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Family Perspectives on Cochlear Implants
ghue, 2001; Zaidman-Zait & Most, 2005). Zaidman-
Zait (2007) found that families indicated they
expected more rapid progress in the first few months
following implantation. Such appears to be the case
in the current investigation as well; 67 percent of
parents (n 5 40) who responded to the current
survey agreed or strongly agreed with the statement
that ‘‘progress during the first few months’’ following
implantation ‘‘seemed very slow.’’
Services
Increased social interaction involving meaningful
sounds and more specific intervention in the child’s
home environment are recommended because only
38 percent of parents reported their child postimplant
‘‘participates in family activities more.’’ Simply
receiving a cochlear implant does not guarantee a
child’s increased participation. A child’s participation
should be facilitated by systematically teaching
families to provide opportunities for meaningful use
of auditory perception and oral language in natural
routines and activities. A child must have opportunities
to hear meaningful speech and language within
the context of communicative interactions.
Children need to be taught how to use auditory
skills in authentic environments. Examples of skills
needing to be taught include differing responses to
familiar speech, environmental sounds, music, and
unfamiliar speech; use of vocalizations/verbalizations
as communication, vocal inflection, and intonation;
and expansion of receptive and expressive vocabularies
(Bashinski, Stremel Thomas, & Durando,
2009). Forty-three percent of parents (n 5 26)
expressed ‘‘worry that [their] child might not be
receiving the support services’’ needed; 30 percent
(n 5 18) indicated their child has only ‘‘received
services from a speech/language pathologist who did
not have specific training regarding how to teach a
child to use a cochlear implant.’’ Responses such as
these, indicating parents’ concerns regarding the
frequency and/or quality of services their child is
receiving, indicate the need for service providers and
agencies to become more knowledgeable regarding
proactive strategies for meeting the needs of the
children with vision loss/blindness, motor disabilities,
and cognitive delay who have received a cochlear
implant.
Archbold, Nikolopoulos, & Lloyd-Richmond (2009)
documented noticeable changes in the use/nonuse
of a cochlear implant, child outcomes, and educa-
88 | AER Journal: Research and Practice in Visual Impairment and Blindness
tional placement for as long as 7 years after
implantation. Several studies investigating long-term
outcomes with children who are deaf only have found
that children’s communication mode changes significantly
over the long-term—even so much as 5 to
7 years postimplant (Archbold et al., 2009; Watson,
Archbold, & Nikolopoulos, 2006). These findings are
in stark contrast to this survey’s finding that 38
percent of respondents (n 5 23) indicated their child
received no services related to learning to use the
implant only 3 years postsurgery.
Process of Implantation
Although 88 percent of families in the current
study indicated ‘‘it was easy to get a referral from
[the] child’s doctor to the implant center’’ (n 5 53),
12 percent of families experienced some difficulty
securing a referral. It is also important to note that 13
percent of respondents (n 5 8) had difficulty finding
an implant center that would implant their child; this
finding was reinforced by a number of families who
communicated informally with the researchers. From
results of this survey, it cannot be determined
whether various implant centers had different criteria
for implantation, or if they were simply hesitant to
implant children with multiple disabilities.
Berrettini and colleagues (2008) found that almost
all (96 percent) parents/guardians of the participants
(deaf with additional disabilities, but no mention of
vision loss) indicated that, given the option to implant
their child again, they would chose to do so. The
results of the current family survey showed slightly
lower results, with 85 percent of respondents
indicating they would chose to seek an implant for
their child again.
Implications for Daily Use
Survey findings confirmed through direct communication
with participating families emphasize
that parents need more effective strategies for
ensuring the implants stay in place on their children
who have motor challenges/cerebral palsy. Thirtyfive
percent of respondents (n 5 21) agreed or
strongly agreed with having ‘‘trouble keeping the
implant on [the] child because of…motor disabilities.’’
For those children who voluntarily take their
implants off, as reported by 24 parents (40
percent), more systematic procedures are needed
to help them learn to tolerate, and perhaps even
enjoy, wearing the device.