causes of Deafness. And therefore outcomes vary a lot depending on what the exact condition is. If the issue is with the auditory nerve for example, cochlear implants won't solve anything. And the whole debate can go in some other direction entirely.

poulpy123 2y ago

as a foreigner, the language used is baffling (for example: "rarely addressed in moderate, bipartisan terms" that comes out of nowhere)

resoluteteeth 2y ago
Bipartisan probably isn't quite the right word there

swalker326 2y ago

I have two deaf daughters, both have cochlear implants and I’m very happy with the decision. My wife and I both learned sign, and let our kids wear or not wear their cochlear’s as they see fit. The youngest is too young to really understand but the oldest understands and almost exclusively selects to wear them. She is in main stream school but does spend time with her dhh friends. She 100% prefers to be with other dhh folks and sign, but likes being able to hear. All in all the decision is yours to make and people can weigh in or tell you what to do. We got a lot of hate from Deaf community members for going down the road of implants, but we also got a lot of support. There are hatful people in all walks of life. Do what you think is best and love your kids.

techsupporter 2y ago
My niece was born deaf and her parents went the opposite direction: they chose not to have her get an implant because of the risk of surgery at such a young age and being fortunate to live in an area with a sizable deaf community. They took ASL classes (my spouse and I joined them) and she’s now enrolled in a mix of ASL and English interpreted classes. I agree that people can only make the decision with what they have at the time. After watching her grow up these last several years, her parents think they made the right choice.
deleted 2y ago
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sheepscreek 2y ago

I like this pragmatism because it sheds light on the realities of life. People live their experience in a muddy grey world, which is far less crystal than any activist would like to imagine. Activism thrives on polarizing individuals and circumstances, more so off-late. We could call it politicization. Either way, I believe that it’s more harmful than helpful. That polarizing the PoVs of individuals makes them more apathetic for those that hold different views. The piece that was beautifully described by the author (paraphrasing) - “we can follow X while acknowledging that this isn’t how things should be, that it’s unfair - yet this is how the world is today”. On a similar level, but less consequential for sure, being left handed creates an additional step/mental block for individuals in a world that mostly defaults to right-handedness. I consciously nudged my own child towards being more right-handed for this reason, because I didn’t want them to have this additional piece to process on top of the already complex life they were going to have by likely inheriting my ASD.

rangestransform 2y ago
As a left hander, I highly recommend you don’t do this, I remember reading some article that forcibly switching handedness makes someone more stupid (severely paraphrasing here) I don’t find left handedness super disabling, I still learned to use right handed things where necessary (mouse and violin mostly), but for the most part left handedness is adequately accommodated

dghughes 2y ago

I'd certainly urge someone to get a cochlear implant. Deafness and even being hard of hearing carries a known increased risk of dementia. https://www.health.harvard.edu/blog/want-to-reduce-your-risk-of-dementia-get-your-hearing-checked-today-202302162891 https://www.health.harvard.edu/blog/want-to-reduce-your-risk...

bkfunk 2y ago
This is a study of people in their 70s. The vast majority of people with hearing loss in their 70s lost it late in life; they have no Deaf/HH community, they almost never learn to sign, and they often struggle to adjust for their loss of hearing. The study you linked talks about reduced stimulation, and in particular _social_ stimulation: > when an individual suffers from moderate to severe hearing loss, they are less likely to participate in social activities. Perhaps they are embarrassed about their hearing loss. Or they may simply find it unrewarding to attend a social event when they cannot hear what is going on. People who are born deaf/hh , or who lose their hearing early in life, if they are allowed to access and participate Deaf/HH communities and spaces, simply do not have any of these difficulties in social contexts within those communities. Martha’s Vineyard had an unusually high rate of congenital deafness for centuries [1]. It became a place where everybody, deaf and hearing alike, used sign language regularly. In such a society, being deaf was not a significant impediment to participating in social society at all; I am aware of no evidence that would suggest the dementia rates would be higher for the deaf residents just because of their deafness. A disability is only a disability in a given context; for some conditions (eg advanced ALS), they are disabling in almost all contexts, while for others (eg a food allergy), they are disabling in a relatively narrow set of contexts. The relationship to dementia is caused by the hearing loss mis-fitting the individual’s context; people with the same condition but different contexts would not be deprived of stimulation and therefore not susceptible to dementia in the same way. [1]: https://en.wikipedia.org/wiki/Martha's_Vineyard?wprov=sfti1#Hereditary_deafness_and_sign_language https://en.wikipedia.org/wiki/Martha's_Vineyard?wprov=sfti1#... (Martha’s Vineyard sign language is a major source for what became American Sign Language. The other was French Sign Language, which is why British Sign Language and ASL are quite different despite sharing the same local spoken language)

