The cochlear implant question

(aeon.co)

34 points | by Tomte 6 hours ago ago

51 comments

  • James_K 2 hours ago

    I feel like the narrative around disabled people has advanced to the point where some now insist that they aren't disabled. In reality, it's a pretty objective fact that being disabled means being unable to do something. It is a net negative on someone's quality of life. I'd be jolly pissed off if my parent decided not to get me an implant that enabled me to hear just because someone had told them that being deaf was actually the same as being able to hear. Give the kid the hearing aid, and if they don't like it they can take it out later.

    There are plenty of things where this "different, not worse" narrative holds up. Children with autism or ADHD might struggle in some ways, but be better off in others. It seems clear that there is no objective reason they are worse than a neurotypical person, so if a "cure" to these conditions was developed, you would have some degree of moral quandary. But someone without hearing is just objectively worse off than someone with it, the same way someone without legs is worse off than someone with legs.

    The last part is what really gets me about this. The child values the hearing aid so highly that they literally hug it as they go to sleep, and this is somehow presented as a "both sides are right" outcome. To me at least, that's a pretty conclusive endorsement that kids should be given these things.

  • sheepscreek 4 hours ago

    I like this pragmatism because it sheds light on the realities of life. People live their experience in a muddy grey world, which is far less crystal than any activist would like to imagine. Activism thrives on polarizing individuals and circumstances, more so off-late. We could call it politicization. Either way, I believe that it’s more harmful than helpful. That polarizing the PoVs of individuals makes them more apathetic for those that hold different views.

    The piece that was beautifully described by the author (paraphrasing) - “we can follow X while acknowledging that this isn’t how things should be, that it’s unfair - yet this is how the world is today”.

    On a similar level, but less consequential for sure, being left handed creates an additional step/mental block for individuals in a world that mostly defaults to right-handedness. I consciously nudged my own child towards being more right-handed for this reason, because I didn’t want them to have this additional piece to process on top of the already complex life they were going to have by likely inheriting my ASD.

  • dghughes 4 hours ago

    I'd certainly urge someone to get a cochlear implant. Deafness and even being hard of hearing carries a known increased risk of dementia.

    https://www.health.harvard.edu/blog/want-to-reduce-your-risk...

    • bkfunk 3 hours ago

      This is a study of people in their 70s. The vast majority of people with hearing loss in their 70s lost it late in life; they have no Deaf/HH community, they almost never learn to sign, and they often struggle to adjust for their loss of hearing.

      The study you linked talks about reduced stimulation, and in particular _social_ stimulation:

      > when an individual suffers from moderate to severe hearing loss, they are less likely to participate in social activities. Perhaps they are embarrassed about their hearing loss. Or they may simply find it unrewarding to attend a social event when they cannot hear what is going on.

      People who are born deaf/hh , or who lose their hearing early in life, if they are allowed to access and participate Deaf/HH communities and spaces, simply do not have any of these difficulties in social contexts within those communities.

      Martha’s Vineyard had an unusually high rate of congenital deafness for centuries [1]. It became a place where everybody, deaf and hearing alike, used sign language regularly. In such a society, being deaf was not a significant impediment to participating in social society at all; I am aware of no evidence that would suggest the dementia rates would be higher for the deaf residents just because of their deafness.

      A disability is only a disability in a given context; for some conditions (eg advanced ALS), they are disabling in almost all contexts, while for others (eg a food allergy), they are disabling in a relatively narrow set of contexts. The relationship to dementia is caused by the hearing loss mis-fitting the individual’s context; people with the same condition but different contexts would not be deprived of stimulation and therefore not susceptible to dementia in the same way.

      [1]: https://en.wikipedia.org/wiki/Martha's_Vineyard?wprov=sfti1#... (Martha’s Vineyard sign language is a major source for what became American Sign Language. The other was French Sign Language, which is why British Sign Language and ASL are quite different despite sharing the same local spoken language)

    • ibejoeb 3 hours ago

      That study seems to have found that there is an association between dementia and concurrent vision and hearing impairment in elderly adults.

