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Cochlear Implant

[Japanese]

last update:20160324


General Information

A cochlear implant is an artificial organ/medical aid device that was developed for people among those, who have sensorineural hearing impairment or deafness of such severity, that using hearing-aid is not effective for neither of the ears, who have a disability in the internal ear (please refer to below concerning eligibility standards for surgery of cochlear implant). When the hearing impairment is severe and the problem resides in the internal ear or deeper, the effectiveness of hearing-aid is very limited. Cochlear implant, on the other hand, which consists of an electrode embedded in the internal ear that sends audio information to the nerve center by electrically stimulating the acoustic nerves directly, has given a hope to those among people, who have completely lost their hearing ability, whose disability is in the internal ear.

The history of cochlear implants started with research and experiments (surgeries) around 1960 in Europe, the U.S. and Australia, the first international academic congress on the technology was held in the 70s, and around that time the technology began to spread across the world. There were attempts to develop multi-channel devices with a number of electrodes, but due to technological problems, initially experiments were conducted with single channel devices only. The endeavor encountered a setback though ? the experiments showed that although single channel method that employs just one pair of electrodes to stimulate all the acoustic nerves that carry different frequencies in bulk can, in fact, make the sound heard, there is a limit to what this method can do to enable the implantee to recognize language information. The solution to the problem was found when Professor Clark of the Melbourne University, Australia, made a successful surgery on an adult with post-lingual deafness implanting a trial model of a 10-channel cochlear implant in 1978, and in the early 80s, clinical trials of 22-channel cochlear implants were carried out all over the world. In the mid-80s, U.S. Food and Drug Administration approved the 22-channel cochlear implant developed in Australia by the Cochlear Ltd. for commercial use. Since that time, the number of people using cochlear implants centering on the Nucleus 22 (N22) developed by an Australian company called Cochlear Ltd. has been increasing. At first, there were many aspects of the technology, which were inviting doubts and suspicions regarding use of implants for children, but as the efficacy and the safety of the treatment gradually became an established fact, more and more children in Europe, America, and Australia started to receive cochlear implants and in the 90s there was a rapid increase surgeries giving cochlear implants to children.

In Japan, since the 1980s, several adults with post-lingual deafness received single-channel cochlear implants, and in 1985, the first 22-channel cochlear implant manufactured by Cochlear Ltd. was received by an adult. In 1991, several surgeries were conducted on children (among which there were children of 10, 8, 7 years old), and in 1994, the treatment was approved for coverage by the national health insurance. Compared with other countries, Japan was very cautious regarding adoption of this technology for children, and there was no rapid increase in the number of children using cochlear implants, but since 1998, when Oto-rhino-laryngological Society of Japan announced the minimal age for cochlear implant surgery as two (the standard was revised in 2006 making the minimal age 1 year and a half) the number of children receiving cochlear implants has been increasing little by little. Moreover, after a system of screening for hearing loss of newborn infants (Note 5) was launched by the Ministry of Health, Labour and Welfare in 2000, it made possible to detect hearing impairment earlier, and with a larger number of infants diagnosed with hearing disabilities, the number of parents and children deciding on cochlear implant surgery at an early stage also increased.

Since the late 1990s, manufacturers other than Cochlear Ltd. started to make inroads into the Japanese market (Bionics (U.S.), MED-EL (Austria)), and as a result of appearance of new models, which was made possible through development of technology at the respective companies as well as the diversification of the speech processing methods (codification), hearing accuracy also improved.

As can be seen from the above, although the history of cochlear implants is very short, they have come a remarkably long way. One recent development in Japan is the increase of people receiving implants for both ears (which is not uncommon in other countries). As for points of interest common across the world, one is the new 'hybrid' technology using a hearing-aid and a cochlear implant at the same time, with hearing-aid being used for low-frequency sound region, which the recipient of the technology can still hear, while the high-frequency sound region, which is no longer audible due to disability, is covered by nerve simulation by a cochlear implant. Another point worth mentioning is the constant increase in the number of people receiving the implants. By 1983 (the 10th anniversary of the International Conference on Cochlear Implants), the number of people, who received cochlear implants across the world, has reached 1000 (at the time, the percentage of single-channel implants was larger, but in 1987, 3M Corporation (U.S.) discontinued the single channel cochlear implants, which resulted in a decrease of people using single-channel implants, as it seems that some users underwent surgeries to receive multi-channel implants; in Japan there were eight people with single-channel cochlear implants, but some stopped using them, some underwent further surgery to receive an N22; there is no reliable data regarding the number of people continuing to use singe-channel implants), and by 1992, the number of people, who received cochlear implants across the world, has exceeded 5,000 (of which over 30% were people, who received the implants during childhood (under 18 years of age)), the number in Japan has reached 161 (with those receiving implants in childhood accounting for less than 10%), and by 2003, numbers increased to about 70,000 across the world (50% of which are children) and 3,000 in Japan (approximately 30% of which are children). Recently, the numbers have been showing an even more rapid increase with global number as of the end of fiscal 2007 reaching 140,000 (about 50% of which are children), 157,000 people by October 2009, and approximately 200,000 people by August 2010, while in Japan as of the end of fiscal 2007 the number reached 5,200 (about 39% of which are children), 5,700 people by October 2009, and about 7,000 people by August 2010. Initially, the proportion of children using cochlear implants was lower in Japan that in other countries, but recently, as the figures in 2010 show, the proportion of children increased reaching about 40% of the whole. It is widely presumed that in the future, the percentage of children (and people using implants from childhood) will be larger than that of adults (and people using implants after they reached 18).

Probably, this also reflects the technological improvements (both of the equipment and of the medical care) surrounding cochlear implants, and the increased trustability of the safety measures available. Also, the past violent critique of use of cochlear implants by children has subsided. At the same time, however, we have to understand that making a decision on cochlear implant surgery during childhood is an important problem related to the outlook on life and on disability for both the child and his or her parents, the problem of coming to terms to non-ability to hear, either by trying to adapt to the society constructed around vocal communication that requires hearing capabilities or by living a life with sign language as one's native/mother tongue, proud of one's deaf culture. Today, as the minimal age has been lowered to one year and a half and the number of two-year old children with cochlear implants is rapidly increasing, what is needed is a prudent attitude of the parents, who make the decision regarding the surgery for their small child, the child who cannot yet make decisions him/herself, as well as appropriate and ample provision of information by all those surrounding the child with hearing disability and his or her parents.

Classification, etc. of Cochlear Implants

As was explained above, cochlear implants can be classified into single-channel ones (with just one stimulating electrode), which was the main type developed at the initial stage, and the multi-channel ones (with 4 to 22 electrodes), and from the earliest stages of development, it has been thought that multi-channel implants would be more effective. In the West, people related to the technology well know the four-channel technology developed in the Utah University and Vienna University, but the effectiveness of the multi-channel method over the single-channel one has been finally established using the 22-channel implant created in Melbourne University. This implant was jointly developed by scientists together with the Australian Nucleus Ltd. (the present Cochlear Ltd.) and the device earned a particularly high reputation and became popular all over the world. The first cochlear implant was used in Japan in 1980, and was of the single channel variety, but the first multi-channel cochlear implant, which came to Japan in 1985, was a 22-channel device developed in Melbourne. And today 70 percent of cochlear implants used in the world are developed in Melbourne and produced by the Cochlear Ltd. Other popular versions are implants made by Bionics (U.S.) and MED-EL (Austria).

As was described so far, at one point, single channel cochlear implants were also used, but, due to safety concerns and decreased effectiveness in terms of the hearing ability enhancement they offer, by now people using such devices constitute a very small percentage of the implantees. Therefore, here we will only look at the structure and functions, efficacy and problems, and applicability criteria of the multi-channel cochlear implants.

Structure and Functions

A cochlear implant contains two parts, an external part that converts language information into electric signals and conveys it to the internal part, and an internal part implanted beneath the skin and consisting of a receiving antenna and electrodes of little over 10mm long, which connect it to the transmitter.

(1) External Parts
1. Microphone: sends sound information from the outside to a speech processor
2. Speech Processor: a device that plays the role of the cochlea determining for each sound how to send electric current to which electrode and stimulate the primary auditory nerve. In addition to the portable devices, which have been around for some time, there is a miniaturized version that can be hung over the ear now.
3. Transmitting Coil (Antenna): an antenna, which conveys the audio signals processed by the speech processor to the receiving coil beneath the skin. Using a magnet, it is fastened close to the receiving coil hidden beneath the skin.