pmarreck 2y ago

I wrote a commandline app that takes a youtube URL (or path to any audio or video file that ffmpeg can read) and converts it into a transcript using the Whisper model and then optionally translates or summarizes it using OpenAI. It's been incredibly useful for chewing through my youtube backlog, but it might also be hugely useful for the deaf or hearing-impaired. It uses Nix to manage dependencies, although I got clever about making that not necessary (I don't like forcing Nix on people until they're ready for it) https://github.com/pmarreck/yt-transcriber https://github.com/pmarreck/yt-transcriber This is mainly useful for single-speaker videos that are conveying information. Most other solutions out there that claim to do this only download the closed-captioning and summarize that, but MANY YouTubes do not have a good closed-captioning track, in which case my method still works. (Note: Aiming for Linux/Mac compatibility but have only tested it on Mac so far) I next want to convert it into a simple web service and/or perhaps Docker image to democratize this out to everyone. (I don't know if I'd be able to afford to host since the CPU/GPU cost for running Whisper on spoken audio is not insignificant, but it should work fine on anyone's local machine assuming they have the hardware for it.) I also want to add speaker identification (something called "diarization"), possibly by going to WhisperX or other solutions out there, which would make this more useful for multi-party conversation audio. In other news, I'm looking for contract work (I'm just doing side projects like the above to keep myself busy and, ideally, useful). My last job was Director of Engineering for a startup, but due to having a toddler I wish to remain work-flexible for the time being. https://www.linkedin.com/in/petermarreck/ https://www.linkedin.com/in/petermarreck/

plondon514 2y ago

As the hearing brother of a deaf sister with hearing parents, what I usually tell people is to learn sign language and get the cochlear. Forcing only cochlear on the child means that the family does not live in the deaf world with their child, while only speaking SL might distance them and cause them to miss out on a lot in the hearing world. It reminds me of basque spain, where everyone speaks catalan and some people continue to speak euskera at home or with friends they know can speak.

jborichevskiy 2y ago
This seems like a really thoughtful compromise, a meeting-in-the-middle that keeps optionality as open as possible for the child.
plondon514 2y ago
edit: castellano not catalan
aslyes25 2y ago
Hearing people always assume to make a good decision for any Deaf child by sharing the two worlds. Deaf child will always always be deprived with a lot of information. If parents learn sign language, it does not mean that they include a Deaf child in any kind of conversations. You chose not to listen to our life experience in the hearing world. We know what it is like to miss out a lot of information because you would not sign 24/7. If you sign, you would use voice at the same time. Simcom is not a language. Having a cochlear implant would not make him/her hearing. They will continue to struggle with all information

deleted 2y ago

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James_K 2y ago

I feel like the narrative around disabled people has advanced to the point where some now insist that they aren't disabled. In reality, it's a pretty objective fact that being disabled means being unable to do something. It is a net negative on someone's quality of life. I'd be jolly pissed off if my parent decided not to get me an implant that enabled me to hear just because someone had told them that being deaf was actually the same as being able to hear. Give the kid the hearing aid, and if they don't like it they can take it out later. There are plenty of things where this "different, not worse" narrative holds up. Children with autism or ADHD might struggle in some ways, but be better off in others. It seems clear that there is no objective reason they are worse than a neurotypical person, so if a "cure" to these conditions was developed, you would have some degree of moral quandary. But someone without hearing is just objectively worse off than someone with it, the same way someone without legs is worse off than someone with legs. The last part is what really gets me about this. The child values the hearing aid so highly that they literally hug it as they go to sleep, and this is somehow presented as a "both sides are right" outcome. To me at least, that's a pretty conclusive endorsement that kids should be given these things.

