The Communication Journey

How does communication change before and after implantation?

Linda Watson from the University of Birmingham and Tim Hardie, parent of a deaf child, worked with Sue Archbold and Alex Wheeler on a study, funded by the NDCS, which used written questionnaires and face to face interviews to look at the changes which take place in communication following cochlear implantation.

Parents of children implanted for five years or more on the Nottingham cochlear implant programme were sent a questionnaire asking about the way in which their child communicated before implant and how they communicate now. We wanted to know if change took place and why.

A high proportion of the children were using sign language prior to implantation but five years following implantation there is a clear switch to greater use of spoken language.

In just a few cases there was a switch in the opposite direction from using mainly spoken language to a greater emphasis on sign language. This reflects instances where, for whatever reason, oral language skills failed to develop after implantation.

Parents said that they wanted to use the most effective communication (84% agreed strongly with this), the language which was most likely to be useful to their child in the future (71% agreed strongly with this).

The Communication Journey

In the final part of the study, the children in the study were sorted into three groups -those who had shown no change in communication mode following implantation, those who had shown a degree of change and those who had shown great change. We randomly selected 12 families from these groups and asked them to take part in a follow up interview along with their local teacher of the deaf and implant centre teacher of the deaf.

Before implantation, parents choose the most effective means of communication. Gradually there is a change from more emphasis on sign communication to increased use of speech; this mostly follows the child as they develop spoken language and drop the signs which they no longer need.

Later the young people may choose to take up sign language again to communicate with deaf friends and to develop their sense of identity.

Results from this study showed that implanted young people are often flexible in their approach to communication mode, switching between sign and speech according to the situation which they find themselves in.


This work has been published in two papers:

Watson, LM, Archbold, SM, Nikolopoulos TP. (2006) Children’s communication mode five years after cochlear implantation: changes over time according to age at implant. Cochlear Implants International 7 (2) 77-91

Watson, LM, Hardie, T, Archbold, SM, Wheeler, A. (2007) Parent’s Views on Changing Communication After Cochlear Implantation. Journal of Deaf Studies and Deaf Education.

Wheeler, A, Archbold, SM, Watson, LM, Hardie, T. (2009) Children with cochlear implants: The communication journey. Cochlear Implants International March 2009 Volume 10 Issue 1 pages 41-62