(2) Internal Parts
1. Receiving Coil: a loop-shaped part of the device hidden under the skin and attached with a magnet to the transmitting coil above the skin; receives the audio information and conveys it to the receiver/stimulator.
2. Receiver/Stimulator: the part of the device, which receives the audio information processed by the speech processor via the transmitting and receiving coils and conveys the impulses it to the electrodes located inside the cochlea. Is implanted and secured inside the temporal bone, in which a hole is made for that purpose. Despite the efforts to miniaturize this part, it is still several millimeters thick and is covered by titanium and other materials to enable it to withstand external pressure.
3. Electrodes: are inserted into the scala tympani cavity of the cochlea, in which an oval window is created for that purpose. Number of electrodes differs depending on the implant model.

Efficacy and Problems

Even people, who became deaf after becoming adults, require rehabilitation to get used to the sound after implant surgery. In many cases, rehabilitation enables the implantees to even speak on the phone. In cases when the implant is received by people with severe hearing impairment with a hearing level of 90dB - 100dB or worse, adjustment (mapping) to enable them to hear sound in the 35-40dB range has to be made. In Japan, as the treatment is covered by health insurance, cochlear implant technology is a viable choice for those wishing to regain hearing, but quite a significant number of people hesitate before implanting a device, which certainly is a foreign substance, inside their body.

Another problem is that children with pre-lingual hearing impairment require not a rehabilitation of the kind needed by adults but a medical educative treatment for acquisition of language through hearing. Applicability criteria for surgery also differ between those established for children and for adults. And while in the case of adults decision to conduct a surgery according to the applicability criteria and the subsequent rehabilitation is comparatively easy, with children there is a need to be very prudent both when making the decision to operate and during the postoperative rehabilitation. Moreover, there is an opinion that when parents decide to go forward with the surgery, it is a 'human rights violation disregarding the child's right to self-determination', and, as we mentioned above, very careful attitude is required from the parents.

Archievements Made by Members of the Research Center for Ars Vivendi

TANAKA Takako 2014 "Impact of Introduction of Cochlear Implants on Deaf Education in Japan, 1970s-1990s", Core Ethics 10: 131-141 [Abstract in English]

TANAKA Takako 2013 "Transition of Understanding Cochlear Implant in Deaf Education in Japan", Ars Vivendi 6: 50-72

History of Cochlear Implants (in Four Periods, Data Rrelated to Cochlear Implants, Data Related to Hearing Impairments)

[1] Early History of Cochlear Implants
1800 Italy; The earliest report related to cochlear implant (Alessandro Volta, an Italian who developed the electric battery, connected batteries to his ears and heard a bubbling sound resembling water boiling.)

June 26, 1800 Great Britain; J. Banks, inspired by Volta's experiment, conducted an experiment inserting a metal rod into his ear, and announced his experience at an international scientific conference. He inserted a device comprised of 30-40 pairs of two-sets of electrified metal plates (a gold or silver one and an unleaded one for each pair) in both ears, then connected the end of a metal rod cord to the device, and reported that after the circuit was concluded, he was aware of noise-like sound. He reported that the sound resembled "something boiling or dough fermenting, of a cracking kind" and that "there were no big changes to it and it just continued", but that he felt a sensation that did not feel like it was good for the brain, so he quit the experiment.

Around 1850 France; Duchenne made an experiment stimulating his own ears with an alternating current he produced by a diaphragm made of a circuit containing a condenser and induction coil. He reported that "the sound was not a heavy one like boiling water, but a lighter one more like a grasshopper struggling and crying between a pane of glass and a curtain."

1878 Japan; Kyoto Blind and Dumb School, the first school for the deaf in Japan is established. Tashiro Furukawa studies the gesture communication naturally occurring between deaf children and devises the so-called shuseiho (gesture method; at the time was also called te-mane (hand imitation)), an original Japanese system of gestures that differs from that created in Spain, and educates children using shuseiho for communication.

1880 Abroad; During the 2nd International Congress on Education of the Deaf in Milan, Italy, a declaration is made that oral education is better, and decision is made to use it for education of the deaf. Henceforth, sign language disappears from education of the deaf. The oral education also comes to Japan from the U.S., and sign language is prohibited (from 1925).

1908 Japan; For the first time, carbon hearing aid is imported and sold.

1915 Japan; Japanese Association of the Deaf and Dumb is established.

1915 Japan; Import and sales of hearing-aid is launched by Katsue Yoshida (Tokyo).

1920 Japan; Japan Oral School for the Deaf is opened. Dr. Reischauer (a missionary from the Presbyterian Church, who was working at the Meiji Gakuin as a teacher) and his wife went back to the U.S. as their eldest daughter lost hearing due to a disease, had her enroll in an oral school in America, and mother also learned the oral teaching method. She then came back to Japan and opened an oral school for the deaf in the church.

1925 Japan; Japan Oral Communication for the Deaf Popularization Society is established, and as the Ministry of Education at the time also made a strong effort to popularize oral communication, sign language gets prohibited just as it is overseas. A violent dispute arises between the society on the one hand and Kiyoshi Takahashi (Head of the Osaka Municipal School for the Deaf and the Dumb) and Zaikan Sato (Director of the Hakodate Private Asylum for the Blind and the Dumb) and others, who stressed the importance of sign language education.

1926 Japan; Class for people with impaired hearing is established in the Tokyo School for the Deaf and the Dumb. In addition to Unosuke Kawamoto of the Tokyo School for the Deaf and the Dumb, oral education gets to be promoted by Tokuichi Hashimura (Head of the Nagoya Municipal School for the Deaf and the Dumb), Yoshinosuke Nishikawa (Head of the Shiga Prefectural School for the Deaf) and others.

Around 1930 Abroad; Wever and Bray conduct experiments on cats proving that acoustic nerves react to stimulation by electricity similarly to the way they react to natural sounds.

Around 1930 Russia; A number of scientists conduct experiments on reaction of hearing to stimulation by electricity. The report states that the subject could hear even the language sounds, but doubts remain as to the credibility of the report as the subject may have been a person with normal hearing or with some hearing ability left, so in the conclusion the scientists are cautious regarding the interpretation of the hearing reaction.

The second half of the 1930s Researchers in the U.S. and the Soviet Union working independently from each other at the same time discover that even a deaf person when his or her internal ear is stimulated by electricity can hear (no implants ready for clinical application are made).

1933 Japan; Ichiro Hatoyama, the Minister of Education at the time, gives instructions to promote oral education. Up to that point, Kiyoshi Takahashi (Head of the Osaka Municipal School for the Deaf and the Dumb) and Zaikan Sato (Director of the Hakodate Private Asylum for the Blind and the Dumb) were stressing the importance of sign language education and there was an intense dispute among the proponents of oral education and those defending sign language, but after the instructions of the Minister of Education were announced, the majority of schools for the hearing impaired in Japan switch to oral communication (although there were some exceptions, such as the Osaka Municipal School for the Deaf and Dumb), and prohibition on the use of sign language gets more and more strict.

1937 Japan; a deaf blind person Helen Keller makes her first visit to Japan and subsequently comes to Japan two more times.

1938 Japan; Education Minister Sadao Araki gives instructions that schoolchildren, for whom oral education is not suitable, should not be educated through oral education by force, but the tendency to prefer oral education to sign language persists.

April, 1946 Japan; Proclamation of the eGovernment Schools for the Blind and Schools for the Deaf and Dumb Organization Orderf.

November, 1946 Japan; Proclamation of the Constitution of Japan.

March, 1947 Japan; Proclamation of the Fundamental Law of Education and School Education Law.

1947 Japan; Japanese Federation of the Deaf is established.

May 3, 1947 Japan; Constitution of Japan is enacted.

December, 1947 Japan; Proclamation of the Child Welfare Act.

April, 1948 Abroad; The Constitution of the World Health Organization (WHO) comes into force.

April, 1948 Japan; Proclamation of the eGovernment Ordinance regarding Junior High School Attending Duty, School for the Blind and School for the Deaf Attending Duty, and Duty of Establishment thereof e (duty to attend elementary classes of schools for the blind and the schools for the deaf is enforced on children at the beginning of the school year).

1948 Japan; Visit of Helen Keller to Japan.

December, 1948 Abroad; The Universal Declaration of Human Rights is adopted by the Third Regular Session of the United Nations General Assembly.

1949 Japan; Act for the Welfare of People with Physical Disabilities is established and enforced from the following year. Hearing-aid is officially recognized as assistive device.

1950 Japan; Japanese Federation of the Deaf becomes an incorporated federation.

The 1950s Education of the deaf and impaired hearing children in Japan; Against the background of the progress made by audiology in Japan and the rapid advances in engineering, there is a rise of expectations towards oral communication and enthusiastic accumulation of results in the area.

The 1950s Education of the deaf and impaired hearing children in the USSR; The age of experimental education based on new doctrine in oral education that stresses early education, use of fingers, and teaching letters earlier.