exceptione 2y ago
Children with autism or ADHD might struggle in some ways, but be better off in others. It seems clear that there is no objective reason they are worse than a neurotypical person, so if a "cure" to these conditions was developed, you would have some degree of moral quandary. Careful, you are most likely talking about someone spending their energy at masking their handicaps. *You only see the handicap you can see*. Someone with high intelligence but severely damaged executive functioning might look like the under performer in your team, but is giving all they have to work and still failing in silence, with their personal life being a giant mess.
- James_K 2y ago
  No, I'm not talking about that.
Workaccount2 2y ago
A common thread across all the disability groups is an intrinsic desire to normalize it, a drive towards a world where everyone has the disability and therefore no one is disabled. Prune it down and it is simply "You can fix something by developing a fix, and if you can't do that you can fix something by redefining what "fixed" means".

zie 2y ago

“Blindness separates people from things; deafness separates people from people.” ― Helen Keller

ibejoeb 2y ago

Anyone here with SSHL have experience with CI? I've heard mixed things due to the rather different sound experience vs natural hearing.

observationist 2y ago
I don't have personal experience with CI, but have researched it extensively as a potential fix for my hearing loss. From what I understand, the number of electrodes or links to neural tissue is the limiting factor. With something like NeuraLink with 1024 electrodes, the resolution of the sound signal can be much higher. For something like early cochlear implants, with 8 or 12 channels, the signal is going to be very digitized and artificial sounding; you have to heavily optimize for a particular type or modality of sound, and that's usually speech. That means all sorts of nuance things like music and voices get lost in compression, or filtered out entirely. Cochlear implants are essentially BCI implants, taking the place of the cochlea in signaling via neural tissue. To completely replicate natural sound, you'd likely need somewhere between 15,000 to 30,000 electrodes. It's not linear, however, and 8-12 electrodes might get you to sound that is about 25% of normal, and 1024 will get you to 85-90% normal. Full fidelity of sound, or even better, will be possible once we get implants working with many tens of thousands of electrodes. People will have senses that far exceed biological human limitations. One neat thing with all of this is that due to plasticity, any connections on the neocortex can be trained to behave as if they're wired to any sensory organ; there aren't any hard limits on where an implant has to be connected. If you had an implant with 50k electrodes, half of them could be dedicated to sound, and the other half to sci-fi level possibilities like BCI mouse and keyboard control, simple virtual displays through modified sight, secondary audio channels, North sense, radar, electromagnetic signals, or immersion tweaks that modulate proprioceptive signaling. 1-500k would allow for convincing replication of normal sight, with the obvious advantage that with everything being digital, you'd be able to process your vision in software (Please watch this ad before waking! Skip in 10...). With a million electrodes, you could get into convincing totally immersive full sensory simulation. There would be some resolution issues, initially, but we're some materials science, software design, and engineering problems away from full Matrix style simulations. 1 sq cm of neocortex is all you'd need for access to 1 million neurons - things are pretty densely packed, and all the neurons we need to access live on the outer surface of the brain. Things are gonna start improving and the rate will accelerate, so hopefully we start seeing radical doublings of cochlear implant and other BCI capabilities in the near future. TLDR; as much of normal hearing as possible is compressed down to around 100hz over 8-12 electrodes in a cochlear implant. This results in significant quality degradation compared to normal hearing, but it can be a huge boon to someone who is totally or profoundly deaf. Implant technology is experiencing a boom, and we're going to see a period of Moore's law like scaling of electrodes until implants reach parity with the rest of our computing technology.

arjie 2y ago

My wife and I faced a similar situation and found it a simple decision. We both carry GJB-2 gene mutations that will likely result in profound non-syndromic hearing loss. We went through Orchid Health to get a whole genome sequence of our prospective embryos and then selected one that was not affected by the condition. We have 1 more carrier girl and 2 more unaffected girls to work with, and if we want boys later in life we will probably wait for Decibel Therapeutics / Regeneron to finish their GJB-2 gene therapy before we have that child. If there are constraints then we will have a cochlear implant or simply not implant that embryo. It was obvious to us how it should play out. My wife and I have an obligation to maximize the cone of possibility for our children and a duty to equip them best to experience the world so that they can choose the path through it that they wish. Just like I would not pierce the eardrums of my child after she is born, I shall not intentionally choose an embryo that carries a debilitating condition that I cannot remedy or mitigate if I can choose otherwise. I don’t think this is a dilemma in any way. There is an obvious choice for us. We will not deny her normative sense organs. My parents got me glasses and contact lenses. My life would have been much less vibrant if they had chosen to not provide me those prosthetics. Some parents are not so fortunate as us to have this choice. I hope modern therapeutics will enable all children and adults to have the full range of sensors that most humans carry.

