The Lasker Awards, announced earlier this week, honored the developers of the cochlear implant. The Lasker is often called America's Nobel. It's a great tribute to these three scientists, and much deserved.
But I worry that despite the immense good cochlear implants have done for hundreds of thousands of people, this award may contribute to some existing misunderstandings.
Currently about 312,000 people world wide have cochlear implants, sixty percent of them children. A generation ago, these people would all have been profoundly deaf. As far as I'm concerned, that is an unalloyed good.
But I fear that this award may reinforce the notion many people have that the cochlear implant is a cure-all. I've actually had people say to me that yes, their hearing was getting worse with age but they didn't need a hearing aid -- they'd just get a cochlear implant when it got worse.
The is a serious misunderstanding of the efficacy of cochlear implants. First, with current technology, they are nowhere near as good at correcting hearing loss as a hearing aid. If you can benefit from a hearing aid, you will benefit far less from a c.i.
This may change as technology allows combination hearing aid-cochlear implant devices, but these are only now coming on the market.
Second, for most adults, cochlear implants allow for far from perfect hearing. As the Lasker announcement said, most people with c.i.'s can carry on conversations "in relatively quiet environments." This is a blessing, but most conversations don't take place in relatively quiet
environments. They take place in offices or on the street or at dinner tables with the family, not to mention on public transportation or at parties or in a car or taxi or in a hallway with people walking back and forth.
Cochlear implants are miraculous but they don't restore normal hearing, as all formerly hearing adult cochlear implant recipients, including me, know.
Implants are far more successful in children who are born deaf, if they are implanted when they are prelingual. Most surgeons prefer to implant the first device as 6 or 8 months and the second before the child is a year old.
One in a thousand children is born deaf, most to hearing parents. This means that parents have to make a difficult
decision in the first months of their child's life. This decision is
infinitely more difficult for parents who are themselves Deaf,
culturally Deaf, and using sign language. Cochlear implants remain controversial in the Deaf community.
So, cheers and congratulations to the winners. But let's not lose a realistic understanding of what cochlear implants can do.