Communication Choices, Identity, and Outcomes in Children with Cochlear Implants

Abstract

Early detection of hearing loss leads to early intervention-related decisions. For most parents of children with cochlear implants (CIs), access to oral communication and the ‘hearing’ world, is a priority. Disagreement between professionals around using a visual language make it difficult for parents to decide between an ‘oral-only’ or ‘bilingual/bimodal’ approach, for fear that either decision may negatively affect their child. In theory, deafness can be regarded as a social construct. Language plays a significant role within culture and, according to social identity theory, may influence children’s d/Deaf identity development. The research used a mixed-methods design to identify factors influencing parental decisions around language choice, child’s d/Deaf identity, and children’s outcomes in self-esteem, social skills, academic competency, and oral language. Phase 1 comprised semi-structured interviews with 14 parents, 13 teachers, and four adolescents. Three main themes were identified: parental perspectives on deafness (‘disability’ vs. 'variant of normal’), Family cultural affiliation, and resources available. A model of d/Deaf identity was developed based on parental attitudes to deafness, mode of communication chosen, level of family involvement within the Deaf community, and access to resources. These influence the child’s ‘Bicultural’ development. Phase 2 comprised the development of a questionnaire to assess the model, based on findings from Phase 1 and relevant literature. Twenty-seven parents of children with CIs completed the questionnaire and the model was revised based on findings. Parental attitudes to deafness influenced children’s Bicultural identity, via access to Deaf-related resources and Deaf community involvement. The association between children’s outcomes and their level of Bicultural identity was explored. No evidence was found for an influence of Bicultural identity on standardised measures of oral language, or parent-reports of academic outcomes, social skills, or self-esteem. This contributes to the debate around using a visual language in addition to oral language, by suggesting it confers neither an advantage nor a disadvantage in these outcomes. Rather, it is a cultural matter (i.e., whether the parents prefer the child be raised Biculturally or Hearing acculturated). For those wishing to raise their child Biculturally, access to deaf-related resources and Deaf community involvement is important.