In deaf culture, sign language is used in much the same way than any other ethnic language is used by homogenous collections of people, with only the difference that the former is express as sign and the latter with voice.
If one would meet a different ethnic culture and needs to express thoughts, one would use an interpreter to convey meaning and in sign, the same concept is relevant. Therefore, many of the signers have no use for sound and would use interpreters to express themselves.
Adults with normal hearing and then loss of hearing after full comprehension of communication have a fair opportunity to restore to the former, but those who from birth have been deaf may experience implants as irritating and / or ineffective. We must remember the potential of the brain organ which is the ultimate center of translation of all sensory stimulation. If this is not utilized, the ability to change designated functions to prevent decomposition, and thus a longer period of stimulation might be needed to rehabilitation if at all because of neural patterns vested in early life.
Implants can be categorized in three efficiency levels namely:
- very effective
- partially effective
- and not effective at all.
Realistic expectations relevant to results in that implantations are not a cure, but an added implement to normalize social interaction to the outside world is essential. Memory of comprehension of sound plays a crucial role in restoring functional communication and the lesser period to loss of hearing and restoration of sound impulses tends to enhance the success of the procedure.
Wikipedia referring to Member of Parliament Jack Ashley after 25 years of loss of hearing and receiving implantation in 1994 at the age of 70 and U S talk radio show Rush Limbaugh who both had a measure of success.
As mentioned before, a functionally auditory nerve needs to be present in the prospective implantee for the implant to be successful and this is normally established at the initial research on the patient. Less than 1% of researched deaf persons lack this viable nerve, and in these cases not all are lost. Technology and methods today make it possible to address this with an Auditory Brain stem Implant.
Cochlear implants in children are very successful, as a very high percentage of these implants function quite well. Almost all kids after implants hear well, but as in everything, this is not guaranteed for all. Success rates in very small kids are also of such a nature that this option is viable