Family and Educational Support

It is well understood that establishing clear expectations for the family about the benefits of a cochlear implant and its place as only one of the elements in their child's habilitation is critical. It is also well accepted that educational programs and families in which spoken language and listening experiences are emphasized are critical to the child's successful use of an implant to aid in developing spoken communication and reading and writing.

Establishing communication with, and developing language in, a child with congenital deafness is one of the most challenging problems to confront a family. The vast majority of parents (90%) who have a deaf child do not know anything about the habilitation process and do not know how to use sign language or how to otherwise communicate with their child. Furthermore, outside of populated areas, strong educational programs or intervention teams, or both, are often not available to children and their families. If these support systems cannot be identified, implantation is not advisable. Use of sign language, per se, should not recommend against implantation. Measurable gains in language performance, including acquisition of intelligible speech, have been noted for children with implants who are in programs or homes in which sign language is used in addition to speaking and listening. Sadly, however, most families do not develop into competent communicators with their child in any mode, but particularly when sign language is introduced into the habilitation process. In such families, whether they talk or try to sign, or try both, the cochlear implant is likely to be of questionable benefit.

Luetje and Jackson11 suggest that socioeconomic factors, poor compliance by families, and family impatience with habilitative training should be considered complications as serious as medical/surgical issues or device failures when implanting children.

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