The British Association of Teachers of the Deaf
Promoting Excellence in Deaf Education

Sign bilingualism and cochlear implants - the challenges

Sue Archbold, The Ear Foundation

Controversy about what mode of communication to use with deaf children to promote language acquisition is not new, but the advent of cochlear implantation has added a new dimension. Since the aim of implantation is to provide sufficient hearing to enable a profoundly deaf child to hear speech in ways not possible for that child through hearing aids, the goal has often been seen only in terms of speech perception and production. Research endeavours have focussed on these areas, (Thouthenhoofd et al, 2005) and speech intelligibility has often been confused as a measure of language.

Newer research is looking in more depth at the realities of the complexity of language development for deaf children, particularly in the long-term. Marschark and Spencer (2003), in their review of cochlear implant research summarised that
" language modality has yet resolved deaf children's continuing language delays after implantation." Watson et al (in print) have found that children's communication mode changes after cochlear implantation over time, particularly for those implanted young.

Paediatric cochlear implantation raises many challenges for those working in sign bilingual settings - providing access to rich spoken language, providing a changing environment over time and monitoring the development of spoken language over time. It was with this background that two meetings have been held this year at The Ear Foundation with members of the Sign Bilingual consortium, to look at these issues and ways in which effective support for deaf children with implants could be provided in these settings after implantation. These meetings were supported by NDCS and RNID and there have been several positive outcomes: research has been funded with Ruth Swanwick of Leeds University, looking at good practice in this area, and training days looking at ways of meeting the needs of children with implants in sign bilingual settings have been incorporated in the Continuing Education Programme at The Ear Foundation. In addition, ‘Sign Bilingualism: a model’, is now being revisited in the light of experiences with children with implants, in a group led by Sue Gregory.

Although cochlear implants have made intelligible spoken language an attainable goal for the majority of profoundly deaf children, many choose also to use sign language. It is evident that children can use sign language first and move onto spoken language, given appropriate input, and there are also up to 40% of deaf children, likely to have another difficulty, for whom sign language may be appropriate. It is important that we look carefully at this issue, to ensure now that the majority of profoundly deaf children receive implants, that they receive long-term support appropriate for their changing needs over time.

Current research into communication mode after implantation A current research study looking at communication changes after cochlear implantation, funded by NDCS, is asking parents initially about their child's communication choices before and after implantation, whether it has changed, and, if so, why it has changed. The study, with Sue Archbold, Linda Watson and Tim Hardie, will then go on to talk to the children themselves and their teachers. Early results from the initial questionnaire are showing changes over time towards the use of spoken language, particularly with those children implanted at an early age. We look forward to exploring these complex issues and the factors that are important in more depth.

You may be interested in The Ear Foundation's one-day symposium on the Educational Implications of Cochlear Implantation, to be held at the National College in Nottingham, on June 26. Some of these issues will be explored then, and keynote speakers will be Marc Marschark and Patricia Spencer.


Marschark and Spencer (2003)
Deaf Studies Language and Education

Thoutenhoofd ED, Archbold SM, Gregory S, Lutman ME, Nikolopoulos TP, Sach T (2005)
Paediatric Cochlear Implantation - Evaluating Outcomes

Watson LM, Gregory S (2005)
Non-use of cochlear implants in children: Child and parent perspectives
Deafness and Educational International 7 (1) 43-58 Whurr

March 2006