The issue

Cochlear implant surgery on deaf infants and children is now widespread in Canada.

Our position

Cochlear implants do not lessen the need to provide every deaf child with the full range of options — including Sign language — for acquiring linguistic competence.

The Canadian Association of the Deaf-Association des Sourds du Canada is not concerned with decisions made by autonomous deaf adults to have cochlear implant surgery; we recognize that the implants may be of assistance to some adults, particularly those who have been deafened later in life. Instead, we focus on the success rates and ethical dimensions of cochlear implants in young deaf children.

The language learning situation faced by a young deaf child is completely different from that of a deaf, hard of hearing or deafened adult who has already acquired language. The difficulties faced by deaf and hard of hearing children in developing linguistic and social competence when exposed only to spoken language is well-documented. Language deprivation can cause academic failure, social stigmatization, and literacy problems. The opportunity to fully acquire a first language in the most natural and most easily-managed modality prevents language deprivation for any child; in deaf children, this modality is visual, and their first language is Sign.

Since our first position paper was issued in 1994, a number of studies have been completed regarding the benefits of Sign language in supporting auditory language acquisition for children with cochlear implants. This research has shown that cochlear implantation with only auditory language support or no support at all is insufficient to develop a first language. In order for deaf children to progress in their cognitive abilities, their literacy skills, and their acquisition of English/French skills, Sign language development in a bimodal/bilingual environment is needed.

For these reasons, the Canadian Association of the Deaf-Association des Sourds du Canada strongly asserts the right of all deaf children to acquire Sign language from infancy onward. The argument commonly made by proponents of auditory-verbal therapy and cochlear implants, that learning Sign language inhibits hearing and speech development in deaf children, is contrary to everything that is known about language acquisition and bilingual development. In addition, the presentation of Sign language and cochlear implants as being in opposition to each other by medical, audiological, and education professionals is a disservice to deaf children and their families. Children with cochlear implants, like other deaf children, will benefit from learning Sign language in early childhood.

Sign language establishes a first language in a pre-implanted child. The establishment of a first language prevents language deprivation. This in turn provides the child with linguistic building-blocks to support their bilingual education, with or without a cochlear implant. The child is thereby supported in their literacy skills development, their cognitive skills development, and their ability to express themselves in both the Deaf and the non-Deaf cultures.

We advocate for the right of all deaf children with and without cochlear implants to grow up bilingual and bicultural. Access to Sign language and the Deaf community provides the child with opportunities for his or her optimum development and participation in education, recreation and social and family life. To support deaf children’s access to Sign language, we call for the full involvement of Sign-fluent Deaf professionals in early intervention and education services provided to families of deaf children.

In addition, the Canadian Association of the Deaf-Association des Sourds du Canada calls for greater scrutiny of the financial profits and marketing schemes of cochlear implant corporations in Canada. The relation-ship between these corporations, provincial health ministries, children’s hospitals, and auditory-verbal therapy organizations remains shrouded. It is in the public interest for full transparency to be exercised in all dealings by these parties. The deaths and injuries of some deaf children who have undergone cochlear implant surgery are a reminder of the real and serious risks involved.

Deaf children with cochlear implants are an important part of the Deaf community. Regardless of individual background and choices, every Deaf person’s participation strengthens and enriches the Deaf community. The Canadian Association of the Deaf-Association des Sourds du Canada continues to advocate for the language and education rights of deaf children, including those with cochlear implants.

Recommended reading: “Language acquisition for deaf children: reducing the harms of zero tolerance to the use of alternative approaches”, by Tom Humphries, Poorna Kushalnagar, Gaurav Mathur, Donna Jo Napoli, Carol Padden, Christian Rathmann, and Scott R. Smith. Harm Reduction Journal, 2012, 9:16.

Recommended reading: “Cochlear implantation (CI) for prelingual deafness: the relevance of studies of brain organization and the role of first language acquisition in considering outcome success”, by Ruth Campbell, Mairéad MacSweeney, and Bencie Woll. Frontiers in Human Neuroscience, 2014, October 17.


The Canadian Association of the Deaf-Association des Sourds du Canada
606- 251 Bank Street
Ottawa, Ontario K2P 1X3
(613) 565-2882