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There is no question that cochlear implants work and work well for many profoundly deaf children and adults. The speech and language outcomes data published in the journals over the last two decades document quite extensively the benefits of cochlear implants using numerous behaviorally-based measures of speech recognition, speech intelligibility and language processing in children and adults who have received cochlear implants. In fact, it has been stated recently by Blake Wilson and Michael Dorman (2011) that the cochlear implant is "one of the great success stories of modern medicine" and that "the cochlear implant is the most successful neural prosthesis developed to date" and "exceeds by orders of magnitude the number for all other types of neural prostheses."
Despite these broad sweeping statements about the "efficacy" of cochlear implants as a medical intervention for profound hearing loss by Wilson and Dorman, there still remain a large number of clinical and theoretical issues that deal with the "effectiveness" of CIs that have not been successfully resolved yet despite many years of research on CIs. In this talk, we critically examine a number of "controversial questions" that deal with cochlear implants. We will not present any new findings or report any data from studies underway; instead, we will focus our presentation on why we have made so little progress in understanding the core foundational neurobiological and neurocognitive processing mechanisms that underlie the enormous individual differences and variability universally observed in speech and language outcomes measures in children and adults who have received cochlear implants.
We will consider some of the following unresolved issues: (1) age of implantation (AOI), (2) communications mode (OC vs. TC vs. ASL), (3) bilateral and bimodal CIs, (4) bilinguals, (5) poor-users, (6) multiply-involved (MIs), (7) behavioral predictors of CI outcomes, (8) speech-in-noise and mental workload, (9) family factors and family dynamics, (10) genetics, (11) indexical processing of speech, (12) very long-term outcomes, (13) learning & memory, (14) working memory dynamics, (15) neurocognitive (EOI) processes, (16) CI simulations, (17) environmental sound recognition and perception, (18) interventions using auditory training and perceptual learning, (19) music perception and (20) linguistic deprivation and ASL. These issues raise important controversial questions that are closely related to the nature of variability and individual differences in outcomes following cochlear implantation in adults and children.
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