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Choosing a Cochlear Implant?
sydsavage asks: "My mom, who is profoundly deaf, has finally qualified for a cochlear implant. She is having the procedure done at the University of Minnesota, and is scheduled for surgery in early March. The doctors have left it up to her to choose between two different implants. The differences between them are highly technical, and well above her level of comprehension. So she decided to ask her geek son to take a look at the differing technologies. Unfortunately, I'm a systems administrator, not an audio engineer or signal processing guru, and reading
up on the technologies made this fact blaringly obvious to me. About the best I can tell her is one has more accessories available, as any good geek could ascertain. While this may have an impact on her decision, at the end of the day, she just wants to be able to hear better. Are there any slashdot readers with first or second hand experience with these two devices? Any signal processing engineers that would like to weigh in on the different technologies involved?"
"The two implants that are available to her are the Clarion, manufactured by Advanced Bionics, and the Nucleus, made by the Australian firm Cochlear.
The Nucleus system is the one with more bells in whistles, such as the ability to interface to FM systems for hearing impaired that are found in museums, auditoriums and theaters. It can also plug into an audio out jack of a tv, stereo or computer. It also has a built in 'tele-coil' for use with phones that are design to work with hearing aids.
My mother and I would both like to say thank you in advance for your help in making this life changing decision."
>What joke of a doctor tells the patient to look at two implants
> and chose based on highly technical differences
It is quite possible that the doctor did not do this. My advice: visit the doctor with your mom to hear for yourself what he is asking your mom to do. There probably is a good reason that he gives her a choice, for instance:
- the two devices differ in cost (to your mom)
- one will cost here more learning effort, but will eventually give here better hearing (AFAIK, cochlear implants never 'just work'; your mom will require training to use one)
- neither of them is better than the other in all environments
- one of them allows/requires her to adjust some parameters for optimum playback, the other lacks those fine controls, making it easier to use at the cost of some sound quality
I am Deaf.
I don't pretend to be an expert on Cochlear implants, but you do have to realize that there is a lot more to "curing" deafness than simply picking the best hearing aid due to its technical specs.
As an analogy, take someone who's been doing graphics work on a Mac for years, decades and suddenly tell him that if he wants to keep his job, he has to become an OpenVMS system administrator and maintain the company's equipment without the benefit of a GUI.
Don't pick an implant on the basis of what it says it can do. Pick an implant on the basis of what your Mom wants to do, and is comfortable doing. For example, the Nucleus system boasts of being compatable with tele-coils. Most conventional hearing aids today are compatible with tele-coils, and within the next five years or so, all "new" models will be.
Furthermore, in order to use tele-coils, we usually have to flick a tiny switch on our hearing aids to switch from "conventional" sounds (that use sound waves) to induced sounds. Cochlear implants have the same switch or something very similar. For the elderly, manipulating that tiny little switch is usually a pain in the ass. Guess what the predominant preference is? An amplifier that can be plugged directly into the telephone line - or better yet, phones that come with sufficiently loud speakers built in.
Your next step should be to speak to an audiologist if you have not done so already. What you need to know is what frequencies you (or your Mom in this case) tends to listen for. Like any decent home stereo system, implants are optimized for a certain range and stutter, hiss, whistle, whatever outside of that range.
As an hypothetical example, it may be that she cannot hear high frequencies at all, but she can hear bass tones easily. If that's the case, you want one that will "magnify" those high frequences until she can hear them, and give maybe just a slight boost to the lower frequencies. Then you can select a model that will give you the most flexibility in compenstating for her deafness.
Trillian_1138 (221423) sez (a bunch of stuff; I'll take it a bit at a time): "You sound like someone who, while not involved in a directly emotional sense, might have an opinion on cochlear implants and the entire idea of deaf culture."
I'm not deaf (small d, as in hearing loss), but I was a "terp", and before that hung out with Deaf (capital D, as in the culture) poeple and did ASL enough that they and I considered me to be Deaf.
"My understanding is that deaf culture revolves around the idea of deafness not being a disability, and deaf people (specifically those born deaf) have developed their own unique culture in the same way that more regularly recognized cultures have...Deafness, if my understanding is correct, isn't even viewed as a disability."
To many this is the case. While undoubtedly people could rationalize themselves into believing this because they're stuck with the condition, I think there are other aspects to consider. How hard is it for you to talk to one person on the other side of a crowded room? How hard is it for you to talk with someone in a loud party? And if someone is hanging around you blabbering on endlessly about something you don;t want to hear, how hard is it for you to close your ears? In these respects, and others you can probably think of, people who don't use ASL are hampered -- they are the disabled ones. At the risk of sounding politically correct, in these respects, the deaf are really "differently abled".
"I have very mixed feelings on this. On the one hand, I can emotionally understand how a group such as deaf individuals could see themselves as a seperate culture than everyone else... On the other hand, when I view it from a more removed position, I can't think of deafness as anything other than a disability."
Now, some adhere to the Deaf culture and dislike anything that impinges on it. Others would prefer not to have to have the condition. In my experience it is more often the former who have a problem with other people doing one thing or the other -- getting artificial assitance or staying away from it. They react more strongly. They even get upset of the parents of a child born deaf get it an implant without giving it the chance to become Deaf and make up its own mind.
Then again, they view this as an attempt by a dominant culture to enforce their mores and decisions on them and those like them. Being Native American, I can relate to this also. Despite what may (or may not) be the best of intentions, it's still paternalism.
The nature of the problem seems to come down to the same point as gun control and abortion -- some people wanting others to do one thing, while the others want to be able to do what they choose. Such things probably aren't solveable without giving each their own space to do as they wish with the understanding they can express their opinion but cannot enforce it on others.
In practical terms, someone born completely nerve deaf will probably never benefit from an implant. They might gain a new sensation, but it's not very likely they can turn it into a useful perception. Children, or the newly (or slowly) deaf, can probably benefit. They should be allowed to decide for themselves, and that includes being exposed to both sides, the oto/neuro people who can give them hearing, and the Deaf who could accept them as they are.
One last thing: consider how ASL works. There's a hand sign, and it can be modified by where it is in relation to the body, movement, and associated body language and facial expressions. These can all happen simultaneously (I usually use the example of the sign for "standing around for a long time, not paying attention"). In such instacnes there is communication going on in parallel, whereas with speech it is by necessity serial. If one can be taught to communicate over several parallel channels, might this not be beneficial brain exercise? I. and others, are of the opinion that teaching ASL to all young children for precisely this reason is a good idea. They could learn
"I may be synthetic, but I'm not stupid." -- Bishop 341-B