March, 1951 Japan; Proclamation of the Social Welfare Act.

May, 1951 Abroad; The Fourth World Health Organization Assembly held (Japan participates and becomes a member).

June, 1951 Japan; Guidance on medical treatment and education of children with physical disabilities is issued, system granting assistive devices is established.

1951 Japan; The Ministry of Health and Welfare implements the first survey on persons with physical disabilities (which is implemented every five years thereafter)

1951 Abroad; World Federation of the Deaf (WFD) is established and the first World Deaf Congress is held in Rome

1953 Japan; The slogan "Full-time welfare officers for the deaf and the dumb!his put up by the Fourth National Convention of the Deaf and the Dumb organized by the Japanese Federation of the Deaf, demanding for the first time that welfare officers for people with physical disabilities understanding sign language are appointed.

October, 1953 Japan; Proclamation of the eGovernment ordinance establishing the date of enforcement of provisions stipulating the parts on attendance of schools for the blind and schools for the deafe (duty to attend junior high classes of schools for the blind and schools for the deaf is enforced on children at the beginning of the school year).

1954 Japan; March 3 is set as the "Ear Day".

March, 1954 Japan; Child Welfare Act revised (stipulating public health care benefits for physically disabled children, welfare medical benefits for physically disabled people, and establishment of erehabilitation facilities for the deaf and mutef)

May, 1954 Abroad; The Seventh World Health Organization Assembly held (Japan becomes a permanent member of the executive board)

June, 1954 Japan; Proclamation of the eAct for encouragement of school attendance at special schools for blind persons, deaf persons, physically disabled persons and mentally disabled personsf

December, 1955; Japan; The Eleventh United Nations General Assembly is held (Japanese membership approved)

1957 France; French scientists/surgeons Andre Djourno and Charles Eyries successfully stimulate acoustic nerves of a patient (who volunteered for the treatment) with electricity.

April, 1958 Japan; National Center of Speech & Hearing Disorders established

April, 1958 Japan; Proclamation of the "School Health Act"

April, 1959 Japan; Proclamation of the "National Pension Act"

1959 Denmark; Proclamation of the Danish Act of 1959 (based on normalization philosophy advocated by Bank-Mikkelsen)

1960 U.S.; Surgeon Dr. William F. House is shown by a patient with hearing loss a newspaper clipping regarding research conducted by Djourno, and decides to try the method with his patients.

1960 U.S.; William C. Stokoe (professor at the Gallaudet University) publishes Sign Language Structure on grammar of sign language as it appears in the American Sign Language (ASL). With the publication of the book, sign language starts to be recognized as a language.

The 1960s Education of the deaf and impaired hearing children in Japan; Advocacy and practice of cued speech to complement the oral communication.

The 1960s Education of the deaf and impaired hearing children in the U.S.; Presentation of the concept of total communication and advent of era of education, research, publication of books on sign language based on this concept.

The 1960s Education of the deaf and impaired hearing children in Great Britain; Although the country has been proud of its achievements made based on the philosophy that put auditory-oral approach above all else, in a report (announced in 1968) of a research on communication of pupils and graduates of schools for the deaf, it was stated that those surveyed used fingerspelling and sign language quite a lot, and that "there is no single method that would be suitable for all deaf children of all ages". The research pointed out the need for a large-scale research on the functions of fingerspelling and sign language in education and was highly influential both in and outside the country.

1960 Japan; Proclamation of the "Road Traffic Act" (making it possible for persons with physical disabilities to get driver's licenses)

1960, September Abroad; First Paralympic Games held in Rome (since then, Paralympics are held at the same location and in the same year as the Olympic Games)

1961 Japan; Child Welfare Act is revised (establishing health checkup system for children of 3 years of age, home visit guidance for newborn infants, etc.)

1961, November Japan; Start of payment of welfare pensions for persons with disabilities

1961 Japan; Establishment of system of the public health insurance for the whole nation/universal pension coverage

1961 U.S.; Dr. William F. House starts the above-mentioned experimental medical treatment. Although at first he was trying to create a multi-channel cochlear implant with several stimulating electrodes, seeing it as technologically difficult, he concentrates on research on single channel implants (using just one stimulating electrode).

1962 U.S.; A group led by Dr. William F. House decides that development of a multi-channel cochlear implant is technologically difficult and concentrates on research on single channel implants (using just one stimulating electrode).

1963 Japan; The first sign language club is opened in Kyoto.

1963, July Japan; Research Center on Rehabilitation Technology is established in the National Rehabilitation Center for Persons with Disabilities

1964 U.S.; Proclamation of the "Civil Rights Act" (Civil Rights Act: law to ensure that the rights of blacks and other minorities in such areas as education, employment, and election are equivalent to those of the white people, and to prohibit discrimination)

1964 Japan; The first Paralympics in Asia are held in Tokyo (with 567 people from 22 countries participating)

1964 U.S.; A group of scientists led by B. Simmons from Stanford University conducts research and development of a six-channel cochlear implant. They report that they inserted six electrodes into the cochlea of a completely deaf person, sent alternating electric current, and that the patient could feel the difference in pitch (frequency). They discovered that pitch changes depend on both the position of the electrode and the frequency of stimulation, while loudness can be increased by the intensity of stimulation.

1965 U.S.; During Congress of Linguists, Chomsky stated the view that language is a specific relationship between sound and meaning. Later, he is asked by a researcher of sign language about his views of sign language of the deaf, and rectifies his assertion stating that language is a specific relationship between signal and meaning. In other words, he corrected the definition of language so as to include sign language also.

1965 Japan; Proclamation of the "Physical Therapists and Occupational Therapists Act"

1965 Japan; Proclamation of the "Maternal and Child Health Act" (comprehensively and systematically prescribing health measures for mothers and children)

1965 Japan; After this year, associations of hearing-impaired persons are established all over the country.

1965 Japan; During the Third National Convention of the Mimiyorikai Society, OHP is used for note taking of main points (Tokyo).

1965 Japan; Janome Sushi incident (a blind person kills a member of a restaurant staff).

1966 Japan; Ministry of Education proclaims "Ministerial ordinance ordaining high school section of schools for the blind and schools for the deaf".

1966 Japan; Proclamation of the "Special Child Dependent's Allowance Act" (revising allowances to families raising children with severe mental disabilities, expanding applicability criteria to families raising children with severe physical disabilities, etc.)

1966 Japan; Movement is started to ensure sign-language interpreting for the deaf defendant of the Janome Sushi incident that occurred in the previous year.

1966 Japan; The First National Debate Meeting of Deaf Youth is held in Kyoto; the Meeting affirms a common recognition of the view that "discrimination against the deaf is a social problem" and launches a movement for elimination of discrimination.

1967 Japan; A public debate with a sign-language interpreter provided takes place in Nakano-ku, Tokyo.

1967, October Japan; First National Athletic Meet of Deaf is held in Tokyo.

1967 Australia; Graeme Clark (at the time working at the University of Sydney) starts fundamental research for cochlear implants, studying the cochlear nerves (acoustic nerves) with animal experiments.

1968 U.S.; Professor Michelson working at the UCSF (University of California, San Francisco) establishes with animal experiments that it is safe to use electrodes in the cochlea for long periods of time.

1968 U.S.; A group led by Dr. William F. House implants silver multi-channel electrode system in three patients, who volunteered for the treatment. The ultimate goal is to design a portable stimulation device ready for practical use enabling the wearer to use a cochlear implant at all times.

1968 U.S.; A group led by Dr. William F. House restarts clinical study of single channel implants.

Before 1968 Among the materials, which were tried during the development of cardiac pacemakers, the scientists find materials, which are safe for implanting in a human body. Also, scientists get opportunities to observe the impact on the human body of long-term stimulation by electric pulse.

1969 Japan; Publication of "Our sign language".

The 1960s Japan; Movement of the deaf: sign language clubs + social movement (requesting social workers, who know sign language)

The 1960s Japan; Movement of the hearing-impaired persons: expectations regarding functional improvements in hearing aid + creation of system + training of note-takers

The 1960s Education of the deaf and impaired hearing children in Japan; Advocacy and practice of cued speech to complement oral communication.

The 1960s Education of the deaf and impaired hearing children in the U.S.; Presentation of the concept of total communication and advent of the era of active education, research, and publication of books on sign language based on this concept.

The 1960s Education of the deaf and impaired hearing children in Great Britain; Although the country has been proud of its achievements made based on the philosophy that put auditory-oral approach above all else, in a report (announced in 1968) of a research on communication of pupils and graduates of schools for the deaf, it was stated that those surveyed used fingerspelling and sign language quite a lot, and that "there is no single method that would be suitable for all deaf children of all ages". The research pointed out the need for a large-scale research on the functions of fingerspelling and sign language in education and was highly influential both in and outside the country.

