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Mauldin, L.Made to Hear: Cochlear Implants and Raising Deaf Children. Minneapolis: University of Minnesota Press. 2016. 215pp. $87.50 (hbk) $25 (pbk) ISBN 978‐0‐8166‐9725‐0

2017; Wiley; Volume: 39; Issue: 5 Linguagem: Inglês

10.1111/1467-9566.12555

1467-9566

Kristin Snoddon,

Hearing Impairment and Communication

I am a deaf researcher who works with hearing parents of deaf children, the same group featured in Laura Mauldin's Made to Hear, so I read this book with great interest. This book is a sociological, ethnographic study of a cochlear implant clinic and surrounding sites, including family homes, school programmes and parent support groups. Mauldin chronicles what she categorises as the five stages of identification, intervention, candidacy, surgery and long-term follow-up care that parents undergo both before and after their children receive cochlear implants (these phenomena form the basic structure of her book). The children themselves serve, in the author's words, as ‘just placeholders – talked about, referenced, and for whom decisions are made’ (p. 155). Beginning with the diagnosis of impaired hearing via newborn hearing screening, Mauldin suggests that parents are ‘socialized into the medicalized script of deafness’ (p. 27). Such a diagnosis triggers what Mauldin calls, throughout the book, ‘anticipatory structures’ that facilitate medical interventions, including but not limited to a cochlear implant. However, Mauldin does not offer a critique of newborn hearing screening as a form of population screening with links to eugenics. Indeed, the infant hearing screening project is the means by which the near-universal cochlear implantation for deaf children is mandated. Despite arguments that its rationale is to prevent language delays, the screening has never been linked to improved sign language programming for deaf children or their parents. In her first chapter, Mauldin chronicles parents’ and audiologists’ experiences of referral to an auditory brainstem response test as a follow up to newborn screening. The challenging and stressful nature of this test, where infants must remain asleep for prolonged periods, is a prelude to the anticipated grief of diagnosis and further ‘emotional labour’ (p. 37) that awaits parents of newly identified deaf children. The next chapter describes the early intervention stage, which is intended to ‘socialize parents into their new social role as auditory trainers’ (p. 59) for their children. The parent support group meetings described here highlight participants’ assumptions about signing deaf people as inept, alone and dependent. Nonetheless, there is no critique by the author of the absence of deaf professionals from early intervention systems and a further limitation of this book is its inaccuracies over deaf history and deaf education. These range from minor – as when the author calls the noted American educator of the deaf Thomas Hopkins Gallaudet a ‘Parisian’ (p. 136) – to more egregious errors, as when she conflates total communication educational programmes (which follow a monolingual philosophy and utilise signed English) with bilingual education for deaf learners. Moreover, the author does not critically analyse a common theme in early intervention discourses that parents of deaf children are unable to master sign language as a second language. These discourses dominate in early intervention contexts for deaf children, despite there being no research basis for these claims and no outlay of resources for parents’ sign language learning to match the investment in cochlear implants. As such, the book misrepresents what could be more available to deaf children who can grow up bilingually in a signed and spoken/written language. The third chapter, about candidacy for cochlear implantation, is compelling in its description of the social criteria that affect whether children are referred for surgery. Information about families’ race, ethnicity and socioeconomic status has been largely erased from longstanding debates about cochlear implantation but, at least in the US context of privatised healthcare, these factors play a large role in determining which children receive cochlear implants. Middle-class, standard English-speaking white parenting styles align well with the practices and normative ethos of the clinic. These parents also have more resources to perform the work of what Mauldin often calls ‘scientific motherhood’ demanded by the years of auditory training post-implant. The chapter titled ‘The Neural Project’ is also compelling in its description of how deafness has been reconfigured into a neurological condition whereby the cochlear implant and subsequent training are prescribed as treatment and exposure to sign language presents a risk. Although a cochlear implant provides 24 electrodes in place of the ‘tens of thousands’ (p. 114) of hair cells that communicate signals to the brain in normally hearing people, the device itself is not seen as fallible. Rather, it is the children and parents who are implicated for not working hard enough when speech and hearing outcomes are perceived as falling short. The descriptions of configuring cochlear implants, or ‘mapping’, for individual children who cannot communicate what they hear are disturbing due to parents’ accounts of their children's subsequent behaviour. As one parent participant reported a month after her child received a cochlear implant and enrolled in an auditory-oral school programme, ‘Lucy is almost five years old, and she just started shitting her pants. That's something psychological’ (p. 117). The descriptions of children deprived of communication at home and school raise the uncomfortable idea that normative structures in early intervention, at times, can produce forms of social violence. Mauldin's book indicts signing deaf communities as ‘ableist’ because they self-identify as linguistic minorities rather than disabled. Yet after reading this detailed and gripping account of the childhood cochlear implant project, I find myself longing for some suggestion of disability as desirable; as something that can possibly make parents’ and children's lives better and more rich than the normalist script affords. What moments of freedom might we live if this were so?