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Sound and Silence

Of all the questions we wrestled with in the months following Geneva's diagnosis, the biggest one was whether to pursue a cochlear implant. A cochlear implant is a device that tries to do what damaged, dysfunctional, or missing hair cells cannot. It translates sound into electrical impulses that stimulate the auditory nerve, which in turn sends those signals to the brain. Its internal parts, which must be surgically implanted, consist of a receiver and a wire-like electrode array that is threaded into the cochlea. The external parts consist of a microphone that picks up sound, a processor (or mini computer) that digitizes the sound, a transmitter that fastens to the internal receiver with a magnet, and a battery to power the whole thing. The first experimental cochlear implants were tried in adults in the 1950s, '60s, and '70s. But the technology didn't really mature and become popular for deaf children until the last 15 years. It's still controversial among many deaf people, who don't see their deafness as a defect or something that needs to be fixed. (More on that later.)

The possibility of a cochlear implant for Geneva seeped slowly into our consciousness. At first we didn't really know what the device was or what it was capable of. Then we didn't know for sure if Geneva was a good candidate for one. People with Connexin-26 usually do well with cochlear implants, but if for some reason Geneva's cochlea was malformed or if, as happens on rare occasion, she was missing an auditory nerve, she might not be able to get one. In the early days of cochlear implants, surgeons would often discover such anomalies in the operating room. Today, sophisticated imaging techniques give doctors a clear preop look at a child's auditory anatomy. But we would need to wait until late October 2007, when Geneva was nine months old and her inner ear was more developed, for those tests. And according

While Geneva holds a wooden lion, her mom makes the sign for "lion." By the time she got her cochlear implant at 13 months, Geneva knew at least 60 signs and could sign almost 30 herself.

I'd hit emotional lows when I'd notice some small piece of life that I assumed would not be available to my daughter—like the sound of a bird call or the purr of a cat. But my grief was short-lived. I accepted and began to celebrate Geneva's deafness rather quickly, thanks in large part to our parent advisor from a state agency.

to FDA guidelines, she wouldn't be eligible for the surgery until she was 12 months old. (Children with less severe hearing loss may not be a candidate for an implant until they're even older. In only a very few circumstances are implants permitted before a child turns one.) In the

meantime, we had a lively, growing baby girl with whomwe desperately wanted to communicate.

It was Tami's job to introduce Christian and me to all the ways of communicating with deaf children. Some methods depend heavily on any hearing a child does have, plus or minus lipreading. Others depend on sign language, either American Sign Language (or ASL, an entire language with its own grammar), signed English (which uses many ASL signs but English grammar and word order), or cued speech (which uses hand shapes to represent phonetic sounds). Given Geneva's degree of hearing loss, and the futility of hearing aids, we all agreed that some form of sign

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