Department of Linguistics, Swarthmore College, 500 College Ave, Swarthmore, PA 19081, USA.
Harm Reduct J. 2012 Apr 2;9:16. doi: 10.1186/1477-7517-9-16.
Children acquire language without instruction as long as they are regularly and meaningfully engaged with an accessible human language. Today, 80% of children born deaf in the developed world are implanted with cochlear devices that allow some of them access to sound in their early years, which helps them to develop speech. However, because of brain plasticity changes during early childhood, children who have not acquired a first language in the early years might never be completely fluent in any language. If they miss this critical period for exposure to a natural language, their subsequent development of the cognitive activities that rely on a solid first language might be underdeveloped, such as literacy, memory organization, and number manipulation. An alternative to speech-exclusive approaches to language acquisition exists in the use of sign languages such as American Sign Language (ASL), where acquiring a sign language is subject to the same time constraints of spoken language development. Unfortunately, so far, these alternatives are caught up in an "either - or" dilemma, leading to a highly polarized conflict about which system families should choose for their children, with little tolerance for alternatives by either side of the debate and widespread misinformation about the evidence and implications for or against either approach. The success rate with cochlear implants is highly variable. This issue is still debated, and as far as we know, there are no reliable predictors for success with implants. Yet families are often advised not to expose their child to sign language. Here absolute positions based on ideology create pressures for parents that might jeopardize the real developmental needs of deaf children. What we do know is that cochlear implants do not offer accessible language to many deaf children. By the time it is clear that the deaf child is not acquiring spoken language with cochlear devices, it might already be past the critical period, and the child runs the risk of becoming linguistically deprived. Linguistic deprivation constitutes multiple personal harms as well as harms to society (in terms of costs to our medical systems and in loss of potential productive societal participation).
儿童只要经常且有意义地接触到可理解的人类语言，就能在无需指导的情况下习得语言。如今，在发达国家，80%的先天性失聪儿童都植入了人工耳蜗，这使他们中的一些人在早年就能接触到声音，从而帮助他们发展语言能力。然而，由于儿童早期大脑的可塑性变化，如果他们在早年没有习得第一语言，他们可能永远无法完全流利地使用任何语言。如果他们错过了接触自然语言的关键时期，那么他们后续发展依赖于坚实的第一语言的认知活动可能会受到影响，例如读写能力、记忆组织和数字处理。在语言习得方面，除了口语方法之外，还有一种替代方法，即使用手语，如美国手语（ASL），在这种方法中，习得手语也受到口语发展的时间限制。不幸的是，到目前为止，这些替代方法陷入了“非此即彼”的困境，导致了一场关于家庭应该为孩子选择哪种系统的高度两极分化的冲突，辩论双方几乎没有容忍对方的余地，而且对双方观点的证据和影响都存在广泛的误解。人工耳蜗植入的成功率差异很大。这个问题仍在争论中，据我们所知，对于植入的成功，没有可靠的预测因素。然而，家庭经常被建议不要让孩子接触手语。在这里，基于意识形态的绝对立场给父母带来了压力，这可能危及聋儿的真正发展需求。我们所知道的是，人工耳蜗并不能为许多失聪儿童提供可理解的语言。当很明显，植入人工耳蜗的失聪儿童无法习得口语时，可能已经过了关键时期，而孩子面临语言剥夺的风险。语言剥夺不仅对个人造成多种伤害，对社会也造成伤害（体现在我们的医疗系统的成本和潜在的有生产能力的社会参与的损失）。