From second half of the 1960s to first half of the 1970s Abroad; Failing with the multi-channel cochlear implant, Dr. William F. House resumes research of single channel cochlear implants. However, at the same time, Simmons, Clark, as well as Michelson, Eddington, Hochmair, and others are developing multi-electrode arrays of cochlear implants to insert in scala tympani. Each of the scientists proposes different ways of electrode arrays and stimulation, and a hot discussion regarding the superiority of each method ensues.

1970 Australia; Clark finishes his doctoral dissertation "Middle Ear and Neural Mechanisms in Hearing and in the Management of Deafness".

1970 Australia; Clark becomes the founding Professor of the Otolaryngology Department at the University of Melbourne and launches the project creating cochlear implants for humans.

1977 Australia; Dr. Clark creates a portable speech processor. Although it is portable, the speech processor weighs 1.25kg and is 15cm x 15cm x 6cm in size.

1970 Japan; Basic Act for Countermeasures concerning Mentally and Physically Disabled Persons is enacted.

1970 Japan; Ministry of Health and Welfare starts training sign language volunteers. Sign language courses are organized in various places across the country. Later, a system of sign language interpreters and a dispatch system for sign language volunteers are established.

May, 1971 U.S.; Prof. Michelson announces the results of his studies entitled "The results of stimulation of the cochlea in human sensory deafness" at a meeting of Otological Society. The results were assessed as ready for clinical application, and he received a subsidy from the Department of Defense. Based on this data, he later conducts research and development of a multi-channel cochlear implant. However, scientists perceiving the matter differently express distrust regarding his research.

April, 1971 Japan; Training school for hearing-speech expert personnel (note by Tanaka: presently the term is "speech-language-hearing therapists") is established at the National Center of Speech & Hearing Disorders.

August, 1971 Abroad; The Sixth World Congress of the Deaf is held in Paris and passes "Declaration of Rights of the Deaf"

1972 Japan; Steering Committee for the National Organization of the Hearing-Impaired is established.

1972 Japan; Launch of system of permanently residing sign language interpreters.

1973 Japan; Research Council for Promotion of Area Units of the National Organization of the Hearing-Impaired established (Kyoto). The Council starts official newspaper "New Tomorrow" (the name is changed to "True Age of Welfare" from December, 1991).

1973 Japan; Note-takers dispatch services start in Kyoto.

1973 Japan; The National Police Agency announces availability of driver's licenses for the deaf on condition that the driver wears hearing-aid while driving.

1973 Australia; Dr. Clark at the University of Melbourne announces the results of an experimental study on four cats "A hearing prosthesis for severe perceptive deafness".

1973 U.S.; Dr. William F. House develops a system of single channel cochlear implants, preoperative assessment for patients and postoperative rehabilitation program.

1973 Japan; Kamio Tomokazu (otolaryngologist of the Nippon Medical School, who later conducts the first single channel cochlear implant surgery in Japan) starts his studies in the U.S., which continued until 1976.

1973 U.S.; At the UCSF (University of California, San Francisco), the first international conference on cochlear implants is held on the theme "Electrical Stimulation of the Acoustic Nerve as a Treatment for Profound Sensorineural Deafness in Man"

1973 U.S.; By this year, Dr. William F. House successfully implants single channel cochlear implant systems in ten patients. Based on this experience, he develops a system of preoperative assessment for patients and a postoperative rehabilitation program.

1974 Japan; Club of People with Slight Hearing Impairments is established

1974 Japan; The National Research Association for Sign Language Interpretation is established

1975 Japan; Sign language course for people with post-lingual deafness and the hearing-impaired opens (Tokyo)

1975 Japan; Sign-language interpreter dispatch services start

1975 Sweden; National Agency for Education makes a statement asserting that sign language and none other is the first language of the deaf, and recommends sign language for communication with children with hearing impairment. This signified a great change in the philosophy, methods, and contents of education, and resulted in a great turmoil in the schools for people with hearing impairment. The impact was so great that a large number of teachers even contemplated change of occupation, but it seems that the number of teachers, who did actually quit, was not so large (the transition continued up to the middle of 1980).

August, 1975 Japan; The 14th International Congress on Education of the Deaf held in Tokyo

October, 1975 Japan; School for the Deaf Attached to Tokyo University of Education celebrates 100 years since establishment

1975 U.S.; National Institute of Neurological and Communicative Disorders [NINCDS] implements an evaluation test of persons with cochlear implants. The initiative is of Dr. House, who makes an offer to Dr. Michelson. The work is done jointly by NINCDS and the Department of Otolaryngology at the University of Pittsburgh. Tests are conducted on 13 people with cochlear implants.

1975 Austria; Scientists at the University of Vienna develop an eight-channel mold casting cochlear implant device

1976 West Germany; A team of scientists in West Germany led by Dr. P. Banfai by that time had conducted over 10 years of research on cochlear implants. They were developing an extracochlear sixteen-channel electrode system.

January, 1976 Japan; Hearing Impairment Magazine issues a special number on the simultaneous communication. A scientific paper on practice and research of simultaneous communication using sign language and oral language conducted in Tochigi Prefectural School for the Deaf is published. The paper also touches on the philosophy behind integrated education/welfare education.

1976 France; Team led by Henri Chouard of the University of Paris after conducting independent research on cochlear implants for a few years, develops a 12-channel implant named eChorimac-12f.

1976 Japan; A U.S. scientist Dr. W. House gives a lecture on cochlear implants at the meeting of the Oto-rhino-laryngological Society of Japan.

Autumn of 1976 Japan; Tomokazu Kamio (otolaryngologist of the Nippon Medical School) completes his studies at the House Ear Institute, comes back to Japan and gives a lecture at the Nippon Medical School named "Recent advances in neuro-otology"

December, 1976 Japan; Lecture that Tomokazu Kamio (otolaryngologist of the Nippon Medical School) gave at the Nippon Medical School named "Recent advances in neuro-otology" is published in an internal research magazine of the Nippon Medical School. The paper describes two main points the author learned at the House Ear Institute, namely, treatment of people with severe hearing impairments with cochlear implants (artificial cochlea) and diagnosis of the impairments in the internal ear with inner ear anesthesia.

1977 Australia; Dr. Graeme Clark creates a portable speech processor for cochlear implants. Although it is portable, the speech processor weighs 1.25kg and is 15cm x 15cm x 6cm in size.

1977 Austria; Scientists at University of Vienna successfully conduct an surgery of implanting an eight-channel cochlear implant

1977 Japan; NHK starts broadcasting "Persons with Hearing Difficulties Hour" program

1977 Japan; Hearing Impairment Magazine covers total communication in the April and June issues and cued speech in the August issue.

June, 1977 Japan; Ministry of Health and Welfare establishes 18-month-old health checkup system

February, 1978 Japan; The January issue of the Hearing Impairment Magazine carries the contents of a symposium (on use of hearing) held during the National Convention of the Study Group on Education for the Deaf year before.

February, 1978 Japan; Zennancho (All Japan Association for Hard of Hearing People) is established in Kyoto (and becomes an incorporated association in 1991). Activities of people with post-lingual deafness and hard of hearing people intensify across the country (demands for public financial aid for purchases of hearing-aid, demands for magnetic loops, and OHP).

The 1970s Abroad; Reports on mechanical or electric damages to the implantees associated with cochlear implants are published resulting in a wide range of efforts to find materials of appropriate quality and appropriate ways to send the electric current. At the same time, a large body of research on the multi-channel method is done. The most representative achievements are the four-channel technology developed in Utah University and Vienna University, and the 22-channel method created in Melbourne University.

1978 Austria; Scientists at University of Vienna successfully conduct the second surgery implanting an eight-channel cochlear implant (later, they redesign the device to the six-channel and then the four-channel operation).
*The extracochlear cochlear implant was manufactured and developed by the 3M Corporation in the U.S. positioning the electrodes outside the cochlea to avoid damaging it. The system enabled the implantee to distinguish voice and noise and grasp some other differences in sound environment, but could not make understanding words and conversation possible.

August 1, 1978 Australia; Dr. G. Clark and a physician B. Pyman at the Melbourne University successfully conduct a surgery on a completely deaf adult with post-lingual deafness implanting a multichannel (the prototype was a ten-channel version) cochlear implant.

1978 Australia; Dr. G. Clark of Melbourne University successfully conducts the second surgery implanting the prototype of his multi-channel cochlear implant.

1978 Japan; Otolaryngologist Sotaro Funasaka (University of Tokyo Medical School) gets from Dr. Makizo Saito of the Spoken Language Medical Institute of University of Tokyo a copy of a paper written by Dr. G. Clark of Melbourne University. The paper is on 15-channel cochlear implants for deaf patients. Upon reading the paper, Dr. Funasaka decides that he wants to participate in Dr. Clark's research.

