Academic journal article American Annals of the Deaf

Great Expectations: Perspectives on Cochlear Implantation of Deaf Children in Norway

Academic journal article American Annals of the Deaf

Great Expectations: Perspectives on Cochlear Implantation of Deaf Children in Norway

Article excerpt

THE AUTHORS DESCRIBE the use of cochlear implants with deaf children in Norway and examine how this intervention has raised new expectations and some tensions concerning the future of education for deaf students. They report on two studies of communication within school learning environments of young children with implants in Norwegian preschools and primary/elementary schools. These studies involved observations of classroom discourse and teaching activity and interviews with teachers, administrators, parents, and pupils. Results suggested varied patterns of use of Norwegian and of Norwegian Sign Language and several modes of communication, including speech alone, sign alone, and speech with sign. Conclusions are drawn regarding the reasons for the observed variations and the future impact of cochlear implantation on educational policies and services for deaf children and their families in Norway.

People were overwhelmed with amazement. "He has done everything well, " they said. "He even makes the deaf hear and the mute speak. "

MARK 7:37 (cited in Norwegian Directorate for Health and Social Affairs [2006], p. 1)

The use of cochlear implants with young deaf children has accelerated over recent years to a point where many of these children are fitted with single or bilateral implants in their first year of life (Hyde & Power 2006). This process has been considerably aided by the widespread implementation in most developed nations of programs of universal newborn hearing screening, or UNHS (Yoshinaga-Itano, 2003). These programs have the capacity to identify the nature and degree of hear- ing loss in the first few weeks after birth (Morton & Nance, 2006). Audio- logical and neurological processes fol- low diagnosis to ascertain the best possible candidates for implantation, with surgery taking place for many children with severe or profound hear- ing loss sometime in the first year after diagnosis. Many major benefits of ear- lier diagnosis and implantation have been reported (Fitzpatrick, Durieux- Smith, Eriks-Brophy, Olds, & Gaines, 2007; Yoshinaga-Itano, 2003; Yoshi- naga-ltano, Sedey, Coulter, & Mehl, 1998), but other outcomes have also resulted that require major changes in how deafness in young children is ac- commodated by policies and service systems, including those for education (Thoutenhoofd, 2006; Young & Tattersall, 2007).

Of note is the need for families to deal with the diagnosis of their child's hearing loss at an earlier age, when there has typically been no previous suspicion of hearing loss. The important process of relationship building between parents and infant may be disturbed by the real or imagined consequences of a hearing loss for their child, for them, or for their aspirations for their child. As Young and Tattersall (2007) have suggested, early identification is of little value if it is not combined with services designed to assist families in utilizing the potential time advantage that has been gained.

Much of the information that parents acquire about deafness and implantation, and about conditions for a deaf child's development, is received directly from health or education professionals associated with the referral process after newborn hearing screening has occurred. Parents are placed in a situation in which they are required to make early decisions about implantation and how to conduct their interactions with their child to form relationships and develop learning to enhance the child's opportunities for communication, socialization, and cognitive development.

As well as the contexts of individual families, there are the broader political, social, cultural, and educational contexts in which decisions are made and services are provided. Decisions about the child's development and future are made in dynamic personal, familial, and emotional contexts that are embedded in the political and policy traditions in health, social development, and education that a nation provides for its citizens. …

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