sssilver 2y ago
How much money do things like this end up costing?
- UltraSane 2y ago
  Must be nice to be rich.
  - nuancebydefault 2y ago
    The bringing up part of having children is much more expensive than that.
- zonkerdonker 2y ago
  In the US, a full round of IVF plus transfer will be around 20k on the low end, up to maybe 40k on the high end, including all medication required if paid for fully out of pocket. Genome sequencing costs a few k per embryo.

Animats 2y ago

"Botticellian baby"[1] "Many perfections". "I had a stubborn sense that her deafness was not a pit she had fallen into, but just one of many extraordinary discoveries about her that I was making every day." This is coming across as denial. [1] https://en.wikipedia.org/wiki/File:Botticelli_04_Louvre.jpg https://en.wikipedia.org/wiki/File:Botticelli_04_Louvre.jpg

lemursage 2y ago

I'm "almost" a lifelong user of a cochlear implant. I got my first one when I was 9. Before I got it, I was communicating through lip reading and speaking, I never knew sign language. Lip reading I still use relatively often -- when I'm at a crowded restaurant, or at an unbearably noisy party, and there's many interlocutors at the table, I persistently stare at their lips. They take me for a great listener, when in fact, I can't hear shit, and I'm desperately switching back and forth between people's mouths to catch what they're saying. I'm out of shape and this takes so much of my brain power to understand people that I often cannot contribute my thoughts. Though my cochlear isn't perfect, I would never think of not getting it. In fact, I'd probably be rather angry at my parents for not helping me get one as soon as it was possible. During my childhood and up until late college, I've only ever met one person who was so severely hard of hearing and was about my age, and that was where I have been getting my speech lessons before I got my first cochlear implant.

lcnPylGDnU4H9OF 2y ago
> They take me for a great listener, when in fact, I can't hear shit, and I'm desperately switching back and forth between people's mouths to catch what they're saying. FWIW you sound like a good listener. It’s more about understanding than hearing and the dedication to understand what people are saying is the hallmark of a good listener. That said, I’m sure it helps that perception that you have to stare so attentively at whomever is talking.

snakeyjake 2y ago

Three years ago I paid $47k for my deaf nephew to get implants because his fully-insured deaf parents wouldn't pay for them. Not $47k just the out of pocket ($2k-3k-ish). I paid $47k and I got a deal because it was cash. They wanted him to live in and embrace the "deaf world". He wanted to live in the actual real world. They ended up nearly irreparably fucking up his life and denying him the only thing that he wanted so when he turned 18 instead of buying a new car I bought a surgery because crying children piss me off. There is no deaf world. There is only the world. This entire debate is insane. Nobody is going around telling pediatric biliary atresia patients to not get a liver transplant because of "not having a functioning liver" culture. There are an infinite multitude of analogous situations where an "x" culture or "x" world would be considered direct evidence of mental illness or cult behavior but due to the inertia of history here we are. edit: Maybe I should have not gotten a spinal fusion because of the rich tapestry and long history of "living in constant excruciating pain due to degenerative disc disease" culture?

adammarples 2y ago
While I agree with you, the culture is coming from the sign language. Liver disease doesn't come with a shared language.
lcnPylGDnU4H9OF 2y ago
> Maybe I should have not gotten a spinal fusion because of the rich tapestry and long history of "living in constant excruciating pain due to degenerative disc disease" culture? Surely you can argue better than to provide such a clear and obvious false equivalence. It is a matter of fact that there is a distinct culture among those who communicate via sign language and not so that there is a distinct culture among those who... what? They don’t like surgery in general? They don’t like that specific surgery? Why would you even bring that up as a comparison to Deaf culture?
- snakeyjake 2y ago
  Coming up with unique cuss words using ASL isn't culture but let's suppose it is. Not only do member of that culture have no right to attempt to persuade or bully or pressure people into remaining in their culture in order to keep it alive, people who do that should be harassed and ridiculed until they stop out of shame and/or risk to their position in society. It is irrefutable, unquestionable cult-like behavior to criticize someone who doesn't want to be like you for not wanting to be like you. Warning sign #5 you're in a cult: "There is no legitimate reason to leave, former followers are always wrong in leaving, negative or even evil."