1978 Japan; Concept of total communication practiced by Tochigi School for the Deaf leads to establishment of Study Circle of Total Communication (TC-ken), a nationwide organization.

1978 Japan; The Hearing Impairment Magazine in its August and September issues carries a paper by Shinro Kusanagi "Two problems of total communication in education of the deaf in the U.S." Below are the chapters.

1. Rise and development of total communication, 2. Dominant causes of rise and development of total communication, 3. Philosophy of total communication; the August issue carries a paper by Shige Takemura entitled "What do you think about linguistic peculiarities of sign language and sign language in general?" The September issue carries a report "On the Forth Convention of the Japan Sign Language Research Society".

January, 1979 Japan; The Hearing Impairment Magazine in its January issue carries a paper by the T-C Study Group reporting on the First Convention on Total Communication.

1979 Japan; Special education is made compulsory.

July, 1979 Japan; National Rehabilitation Center for the Disabled is established (Tokorozawa). National Rehabilitation Center for Persons with Disabilities, Tokyo National Center for Persons with Visual Impairments and National Center of Speech & Hearing Disorders are merged and National Rehabilitation Center for the Disabled is inaugurated. National Vocational Rehabilitation Center for Persons with Disabilities is also established in the same lot.

1979 Japan; Article 11 of the Civil Code is revised with deaf, dumb, and blind deleted from the category of quasi-incompetent persons.

July, 1979 Australia; Dr. G. Clark of Melbourne University conducts the third surgery implanting a prototype of his multi-channel cochlear implant.

1979 Australia; Dr. G. Clark of Melbourne University conducts the forth surgery on yet another female patient implanting a prototype of his multi-channel cochlear implant. Although the surgery is successful, the patient states that the sound she hears is unpleasant, and, on the patient's demand, the electrodes are removed. Subsequently, the patient gets used to communicating using sign language and speechreading, and is satisfied with it.

1979 U.S.; Auditory Brainstem Implant (hereinafter ABI) modeled after cochlear implant is developed by neurosurgeon Hitselberger2.

1979 Japan; February issue of the Hearing Impairment Magazine carries two scientific papers, namely, "A new start in this first year of special education - towards United Nations Declaration on the Rights of Disabled Persons by Kazutoshi Kitahara (Tokai University), and "On readability of Japan's sign language - in comparison with American sign language" by Saiji Ogawa, and also an essay by Shigeyoshi Watanabe entitled "Some expressions of sign language - from the point of view of linguistics". May issue carries a report by Sho Inokuchi, Youko Noguchi and others entitled "Implementing integrated education in classes for children with hearing impairments". August issue carries a commentary paper of Masakuni Itabashi "Public responsibility of the NHK and the issue of subtitles - my thoughts on the 78.10.13 negotiations", and a review of the first issue of Total Communication; September issue carries an article entitled "America Deaf Theater, a silent troupe to visit Japan".

The 1970s Education of the deaf and impaired hearing children abroad; in this period, debates regarding communication methods get more deep.

1980 Japan; Head Office for Promotion of the International Year of Disabled Persons (note by Tanaka: which was the following year)" is established in the Prime Minister's Office.

1980 Abroad; World Health Organization (WHO) publishes tentative plan for International Classification of Impairments, Disabilities, and Handicaps (ICIDH). According to the classification, impediments are classified into three levels, namely, impairments, disabilities, and handicaps.

1980 Japan; Hearing Impairment Magazine carries the following papers. March issue: "Auditory Learning (part of summary of a symposium)" by Tatsuo Hoshi; June issue: "Keyword of the month: establishment of Information and Culture Center for the Deaf," by Takao Imanishi (Welfare Association of Education for the Hearing Impaired); June, July, August and September issues: Takashi Tagami, Akiko Mori, Minako Tatsuno "Points of argument in education of the deaf" (parts 1, 2 entitled "Problems of perception in combined use", part 3 entitled "Complementarity of oral communication and sign language", part 4 entitled "Pidgin sign language and summary of problems")

[2] Cochlear implants in Japan: Period I

December 3, 1980 Japan; Team led by Tomokazu Kamio, Assistant Professor at the Nippon Medical School, conducts a surgery on a 58 year-old (56 year-old?) male (Mr. H) implanting a single channel cochlear implant (sigma type) manufactured at the House Ear Institute into the left ear of the patient.

January 1981 Japan; January issue of the Hearing Impairment Magazine carries text of a lecture by Takashi Tachiki's (a physician) made in October of the previous year at the Morioka Convention. Among other things, the lecture addresses the subject of cochlear implants (touching on the single channel cochlear implant version developed by Dr. House).

February 1, 1981 Japan; Japan Deaf Newspaper (official newspaper of Japanese Federation of the Deaf) carries an article (page ten) entitled "Hyogo Ear Bank establishedh (main headline) with photographs of the office and illustrations showing the structure of the ear.

1981 Abroad; International Year of Disabled Persons (United Nations proclaimed this year the international year for implementation of various international measures to ensure the rights of the disables as stipulated in the 1973 Convention on the Rights of Persons with Disabilities. A plan of action regarding the disabled is adopted.)

1981 Abroad; Disabled People International (DPI) holds its first world congress in Singapore. Many persons with disabilities from Japan attend the congress, who later take the initiative establishing DPI Japan.

1981 Japan; International Year of Disabled Persons; World Programme of Action concerning Disabled Persons is adopted. Organizations of the disabled and other social entities engage the mass media to conduct a range of educational activities to let the society know about the problems faced by disabled persons and promote policies beneficial to them.

1981 Japan; In the wake of the International Year of Disabled Persons, there is an increase in the number of sign language courses and sign language clubs.

1981 Japan; Training system of Note takers as volunteers is added to the list of enterprises facilitating social participation of persons with disabilities of the Ministry of Health and Welfare.

1981 Japan; Mini faxes appear on the market and begin to become popular also between hearing-impaired persons.

May 1981 Japan; "Act of Partial Revision of the Medical Act Adjusting Terms related to Disabled Persons etc." is proclaimed (defining such terms as "tsumbo" (dummy), "oshi" (mute), and "mekura" (lit. 'black eyes') derogatory).

May 16, 1981 Japan; Mainichi Newspaper carries an article on the first surgery implanting a single channel cochlear implant in Japan.

July 1981 Japan; "New Tomorrow", official newspaper of the National Liaison Council for the Hearing-impaired Persons, predecessor of the Zennancho (All Japan Association for Hard of Hearing People) in its 31st issue published on July 15 carries an article on single channel cochlear implant surgery in the medical information section.

1981 Japan; Dr. Funasaka (The University of Tokyo Medical School) is appointed as abroad research worker by the Ministry of Education.

November 1981 Japan; November issue of the Hearing Impairment Magazine carries a paper on deaf education overseas entitled "Sign language and sign language communication in Denmark".

December 1981 Japan; The government proclaims December 9 of every year as "Disabled Person's Day".

1982 Japan; Head Office for Promotion of the International Year of Disabled Persons adopts "Long-range plan of measures supporting disabled persons". This plan stipulates "architectural design standards presuming use by physically disabled persons" and sets forth the direction for planning and implementation of measures supporting disabled persons to be conducted by ministries, and municipal corporations.

1982 Japan; Special section of note-takers established at the National Liaison Council for the Hearing-impaired Persons. The Council acquires affiliate membership at the International Federation of Hard of Hearing People (IFHOH). Secretariat is relocated from Kyoto to Tokyo.

1982 Australia; Research on safety, durability, and communicatory improvements of the 10-channel prototype of the cochlear implant started in 1978 by Nucleus Ltd./Cochlear Ltd. advances, the company pioneers titan case for the cochlear implants (the technology is later is adopted by other companies) and successfully produces a commercial version of its 22-channel cochlear implant system

November 1982 Japan; Toshio Kawashima (Department of Electrical Engineering, Tomakomai National College of Technology), Kazuaki Obara (Research Institute of Applied Electricity, Hokkaido University), and Tooru Ifukube (Research Institute of Applied Electricity, Hokkaido University) publish "Design (1) of progressive wave type stimulation device for cochlear implant".

