The Potential Impact of New Technology on the
Speech Perception and Production of Deaf Pupils

by Sue Archbold, Co-ordinator, Cochlear Implant Programme, Nottingham

OVERHEAD HANDOUT

Placing Technology in Context

• medical construction versus social construction of deafness
  
• potential of technology to deliver 'normalisation'
  
• gap between reality and hope;
  
• increasing stress amongst medical/scientific communities that:
  • cochlear implants/digital hearing aids do not 'cure' deafness: the child/adult with CI/DA will remain deaf;
  • possibly more awareness of other language development possibilities, eg; Barry McCormick's comments on the recent 'See Hear' programmes.

How do we judge what is 'effective'

Motion for Debate:

'If cochlear implants work, all children should be implanted as soon as possible diagnosis.'

Ethical issues go beyond effectiveness, but effectiveness itself needs to be explored.

How do we measure effectiveness? How/who decides?

Language Development Issues

The Critical Age hypothesis or indeed hypotheses: there may be different critical periods.

Changing views on this over the last few decades.

Evidence from sign language studies that the critical period may be longer than originally suggested:

"...the critical age period is like a door gradually creaking shut rather a closing with a sudden slam."
Judy Kegl.

"...acquisition of normal language is guaranteed for children up to the age of six, is steadily compromised from then on until shortly after puberty, and is rare thereafter."
Stephen Pinker

What is the evidence re a critical period for hearing and speech? Does lack of access to sensory input lead to a loss of responsiveness of the auditory system? When? To what degree?

"If you perform an implant on a very young child, the speech will sound very normal, but if you do it on a child that is 5, 6, 7 years of age - nobody knows for sure where the cut-off is - the speech they develop will be more like a person who has a hearing impairment."
Dr Simon Parisier, Manhattan Eye and Ear Hospital

Spoken language development needs to be placed in the wider context of 'language development', but it is still legitimate to look at spoken language itself.

How do we 'measure' success in relation to spoken language?

Potential (expected) link between speech perception and speech production.

Possible to have specific measures of speech perception, for example:

• detection and discrimination of speech sounds: phoneme discrimination;
  
• closed set word identification
  
• open set word recognition

Note:

We need to explore the relationship between 'perception' and 'comprehension';

We need to focus not just on segmental patterning, but supra-segmental.

Spoken Language Production

The gap between assessing 'communicative competence' and measuring 'countable' forms, eg, numbers of morphemes, SVO structures, 'function words', word classes, etc.

Use of assessments of conversational interaction, pragmatic intent, functional variation...

Can the child use language for a range of purposes in a range of environments?

Some Dangers

• Reverting to outdated 'speech training' methods;
• Giving contradictory messages to parents and professionals.

"Many professionals admit it is often difficult to keep parents' expectations in check. The device is not a miracle cure for deafness, they warn, and while many children show significant progress with cochlear implants, the successes are built upon years of intensive speech and language therapy and unflagging parental commitment."
Neumann, 1997

Exploring/Facing up to the tensions and inconsistencies(?) within current guidelines, for example, in the statement from teachers of the Deaf who work in Cochlear Implant Centres: BATOD Magazine, March, 1998

Promoting Effective Use of a Cochlear Implant System

Implant Centre Teachers of the Deaf - January 1998
The primary purpose of a cochlear implant is, as with any hearing aid, to provide access to sound. Thereby, the deaf child's potential to develop, internalise or retain spoken language(s) is enhanced. For the majority of profoundly deaf children with cochlear implants, the aim is to give them the opportunity to develop the use and understanding of spoken language to the best of their ability.

Consistency and reinforcement of cochlear implant use in the home, the school and the implant centre are vital. At all appropriate times, the child needs to wear the speech processor set at optimum levels with retuning as necessary provided by the implant centre. Adults in frequent contact with the child should be familiar with the function and maintenance of the system and be able to carry out regular checks. Consistent information regarding expectations and communication mode should be provided by the implant centre to the family and all those involved with each child.

While it is recognised that deaf children should have access to visual modes of communication, in order to maximise the potential of cochlear implantation, they should be in an environment where they are constantly exposed to spoken language in meaningful contexts. Staff supporting these children should therefore actively promote the
use of spoken language.

If children have already acquired language through sign, whether via a Bilingual or Total Communication approach, this should not be suddenly withdrawn or abandoned, but needs to be part of a flexible and changing approach to communication according to the child's new needs. The signing used to support speech should correspond to the word order of spoken language.

Maximising the use of a cochlear implant in the long term should empower the child to have the choice to use spoken language in communication.

New technology