Restoring a Sense: The Cochlear Implant and Accessibility in a Hearing World

With the majority of people on Earth having no problems with hearing, it’s unsurprisingly difficult for those who have different levels of hearing to navigate a world that is centered around the requirement of being “abled” in all five senses to live most comfortably. Being deaf or hard of hearing is fairly common globally, with 20% of the population experiencing it. Also, it’s entirely plausible and not unusual for anyone to become deaf or hard of hearing, even if they are born hearing. The WHO illustrates that this 20% is more than 1.5 billion people who live with hearing loss, with 430 million of them having disabling hearing loss–I’m included in that 430 million, being profoundly deaf in both ears. 

For those who are profoundly or severely deaf in both ears, we have two options, which are either to be implanted with cochlear implants or to communicate through American Sign Language (ASL) while living as a (D/d)eaf person. While the National Institute of Health states that cochlear implantation has become the standard of care for deaf children, it does not mean it is as accessible as some may think: lack of quality insurance can make it immensely difficult to pay for the surgeries and implants themselves, and it’s possible that someone’s ear biology does not allow for an implant.

Now, what is a cochlear implant, exactly? Many people confuse cochlear implants with hearing aids, but there is a very important distinction between the two. Hearing aids only amplify sound in ears that can hear partially, while implants pick up sound in place of a functioning ear for the brain to process. They have two components: the internal implant and the external sound processor that is worn on the ear. The internal device is made of a magnet receiver attached to a string of electrodes that is wound through the spiral of the cochlea, which is what sends sound to the brain (this is why, when people lack a cochlea in their ear(s), or their cochlea is deformed, it is not possible to receive a cochlear implant). The external processor has a small microphone, and the transmitter is also magnetic in order to attach to the receiver. 

All of these intricate parts of the device only emphasize how the cochlear implant is an incredible invention–it was the first creation that actually restored a sense. The person who developed the first successful single-channel implant was William F. House in 1961, who spent 27 years working on it. The single-channel implant was not perfectly functional as a hearing device, however, because cochlear implants require multiple channels (with groups of electrodes assigned to different channels) to pick up on all the nuances of sound. In the years that followed, the implant was only further improved, and presently there are one to two million implanted individuals, including myself, worldwide. 

Personally, I’m very appreciative of being implanted with cochlear implants. I love being able to use my processors to stream music through Bluetooth and take them off at night to sleep in peaceful silence. Also, the ability to hear is pretty much the best part. As a cochlear implant user, I see an audiologist about every year and a half for mapping, which tests my hearing to see if I need to change my programming to improve how I process sound. Because everyone with cochlear implants has to do this on occasion, it means that there is no “standard” on how someone implanted hears sound – we all hear differently at different levels of aptitude. 

While cochlear implants are amazing, and I’m immensely grateful for them, there are absolutely challenges we face, and these challenges are fairly similar to what hard-of-hearing people experience. In noisy environments, discerning what someone is saying is incredibly difficult, and in general, enunciation in regular speech is a must for the best understanding. For the (D/d)eaf and hard-of-hearing community as a whole, closed captioning is required for comfortable viewing of everything. In my experience, I’ve never liked going to movie theaters or plays/musicals due to their lack of captions or having captioning technology that doesn’t work. Even with improved integration of deaf people into the “hearing world” with cochlear implants, it’s clear there is still much work to be done to increase accessibility for all (D/d)eaf and hard-of-hearing people, such as captions, quality and accessible ASL interpreters, and supportive schooling (which I’m fortunate to have at Bush). Typically, Deaf people who do not have cochlear implants and only communicate through ASL are often left behind in comparison to their implanted and hard-of-hearing counterparts, and we must work as a whole to make sure all of the community is recognized and accommodated—we take up 20% of the population, after all.