1982 Japan; Hearing Impairment Magazine carries the following papers. January issue: review by Shigeyoshi Watanabe entitled Working once more with the foundations of deaf education - "The world of sign language" by Takashi Tagami, Akiko Mori, Minako Tatsuno; NHK Publishing". July issue: "Thoughts on oral communication", Shinro Kusanagi, Masuo Ueno (eds.) Tendencies in training of teachers for hearing impairment education in the U.S. (part 1) (part 2 is published in the August issue and the final part in the September issue); Danny D. Steinberg "Letter acquisition of one-year-old congenitally deaf children" (first part; the second (final) part is published in the August issue); Junichi Mikami "How to make voice clearly heard" (the final part); notice "Academic Year 1982 Educational Practice Summer Course for Lingual/Hearing Ability"; September issue: George Montgomery "Effective brains versus defective ears"; November issue: report on the 5th Total Communication Research Convention and 15th National Research Meeting on Problems of Sign-language Interpreting; December issue: Ernest Zelnick "Curriculum for education of hearing-aid specialists in the U.S.", Hiroshi Tateno and Hisako Inaba "Music training for children with difficulty in hearing".

1983 Japan; February issue of the Hearing Impairment Magazine bearing the title "Welcoming 1983" carries a number of suggestions from specialists. "In hopes that devices for deaf children surpass those for the blind" by Masami Harada (head of the Tokyo Metropolitan Government Welfare Center for Mentally and Physically Disabled Persons at the time) "My wishes regarding educational circles for the deaf" by Yoshisato Tanaka (professor of Department of Otolaryngology, Teikyo University School of Medicine at the time).

1983 Japan; Hearing Impairment Magazine carries the following papers; January issue "The third ear - path to development of a proper hearing device" by Taitaro Misawa; February issue: "Possibilities of deaf children and children with severe hearing difficulty" by Hideo Torii; July issue: "My impressions of schools for the deaf and rehabilitation centers in Japan" by William McCrone; October issue: Book review of Training in oral signs and pronunciation by Akitoshi Otsuka; November issue: Book introduction of Oral method and total method by Masumi Aihara and Total communication by Kenichi Suzuki; December issue: Attached schools for the deaf "Watching teletext"

1983 Japan; August issue of the Hearing Impairment Magazine (p. 33-36) carries "What is the movement of hearing-impaired persons?" by Sensuke Iritani (professor of Shimane University)

1983 Abroad; "United Nations Decade of Disabled Persons" starts.

1983 Japan; Joint meetings for campaign speeches by rival candidates are prohibited by Public Offices Election Law.

1983 Japan; NHK starts experimental teletext broadcasting.

1983 Japan; National Council of Note-takers and Related Parties is reformed into National Study Group of Problems of Note-taking.

1983 Abroad; Melbourne University, Australia: number of people using cochlear implants by Cochlear Ltd. reaches seven.

1983 U.S. The University of Iowa Hospital and the University of Texas Health Science Center at Houston on request from the Nucleus Ltd., Australia decide to become first cochlear implant centers in the U.S. and start clinical tests.

1983 Australia; To enable activities in the U.S. and other countries, Nucleus Ltd. makes its cochlear implant department a new company, "Cochlear Ltd." Subsequently, a chain of companies is established in the second half of the 1980s to enable separate operations in each region, namely, "Australia Cochlear Ltd.", "U.S. Cochlear Ltd.", "Cochlear UK Ltd.", "Switzerland Cochlear Ltd.", and "Japan Cochlear Ltd."

* In this year, in Australia, Dr. Tonkin (a national authority in the problems revolving around hardness of hearing and the leader of the Australian Deafness Research Foundation) working at the St Vincent's Hospital Sydney successfully conducts the first surgery in the country implanting a single channel cochlear implant manufactured by House/3M Corporation. Later, he implants cochlear implants into many patients including a 6-year-old child. With several children, he uses multi-channel cochlear implants.

1983 Abroad; Clinical trials of cochlear implants manufactured by Cochlear Ltd. are carried out in nine centers of three countries, namely, the U.S., Canada, and West Germany, proving that the devices help the implantees with severe hearing impairments hear and understand vocal communication. Half of the implantees can understand what is being said without speechreading, and 1/3 can use the telephone to some extent at least.

1983 U.S.; FDA (Food and Drug Administration) launches medical experiments using the N22 cochlear implant by Cochlear Ltd.

1983 U.S.; University of California, San Francisco holds the 10th Anniversary Conference in Cochlear Implants: An International Symposium. During the conference, it becomes clear that over 1000 devices have been implanted in 14 medical facilities across the globe.

1983 Japan; Kiyofumi Gyo completes his doctoral dissertation "An experimental study of cochlear implants: examination for safety of implanting the stimulating electrodes, stimulation waveforms, and implanting electrodes into the internal ear"

1983 Japan; Acoustical Society of Japan bulletin publishes paper by Kazuaki Obara (Research Institute of Applied Electricity, Hokkaido University) et al. "Evaluation of time series stimulation method for cochlear implants"

1983 Abroad; First year of United Nations Decade of Disabled Persons (1983 to 1992)

1983 Sweden; Bilingual education is adopted for education in schools for the deaf. The system teaches deaf children sign language (Swedish sign language) as the first and the most important language, while literacy in spoken language (Swedish) is given the second place; this system gets known as the "Swedish model."

1983 Japan; Ministry of Transport formulates "Guidelines for facilities for physically disabled persons in public transport terminals"

July 1983 Japan; "Law regarding arrangement of terms concerning disabilities" is proclaimed (defining such terms as "fugu" (deformity), "kikei" (malformation), "haishitu" (cripple), and "hakuchisha" (idiot) derogatory).

1984 Japan; Hearing Impairment Magazine carries the following papers. January issue: "Evaluation of the efficacy for hearing aid" by Yasuo Shimizu; March issue: "Educational evaluation of auditory learning" by Suminori Matsuki; June issue: "Cases when efficacy of hearing aid temporarily declines due to foreign substances in sound tubes of ear mold in hearing-aid" by Naoki Onuma, technical information "Letter phone device", Notice of the Fifth National Convention of Study Group on Integration 1984 "Educational technology for the hearing impaired/vacation school", July issue: a special issue entitled "Auditory Learning", Takeshi Okamoto "Origins of wireless hearing-aid", Suminori Matsuki "Auditory learning and loop system", Tatsuo Oka "Hearing-aid fitting", Tadamichi Sato "Auditory learning in kindergarten divisions of schools for the deaf", Takashi Shimizu and Masayuki Yamane "Actual auditory learning in protective care and training", Kinuko Shingu "Auditory learning in classes for children with hearing impairments", Takeshi Kajio "Information on technology - recent trends in hearing-aid", book introduction of Communication with children with hearing impairments in education, August issue: a special issue "Auditory Teaching Method", Hisashi Suzuki "Superiority of senses", Takeshi Ishikawa "Attempting to nourish creative ways of looking at things and thinking about them - training to visualize things using a VTR" Suminori Matsuki "Audiovisual aids and auditory learning", Hirohiko Hyodo "How children with hearing impairments respond to video images (tales shown on VTRs), essay by Seiroku Sato "Daisan Demon's hearing-speech analects"

1984 Japan; Mini fax is added to the list of daily life tools (tools given or lent to disabled children, etc. to make their everyday lives easier according to the concept of the Disabled Persons' Fundamental Law).

July, 1984 Melbourne University, Australia; Number of people using cochlear implants made by Cochlear Ltd. increases to 16 (an increase by nine people from one year before)

1984 Australian Government recognizing the remarkable contribution made by Dr. G. Clark to the science and technology, grants him 40,000-dollar BHP Prize to be used as funds for research on cochlear implants.

1984 Great Britain; Dr. A. Morrison develops a five-channel cochlear implant made of two parts - a juncture box implanted in the head and a receiver under the skin of the rib cage. Clinical trials are launched sponsored by Storz Co., Ltd. Neurodyne manufactures a set comprised of electrodes in the cochlea, surgery tools, a four-channel receiver, and a portable speech processor. 13 people receive the implants by 1986 showing promising results.

April 1, 1984 Japan; Paper (written in 1983) by Kiyofumi Gyo (Department of Otolaryngology, Ehime University School of Medicine) entitled "An experimental study of cochlear implants: site for implanting the stimulating electrodes, stimulation waveforms, and safety of implanting electrodes into the internal ear" is published in the academic journal of the Society of Practical Otolaryngology (Volume 77(4), pp. 959-980).

August 27, 1984 Australia; Australia Cochlear Implant Research Institute is established at the Royal Victorian Eye and Ear Hospital. The purpose of the institute is to exchange information with other countries and contribute to the wellbeing of deaf people through use of microchips and computers.

September 1, 1984 Japan; Rion Co., Ltd. (a hearing-aid manufacturer) launches sales of custom-made ear-shaped hearing aid. Article in Japan Deaf Newspaper with headings such as "Device for in-ear use" stresses that it is "comfortable to wear and volume can be adjusted to fit the extent of hearing loss. Price is 98,000 yen."

October 1, 1984 Japan; Japan Deaf Newspaper (official newspaper of Japanese Federation of the Deaf) for the first time publishes an article with information on cochlear implants.