  • paulryanrogers 5 hours ago

    > it is unarguable that only signed languages are easily accessible in all situations

    Even in the dark? Or at a distance? Or not facing the signer? Or with arthritis?

    Differently abled folks are entitled to their own culture and beliefs. Yet claims like that seem to be trying too hard to find a silver lining.

    • mezzie2 4 hours ago

      Or if you have to talk to a visually impaired person. My vision impairments are on the very mild end of the spectrum, but they're still enough to prevent any effective use of or learning of sign.

      • zie an hour ago
      • bluGill 2 hours ago

        I have "met" people who are both blind and deaf. They use sign language by putting their hand on the hand of the signer and follow that way. (I only know a couple signs so it wasn't worth trying to talk to them except via interpreter and so saying I've met them is a bit strong)

        This also is proof that sign language works in the dark.

        • mezzie2 2 hours ago

          ASL (and sign language generally) and tactile sign are two different languages, and language types that are at least as different as verbal languages and seen/sign languages - an American deafblind person who uses tactile sign and meets someone who uses ASL isn't necessarily going to be able to communicate with them. The signs and underlying language structure (morphology/syntax/etc.) are all different. I wouldn't consider the existence of tactile sign to mean that sign language works in the dark because they're two different language types, but the terminology is confusing and I have a linguistics background so I don't know if the author was including tactile sign or not. I'd guess not since it's about teaching his daughter who is d/Deaf, not deafblind, and tactile sign isn't in much use outside of the deafblind community. d/Deaf and blind people don't use it much, I believe.

        • Fire-Dragon-DoL 2 hours ago

          That is so painful to hear. Having those two disabilities at the same time cut you out of so much of the world

    • robin_reala 5 hours ago

      I’ve seen two signers on a train platform pause their conversation while one got on the train, then carry on through the window after they’d found a seat. While the article is hyperbolic, there are pros and cons to all modes of communication.

      • paulryanrogers 5 hours ago

        Right, I didn't mean to deny the advantages of signing. Rather point out some arguments are crossing over into absurdity.

      • cbsks an hour ago

        I went on a scuba dive trip with a couple of deaf people and I was definitely jealous.

    • throw894389 4 hours ago

      My deaf coworker does not even know sign language, she uses phone for everything. She lives perfectly normal life.

      Entire office is not going to learn new language, just to speak with an odd deaf person. And communicating specialized stuff like technical programming is not possible, gestures only cover basic words.

      • techsupporter 4 hours ago

        > And communicating specialized stuff like technical programming is not possible, gestures only cover basic words.

        I want to gently push back on this. While sign languages do have signs for common, “basic” words (ASL has a lot of 1:1 mapped signs for English), sign languages are languages. They can, and do, express “specialized stuff”.

        I have two coworkers who are deaf and they absolutely communicate specialized medical and technical concepts to each other and other people who use sign language. It’s amazing to watch them sign to each other, as someone who is only intermediate at ASL.

      • mapt 3 hours ago

        "Not possible" is a vast overstatement.

        We've negotiated imperial territory disputes and hired mercenaries on contract with pantomine. You get there eventually if you're motivated & creative. It's about how efficient using the language for that purpose is. If it lacks a lot of specialized jargon, that jargon needs to be unpacked into symbology that does exist in the language both people are trying to use.

        With any language learning, you revert to more basic forms in a sort of puzzle of "How do I say that?" if you don't have a deep exposure to the vocabulary. An elementary learner might use twenty words of clarification to be certain of communicating meaning where an expert uses six.

        With ASL, reverting to fingerspelling to bridge gaps in either person's vocabulary or in the existing corpus of well-known ASL vocabulary is also common.

        But fingerspelling and using long strings of basic words is painfully slow compared to higher bandwidth formats. If two people speak two languages, they can just pick the one that has the best mutual SNR, which allows for the most concise effective communication. Sometimes, that's going to be written text typed into a phone instead of ASL, and sometimes it's going to be the other way around.