GianFabien 2y ago

I can't see anywhere any mention of the fact that the implant portion of the Cochlear implant has been improving. It might be prudent to consider that in the future more capable implants might be available. AFAIK implants can't be removed and upgraded. So it might be a consideration that a child could have a superior implant by waiting a couple of years. Of course the external portion of CI are being upgraded over time. But they will always be constrained by the implanted portion.

2dvisio 2y ago
The internal part can be replaced too. The gain you get from implanting as soon as possible is massive compared to waiting it off. No one truly considering it should be waiting and instead actually pushing for an implant as soon as possible. For our son, in the UK in 2019, they asked us to wait until our son was one year old. We insisted to have him implanted as soon as possible and us being ready to do it at 6 months (possible already in US). We managed to do at 7 months only switching surgeon to a much younger and keen surgeon that was pushing to lower the implantable age in children on the back of the massive benefits gained and very similar complication rate as close age brackets. Our son is currently in mainstream school and doing brilliantly.
- shawabawa3 2y ago
  Hi, I have an 8 week old deaf daughter in the UK and id love to talk to you about your experience getting the cochlear implant, particularly how you were able to get it so early If you're happy to could you get in touch via my email in bio? Thanks
  - 2dvisio 2y ago
    Sure. Thanks for having contacted me.

jpcom 2y ago

Is there such thing as an extensible or upgradeable cochlear implant? My understanding as a layman in audiology is that the silia or tiny hairs are essentially emulated or designed manually at specific frequence-reverberations and this results in some quantifiable Resolution of Hearing. My question is, is there a way or maybe a hardware technique where we could, as equipment improves and nano-scale is reached, add more "hairs" to the board? If not, can someone please make?

stoical1 2y ago

To dismiss deafness as merely a "disability to fix" shows a lack of understanding about Deaf culture and identity. Saying, “Deaf people are worse off because they can’t hear” is like claiming left-handed people are “worse off” because most tools are designed for right-handers. It’s not the person that’s deficient—it’s society failing to accommodate diversity. Another frequent comment, “Give them an implant and let them choose later,” oversimplifies a complex issue. Cochlear implants don’t restore “normal” hearing—they produce robotic, limited sounds, which don’t work for everyone. Choosing implants without teaching sign language cuts children off from the Deaf community and a rich cultural identity, leaving them stranded between worlds. Claiming that Deaf culture is “something to decommission” as if it’s outdated is not only ignorant but deeply offensive. Deaf culture is rooted in a shared language, history, and identity, much like any ethnic or linguistic community. Would you advocate for erasing small languages because they’re “less useful”? Of course not—diversity enriches us all. The idea that “the world is designed for hearing, so fix deafness” ignores a simple truth: the world is designed by hearing people, for hearing people. With accessible design—visual alerts, captions, and sign language inclusion—Deaf individuals thrive without needing to be “fixed.” Instead of framing deafness as a deficiency, let’s respect Deaf individuals and their right to choose how they navigate the world—whether through implants, sign language, or both. Empathy means listening, not dictating.

elzbardico 2y ago

Leftism and its consequences have been a disaster for the human race.

mrangle 2y ago

Ethically speaking, there's no choice. ASAP cochlear implants will allow the child to have the normal audio language input that is absolutely required for normal cognitive development. Deaf people, without implants and no audio language input in childhood, will have curtailed IQ from what they would have had. The "deaf is perfect" subculture was inevitable and has precise parallels across disabled populations. That doesn't mean that it is logical, strictly speaking, and that parents are required to respect it. I'd argue that parents are ethically obligated to help their child avoid a massive disadvantage and have absolutely no obligation to deafness as a wider culture.

akoboldfrying 2y ago

The outright selfishness of Lane, Humphries et al. is mind blowing, and publicly advocating for it would (in the modern world) rightly lead to ostracism in any other context. It is nothing more and nothing less than "I suffered, so you should suffer, too" -- the same attitude that keeps the "culture" of female genital mutilation alive.