October 1984 Japan; October issue of the Hearing Impairment Magazine introduces the following themes of the upcoming International Congress on Education of the Deaf (to be held from August 4, 1985 to August 9, 1985).
"1. Education, 2. Speech and language, 3. Communication methods, 4. Mainstreaming and social integration, 5. Parents' roles, 6. Screening tests and evaluations, 7. Medical aspect, 8. Technical development, 9. Multiple disabilities, 10. Occupational problems, 11. Psychological aspect."

December 1984 U.S.; National Congress on Rehabilitation Engineering is held at the Gallaudet University. Theme: Cochlear electrode and how to train people to use it. Speaker is a researcher of the House Ear Institute (according to an article by Shigeyuki Tsuzuki published in the Japanese Journal of Hearing and Language Disorders and entitled "My impressions of the International Conference on Education of Children with Hearing Impairments").

1984 U.S.; Cochlear Ltd. submits marketing authorization application for the N22 cochlear implant to FDA (Food and Drug Administration).

October 25, 1984 Japan; Dr. Tomokazu Kamio and his group at the Nippon Medical School conduct a surgery implanting an alpha type single channel cochlear implant made by 3M Corporation, U.S., which is an improved version of the sigma type implant by House Ear Institute into the left ear of a 25-year-old male, who lost hearing in both ears three years prior to that (the second surgery implanting a single channel device in Japan).

December 1984 U.S.; FDA announces its permission for manufacture and sales of cochlear implants by 3M Corporation/House restricting surgery to patients aged 18 and above. Implants by 3M Corporation are single channel ones and are said to be an improved version of the implant manufactured by House Ear Institute that was most widely used (approximately 600 clinical trials).

1985 Japan; Note takers volunteers training system is added to the list of enterprises facilitating social participation of persons with disabilities of the Ministry of Health and Welfare.

January, 1985 Australia; At Melbourne University, for the first time a teenager is treated (14-year-old boy with acquired hearing loss). Although Cochlear Ltd. was already trying to design a receiver/stimulation device small enough to fit a child, at that point the device has not been designed yet. The company uses the receiver/stimulation device of the type used for adults.

1985 Japan; Hearing Impairment Magazine carries the following papers. January issue: Takashiro Akiyama, Ichiro Shiozaki "Understanding teletext subtitles", report by Yoshikiyo Toda "Use of TVs with subtitles in schools", February issue: Akitoshi Ootsuka "Educational interpretation of ear use", May issue: Kazufumi Miura "Creating system of support for the deaf", November issue: "Production system for video containing subtitles" and "The hearing-impaired and the society" December issue: Leading article by Takashi Tagami "Changes in the perspective of disabled persons"

April 1985 Japan; Nikkei Science publishes Development of cochlear implant by G.E. Loeb (translated by Hiroshi Ono), which introduces cochlear implant as a "device that shoulders the hearing function" instead of the ear by electrically stimulating the acoustic nerves without passing the auditory hair cell of the internal ear.

1985 Japan; Closed captioning launched.

The service is offered first by NHK General TV, and later followed by commercial broadcasting companies (Tokyo and Osaka are in the vanguard). Although there were only a few TV networks offering the service in the beginning, after the Broadcasting Law was revised to relax the regulations in 1997 (making the license for multiplex broadcast no longer required) one after another the networks across the country pick up the service and by now it is offered by almost all networks.

1985 Melbourne University, Australia; Number of people using cochlear implants made by Cochlear Ltd. increases to 34 (an increase by eighteen people from one year before)

1985 Japan; Department of Otolaryngology, University Hospital of the Ryukyus sends one of its staff members to study in University of Hanover, Germany. At the department, collection of data on cochlear implants and study meetings on the subject are launched. According to Masaharu Ura, Professor at the University Hospital of the Ryukyus, there has been a mass outbreak of deafness in Okinawa due to German measles, and the idea behind this initiative was to somehow find a way to increase the hearing ability of these people.

1985 Japan; Juichi Ito, who was studying in the U.S., returns to the Department of Otolaryngology, Faculty of Medicine, Kyoto University. Following the advice of Dr. Iwao Honjo, he starts a study meeting to research on ways for clinical application of cochlear implants.

August 1985 Great Britain; International Congress on Education of the Deaf is held from the 3rd to the 9th in Manchester. In the afternoon of the 5th, a panel discussion with several symposiasts is held on the theme of cochlear implants.

August 1985 Australia; Dr. Clark holds International Cochlear Implant Symposium and Workshop at the Melbourne University. At the symposium, many case reports are made and the participants are given surgical training.

August 1985 Japan; Dr. Funasaka (University of Tokyo Medical School) participates in the above symposium.

August 1985 Japan; The Rector of the Tokyo Medical University and the director of the attached hospital give permit to launch medical trials of cochlear implants.

August 1985 Japan; Dr. Funasaka has a personal interview with Mr. H, the head of the Medical Technology Development Section, General Affairs Division, Health Policy Bureau, Ministry of Health and Welfare. He consults Mr. H regarding the cochlear implant project, receives information about Health and Labor Sciences Research Grant, a new system for support of research in medical technology, and immediately submits an application.

1985 Japan; Dr. Funasaka reports to Michinari Okamoto, the chairperson of the board of the Oto-rhino-laryngological Society of Japan, regarding his work with cochlear implants.

September (to November) 1985 Japan; The staff of the Otolaryngology Department of the Tokyo Medical University together translate the cochlear implant manual made by Nucleus Ltd. and covering the details of cochlear implants and the rehabilitation to be conducted on the implantee after surgery. The import procedures for a personal computer for mapping is done with the cooperation of Dana Japan, and the staff sets up the computer and makes the necessary calibration. In three months, they grasp all of the aspects of the rehabilitation procedures and are ready to offer them to the patients.

1985 Australia; Nucleus Ltd. informs the Tokyo Medical University Hospital that it will not sell the hospital its N22 cochlear-implant system due to the fact that the hospital does not have a language evaluation system (an officially authorized inspection table for listening comprehension).

1985 Japan; Regarding the above language (listening comprehension) evaluation system, it becomes clear that neither the Oto-rhino-laryngological Society of Japan nor the Japanese Audiological Society have anything else than the tables for evaluation of the Japanese kana syllabary and figures, and that as there is no officially authorized inspection table for words or phrases, the problem in not one limited to the Tokyo Medical University Hospital, but a national one. Dr. Funasaka consults Dr. Clark regarding the above issue, promises to make sure that an inspection table to evaluate the patient to receive cochlear implant in his ability of recognition of speech sounds, words, and phrases will be made (this inspection table was in fact made in the following year with cooperation of Yumiko Fukuda, ST at the Research Institute of National Rehabilitation Center for The Disabled), upon which Dr. Clark convinces Nucleus Ltd. to sell their production to Japan. Later, an inspection table is created with cooperation of Yumiko Fukuda, ST at the Research Institute of National Rehabilitation Center for The Disabled.

1985 Japan; N22 cochlear-implant system arrives to Japan from the Nucleus Ltd., Australia, but as it is not yet approved as medical equipment, it cannot receive an import permit under the Pharmaceutical Affairs Law, and stays unclaimed at Narita Airport. As this way the system cannot be brought into the country, a document from the Ministry of Health and Welfare to the purport that the system was imported on individual responsibility of Sotaro Funasaka is submitted and the implant system is at last delivered to the Tokyo Medical University.

1985 Japan; Dr. Webb from Melbourne University gives a lecture on cochlear implants at the Oto-rhino-laryngological Society of Japan.

October 1985 Japan; The Oto-rhino-laryngological Society of Japan publishes a paper by Katsuhiro Hirakawa "Morphological changes in the cochlea resulting from electric stimulation - basic research on cochlear implants".

October 1985 U.S.; FDA officially approves the cochlear implant model of the Cochlear Ltd. as medical equipment.

1985 Australia; Team of Dr. Clark at the Melbourne University having developed a new 22-channel mini electrode system and feeling assured by their track record with cochlear implants for adults starts to adapt the device to children in early teens and even children under 10.

October 1985 Japan; Hearing Impairment Magazine (monthly magazine published from 1960 by Study Group on Education for the Deaf (a study group comprised of teachers of a school for the deaf attached to the Tokyo University of Education (which later became the University of Tsukuba) which was the leading proponent of the auditory-oral approach in the educational circles of teachers teaching the deaf) publishes a report of a participant at the International Conference on Education of Children with Hearing Impairments held in Manchester, U.K. in August of the same year.

November 1985 Japan; November issue of the Hearing Impairment Magazine carries an article by Masafumi Nemoto entitled "Embedding of electrodes (topics related to cochlear implants raised during the International Conference on Education of Children with Hearing Impairments held in Manchester)".