      • bluGill 2 hours ago

        When you need to communicate something technical you finger spell what you mean once, and the you make up a sign on the spot for that one thing and use that sign there after. The next conversation you can make up a different sign for the same thing, or reuse the old sign. If a sign is used often enough it enters the common language.

        By doing such you can communicate anything technical.

      • EdgeExplorer 2 hours ago

        Sign language is not gestures.

        This is covered in (among many other places) the introduction to the Wikipedia article on sign language: https://en.wikipedia.org/wiki/Sign_language

        • tokai 2 hours ago

          Pedantic and wrong. What was your point here? Sign languages per your own link are expressed through manual articulation in combination with non-manual markers. That's gestures in common speech in all cases unless you are operating with the most specific and unhelpful definition of gestures.

      • zie an hour ago

        When I sign with other deaf programmers, we don't have trouble communicating with signs, even about technical programming.

        When I go to the doctor's office and someone interprets for me, I don't have trouble understanding the doctor.

        Please don't speak so assuredly about things you clearly don't understand. https://en.wikipedia.org/wiki/Sign_language

        I agree with the 1st sentence however. You don't have to know sign language to be content or happy with your life, even if you are deaf.

      • astura 4 hours ago

        >And communicating specialized stuff like technical programming is not possible, gestures only cover basic words.

        This part just absolutely and categorically untrue.

        I've personally witnessed people whiteboard code using only ASL on multiple different occasions.

    • vr46 3 hours ago

      At a distance works great, my friend (not deaf, but works in a school) taught her kids BSL (also not deaf) and recounted the story of how she was able to bollock the kids once in public across a hall.

      She also had no trouble ordering a drink from her boyfriend (not deaf) who was standing at the bar some way away in a crowded pub.

      Sign languages are indeed quite useful.

      The article seemed a bit straw man and whining, as well as recycling old ideas, such as letting groups isolate themselves from others, but I confess I was too bored to finish reading.

  • plondon514 2 hours ago

    As the hearing brother of a deaf sister with hearing parents, what I usually tell people is to learn sign language and get the cochlear. Forcing only cochlear on the child means that the family does not live in the deaf world with their child, while only speaking SL might distance them and cause them to miss out on a lot in the hearing world.

    It reminds me of basque spain, where everyone speaks catalan and some people continue to speak euskera at home or with friends they know can speak.

  • swalker326 4 hours ago

    I have two deaf daughters, both have cochlear implants and I’m very happy with the decision. My wife and I both learned sign, and let our kids wear or not wear their cochlear’s as they see fit. The youngest is too young to really understand but the oldest understands and almost exclusively selects to wear them. She is in main stream school but does spend time with her dhh friends. She 100% prefers to be with other dhh folks and sign, but likes being able to hear.

    All in all the decision is yours to make and people can weigh in or tell you what to do. We got a lot of hate from Deaf community members for going down the road of implants, but we also got a lot of support. There are hatful people in all walks of life. Do what you think is best and love your kids.

    • techsupporter 2 hours ago

      My niece was born deaf and her parents went the opposite direction: they chose not to have her get an implant because of the risk of surgery at such a young age and being fortunate to live in an area with a sizable deaf community. They took ASL classes (my spouse and I joined them) and she’s now enrolled in a mix of ASL and English interpreted classes.

      I agree that people can only make the decision with what they have at the time. After watching her grow up these last several years, her parents think they made the right choice.

  • zie 40 minutes ago

    “Blindness separates people from things; deafness separates people from people.” ― Helen Keller

  • pmarreck 3 hours ago

    I wrote a commandline app that takes a youtube URL (or path to any audio or video file that ffmpeg can read) and converts it into a transcript using the Whisper model and then optionally translates or summarizes it using OpenAI. It's been incredibly useful for chewing through my youtube backlog, but it might also be hugely useful for the deaf or hearing-impaired. It uses Nix to manage dependencies, although I got clever about making that not necessary (I don't like forcing Nix on people until they're ready for it)

    https://github.com/pmarreck/yt-transcriber

    This is mainly useful for single-speaker videos that are conveying information.

