The Process of D/Deaf Identity Development Among Cochlear Implant Users from Childhood to Emerging Adulthood: Evidence from South Korea

Background and Purpose: The number of children who receive a cochlear implant (CI) has dramatically increased over the last few decades. Pediatric cochlear implantation (PCI) can provide significant benefits in terms of increased auditory processing and spoken language. However, CIs do not replicate “normal” hearing, and children with CIs need to undergo intensive rehabilitation to develop auditory and spoken-language skills. CI users often experience challenges in developing their identities (e.g., negative self-images or confusion about whether they are D/deaf or hearing). Furthermore, PCI can profoundly impact the identity development of children with CIs by preventing them from learning and using sign language, learning about and integrating into Deaf culture, and forming a Deaf identity.
Presently, there is little empirical research focusing on the lived experiences and identity development of those who received CIs in childhood. By examining the retrospective narratives of their lives, this study aims to (1) understand how CI users develop their identities related to being D/deaf and (2) suggest implications for social welfare practices that can help CI users develop their D/deaf identities.
Methods: Multiple, one-on-one, in-depth biographical-narrative interviews were conducted with six Korean emerging adults in their early 20s who received PCI. Given the lack of empirical evidence on this topic, purposive sampling was used to increase diversity across gender, educational journeys, and other life experiences. During phase one of the interview, participants were asked to narrate their life stories as a person who received PCI without any interruptions from the interviewer. Later, follow-up questions were asked to examine further what had (not) been discussed. All interviews were audio-recorded and transcribed, as all participants used spoken language as their primary mode of communication. Categorical-content perspective analysis was used to code the data.
Results: Data suggested various mechanisms in the D/deaf identity development process among CI users. The process can be divided into two developmental periods: (1) before exploration (from childhood to early adolescence) and (2) after exploration (from late adolescence to emerging adulthood). In the “before exploration” period, three mechanisms were noticed. Participants first recognized the difference in hearing conditions between themselves and others. They experienced communication and learning problems and encountered prejudice, harassment, or discrimination. Five mechanisms were noticed in the second period, which began when they became interested in D/deafness or disability and explored it as part of their identity. The interviewees experienced various problems and encountered prejudice and discrimination as D/deaf people. However, they also experienced non-prejudicial and non-discriminatory beliefs and behaviors. Additionally, participants engaged with activities or communities related to D/deafness or disability.
Conclusions and Implications: Findings suggest that CI users develop their D/deaf identities in their own ways, but there are common mechanisms of D/deaf identity development among CI users. Social workers can provide CI users with developmentally appropriate support in various settings, such as facilitating family conversations around PCI, promoting a school culture where D/deafness and disability are valued, and providing CI users with opportunities to connect with D/deaf and disability communities.