    Most other solutions out there that claim to do this only download the closed-captioning and summarize that, but MANY YouTubes do not have a good closed-captioning track, in which case my method still works. (Note: Aiming for Linux/Mac compatibility but have only tested it on Mac so far)

    I next want to convert it into a simple web service and/or perhaps Docker image to democratize this out to everyone. (I don't know if I'd be able to afford to host since the CPU/GPU cost for running Whisper on spoken audio is not insignificant, but it should work fine on anyone's local machine assuming they have the hardware for it.)

    I also want to add speaker identification (something called "diarization"), possibly by going to WhisperX or other solutions out there, which would make this more useful for multi-party conversation audio.

    In other news, I'm looking for contract work (I'm just doing side projects like the above to keep myself busy and, ideally, useful). My last job was Director of Engineering for a startup, but due to having a toddler I wish to remain work-flexible for the time being. https://www.linkedin.com/in/petermarreck/

  • poulpy123 4 hours ago

    as a foreigner, the language used is baffling (for example: "rarely addressed in moderate, bipartisan terms" that comes out of nowhere)

    • resoluteteeth an hour ago

      Bipartisan probably isn't quite the right word there

  • FollowingTheDao 5 hours ago

    Saying this as someone who is hearing but close to the deaf community in college and knows ASL. By trying to give her the best of both worlds she is going to diminish both worlds. Not fully in the deaf community and not fully in the hearing community.

    • saalweachter 4 hours ago

      This isn't really a conflict unique to membership in the deaf/hearing communities.

      You can be the kid who stayed on the farm or the kid who left the farm for the big city, but you can't be both. You can be the kid who spends half the year on the farm and half in the city, or the kid who went to the big city for twenty years before returning to the farm, but those are different things.

      We all only get one life to live. All we can do is try to pick a good path and enjoy the stories from people who picked different paths. A person who picks a hybrid path doesn't get to fully enjoy either path, but they do get to enjoy some of each, and they get to be the storyteller who tells the city kids about the farm and the farm kids about the city.

    • sarchertech 5 hours ago

      Who knows what the Deaf community is going to look like in 20 years when this kid is in college. Treatments for hearing loss are advancing and it’s likely that most of her peers will be in a similar position to her. 80% of deaf children born in developed countries receive cochlear implants.

    • keiferski 5 hours ago

      Do you think bilingual kids have the same issue? I don’t.

      • gyomu 4 hours ago

        If you spend time around bicultural people or 3rd culture kids you’ll find this is definitely an issue.

        Eventually most people figure things out and make the most of it in adulthood, but it definitely makes for teenage/young adult identity crises that monocultural people don’t have to deal with.

        • keiferski 4 hours ago

          I think you’re confusing two things: third culture kids who grow up in multiple places while not feeling at home in any of them; and bilingual kids that grow up in a smaller number of places/one place but still speak multiple languages because of their ancestry, etc.

          The former group has more issues fitting in, while the latter seem to be just fine. Certainly plenty of people in Europe speak more than one language natively and don’t feel like they lack a home. And it’s not like there is an actual country where only deaf people exist. So the idea of avoiding bilingualism seems totally absurd to me, especially when probably the majority of the world has some level of bilingualism by default.

      • robin_reala 5 hours ago

        The article talks about the capital-D Deaf community. It’s not just a different language, it’s a different culture.

        • keiferski 5 hours ago

          And people that speak say, Chinese and American English, don’t have two different cultures?

          • bluGill 2 hours ago

            Language does not make the culture. There are many deaf people who are not part of the Deaf culture. There are many people who have heard all their life but are also part of the Deaf culture.

            There are many different cultures in the US. Some are more similar than others. There is a Chinese culture in the US - as someone not part of it I'm content to call it one, but I'm sure those in it know of differences that I cannot see.

          • FollowingTheDao 3 hours ago

            Knowing ASL does not make me Deaf. And knowing Mandarin does not make me Chinese.

            • keiferski 2 hours ago

              Obviously my example was for someone that grew up speaking Chinese and American English natively, as in a person of Chinese descent that grew up in America. There are millions of such people.

              I think you're missing the point entirely.

        • sarchertech 5 hours ago

          Language facilitate access to culture. You think that Deaf culture is the only culture you can’t fully participate in without speaking the language?

          • watwut 4 hours ago

            It is more that there is strong vocal subgroup of the Deaf culture that sees participation in larger speaking community as betrayal.

      • FollowingTheDao 3 hours ago

        I texted this comment to my deaf friend (a graduate of Gallaudet University) and she said; "Not bilingual kids, but certainly immigrants from non-english speaking countries! Just go to any big city and you will see a thriving Mexican, Chinese, or Indian community!" And she suggested you read just one book on the Deaf Community before being so certain. Deaf in America or Inside Deaf Culture would be a good start.

        I will add that most people do not understand how divided the Deaf Community is about Coclear Implants. Least of all what you hear is not like what we would hear. It sounds like a robotic voice.

        https://journals.sagepub.com/stoken/rbtfl/3WBTL0klZP48Y/full

    • Almondsetat 4 hours ago

      The hearing... community?

    • Etheryte 5 hours ago

      An alternative framing would be that she gets to experience both to at least some extent, and isn't that better?

      • rincebrain 4 hours ago

        I think a lot of people who have their feet in multiple commonly "either/or" cultures have written quite a lot about the struggle to establish their own identity given those cultures framing many things in terms of, for lack of a better word, sole/primary membership.

        I'm not sure anyone can say better or worse, in a useful fashion, objectively - more options can also lead to more ambiguity and stress, as with anything in life.

        They're not wrong to say that by necessity, your experience is going to be different if it's defined in terms of choices made before you had agency, that are not mutable - your lived experiences are going to be very different if you cannot hear at all, and spent 10000 hours or w/e framing everything in your life around that, versus being able to hear.

        Unfortunately, I think absent something else, this will go the same way as most narratives of cultures where there are utilitarian reasons to not remain in it - people will often choose the route of most visible potential benefit, in these situations.

        Something more "ideal", in theory, would be if we could ignore critical periods, and just let people choose in adulthood to learn verbal language, but even that presents the problem that the majority dictates the "easy" option, and by nature, people who are not in that group will sometimes be the ones acting as sandpaper on rough edges in that interaction, as they're not as well-polished. (Look at all the government systems in the US that don't know how to handle more than the common "firstname lastname", for example.) So even that option presents the problems of utilitarian optimization resulting in rational actors just opting out of the more demanding route.

        e: Just to be clear, I'm not trying to say I think any of what I just described is "good" - I think homogeneity in human experience deprives everyone of enrichment in the variation of life. But I don't see a way to optimize for this where given the ability, a lot of people don't choose the lower-friction route in their lives.

        • FollowingTheDao 3 hours ago

          "Just to be clear, I'm not trying to say I think any of what I just described is "good""

          Yes, this has been the problem. Many in the Deaf Community do not see being deaf as "bad", but that is the label society has put on them.

          • Etheryte 2 hours ago

            I mean, why would they? It would only create negative emotions, but it wouldn't have any positive impact on anything. Feeling bad about a condition can be useful if it can propel you to improve the situation, e.g. if you're an alcoholic and you feel bad about it, you might stop drinking. But for conditions where it's out of your control and there is no cure, framing it as bad does not do any good. No one needs to wallow in self pity thinking oh if only I was born different, especially if they can lead rich and fulfilling lives.

            • bluGill 2 hours ago

              More importantly, by framing it as a thing (not good or bad just is) they can find ways around the issues. They can live their life just fine. Sure there are some things you cannot do without hearing, but there are more things to do in life than there is time anyway so there isn't a problem. You can't enjoy a symphony concert, but there are a lot of people who could do that yet don't. You can still enjoy a baseball game with those people, or if you don't like baseball - many others don't was well, just ...

  • cen4 5 hours ago

    Will just say, there are many different causes of Deafness. And therefore outcomes vary a lot depending on what the exact condition is. If the issue is with the auditory nerve for example, cochlear implants won't solve anything. And the whole debate can go in some other direction entirely.