November 1985 Japan; Masao Shono, head of the Hearing-speech Research Lab at the Rion Co., Ltd., writes an article for the Rehabilitation Research Magazine published by Japanese Rehabilitation Society that argues that in addition to the "regular hearing-aid", remedies for persons with severe hearing impairments should include also "vibro-tactile aids" and "cochlear implants".

December 1985 Japan; Japanese Journal of Hearing and Language Disorders (a quarterly research magazine published since 1972 by Study Group on Hearing and Language Disorders established at the Special Education Research Institute of the Tokyo Gakugei University ) in its Volume 14, No. 2 carries reports by Takeshi Ishii and Tsuzuki Shigeyuki on the Symposium on Cochlear Implants held at the International Conference on Education of Children with Hearing Impairments.

December 1985 Japan; Dr. Funasaka (University of Tokyo Medical School) conducts a surgery implanting a N22 cochlear-implant of the Cochlear Ltd. (the first to be conducted in Japan; during this year, only one hospital in the country conducted just one surgery on a female patient who lost her hearing less than one year before that).

1986 Japan; Japanese Federation of the Deaf demands the Ministry of Health and Welfare to make a revision of the sign language enterprise that heavily depended on volunteer work ever since the increase of the number of sign language courses and sign language clubs that occurred in the wake of the International Year of Disabled Persons (1981). The Ministry of Health and Welfare creates an investigative commission at the Japanese Federation of the Deaf, which, after three years of probing the possibilities for institutionalization of the sign-language interpreters system, launches a movement to institutionalize it. The commission creates a brochure entitled "I love communication" and promotes sign language and sign-language interpreters in the society.

January 1986 Japan; Tokyo Medical College for the first time switches on the sound for the above-mentioned implantee. A staff member of Nucleus Ltd. comes to Japan for mapping (adjustment of the cochlear implant) and on the first day the patient can clearly hear the difference between "ashi" (leg) and "ishi" (stone). "I can hear! I can understand!" says the patient moved to tears. The hospital staff and other persons present also get very emotional.

January 1, 1986 Japan; Japan Deaf Newspaper carries an article on International Conference on Education of Children with Hearing Impairments, criticizing the symposium on cochlear implants and the cochlear implant itself.

January 1986 Japan; The Hearing Impairment Magazine in its January issue carries a record of a debriefing session held during the International Conference on Education of Children with Hearing Impairments in August of the previous year in Manchester, Great Britain.

January 19, 1986 Japan; New Tomorrow, newspaper of the Zennancho (All Japan Association for Hard of Hearing People), in its 49th issue carries an article on cochlear implants on the 4th and the 6th pages.

January to December 1986 Japan; Hearing Impairment Magazine carries the following papers. February issue: this month's word is "Accepting the disability" by Yoshisato Tanaka, April Issue: "Information and Culture Center for the Deaf (introductory essay)" by Yoshikiyo Toda; June issue: "On what it means when you cannot hear" (opinion) by Shuichi Maruyama; July and August issues: "On auditory teaching method, speechreading, pronunciation training" (first and second part in the respective issues) by Kenji Mori, August issue: this moth's word is "No more 9 year-old age limit" by Ryuzaemon Kagami; August issue: "Record of interviews regarding education of children with hearing impairments in Australia" by Naoki Onuma (details are listed below); September issue: "Changes in musical education in schools for the deaf"by Nagashige Kasamatsu and "A view on teaching music and rhythm" by Chieko Yoshida; October issue: "Advocacy for compensation of appropriate education"; November issue "On speech trainers" by Yasuo Matsuo.
December 1986 Japan; Special issue of the Hearing Impairment Magazine "Education in classes for children with hearing impairments", this month's word is "Varied problems of classes for children with hearing impairments and speech impediments" by Shoji Terada, Akio Nakamoto: "Actual situation in classes for hearing and words", Hiroshi Tateno "Advances in classes for children with hearing impairments and actual situation in teaching", Machiko Murakami "Contents and methods of education in special support services for children attending classes for children with hearing impairments", Satoru Kagawa "Education in classes for children with hearing impairments in junior high schools", "Report on Ibaraki Convention of the National Public Schools Council of Educational Research on Hearing Impairments and Speech Impediments."

March 1, 1986 Japan; Japan Deaf Newspaper (official newspaper of Japanese Federation of the Deaf) on its 6th page carries an article regarding cochlear implant devoting a quarter of the page to it.

March 14, 1986 Japan; Dr. Tomokazu Kamio and his group at the Nippon Medical School conduct a surgery implanting an alpha type single channel cochlear implant made by 3M Corporation into the right ear of a 17 year-old female high school student, who lost hearing before language acquisition (congenitally hard of hearing); this is the 3rd surgery conducted at Nippon Medical School.

1985 Abroad; By the end of the year, the number of cochlear implant implantees across the world (Australia, the U.S., Canada, West Germany, Japan, etc.) exceeds 200.

1986 Australia; Number of people using cochlear implants made by Melbourne University/Cochlear Ltd. increases to 49 (an increase by nineteen people from one year before); number of people using cochlear implants made by House/3M Corporation (U.S.) reaches 35.

1986 U.S.; United States Department of Health and Human Services gives a fellowship grant of 350,000 dollars to Melbourne University, Australia to be used for three years in research to modify the cochlear implant speech processor.

1986 Abroad; The international contribution made by the team at the Melbourne University, Australia is recognized, and they gain recognition as pioneers of the field.

1986 Japan; The Oto-rhino-laryngological Society of Japan and the Japanese Audiological Society announce Dr. Funasaka and others' "22-channel cochlear implant - introduction of the system and speech recognition ability before a full-scale language training".

1986 Japan; The Auditory Research Meeting Sponsored by the Acoustical Society of Japan announces Dr. Funasaka and others' paper "Cochlear implant - the system and the rehabilitation method"

1986 Abroad; Cochlear implant surgery is available in three cities in Canada: Toronto, Vancouver, and Edmonton.

May 15, 1986 Japan; First page of Yomiuri Shimbun carries an article on the first successful surgery implanting a 22-channel cochlear implant in Japan.

June 11, 1986 Australia; Dr. Gibson of Sydney University conducts the second surgery on a teenager with acquired hearing loss (a 16-year-old boy called David, who receives an N22 cochlear implant made by Cochlear Ltd.)

July 1, 1986 Japan; Japan Deaf Newspaper on its 10th page carries an article on the 22-channel cochlear implant surgery.

July 4, 1986 Japan; New Tomorrow, newspaper of the Zennancho (All Japan Association for Hard of Hearing People) in its 51st issue carries an article on the first 22-channel cochlear implant surgery in Japan.

1986 Australia; Melbourne University develops a new mini 22-channel electrode cochlear implant.

1986 Australia; Melbourne University starts implanting cochlear implants to children with acquired hearing impairments.

September 1986 Japan; Tokyo Medical College successfully conducts second surgery implanting an N22 cochlear implant made by Cochlear Ltd.

September 1986 Japan; Cochlear Japan is established (through separation of a part of Japan Telectronics, a company importing cardiac pacemakers and other medical equipment)

September 1, 1986 Japan; Japan Deaf Newspaper (official newspaper of Japanese Federation of the Deaf) prints an article on its 6th page on completion of an educatory video on early detection of hearing impairments in children.

October 1986 Japan; First documentary program on cochlear implants is broadcasted by the NHK Educational channel. The program entitled "A close-up of cochlear implant: getting the sound back - overcoming hardness of hearing through artificial cochlea" covered the second surgery implanting a 22-channel cochlear implant by Cochlear Ltd. in Japan, hailing the technology as "ground-breaking".

December 1986 Japan; Tokyo Medical College successfully conducts third surgery implanting an N22 cochlear implant made by Cochlear Ltd.

1986 Japan; Prof. Iwao Honjo of Department of Otolaryngology, Graduate School of Medicine, Kyoto University attends a special lecture on multi-channel cochlear implants (covering the surgery method and postoperative results) by Dr. Webb of Melbourne University and decides to start cochlear implant medical treatment. Instructor Ito and assistant Haji from Department of Otolaryngology go for a short period abroad to study cochlear implant technology (to Melbourne University, Australia, University of California, San Francisco, Stanford University, U.S., etc.)

1986 Japan; Graduate School of Medicine at Kyoto University submits an application for clinical application of cochlear implants to the Ethics Committee of the Graduate School of Medicine Kyoto University. The application is approved in the end of the year, and the Committee issues a guidance document.

1986 France; In Bordeaux, research on cochlear implants is conducted by a team led by Dr. M. Portman of the Hearing Research Institute of the National Institute of Health and Medical Research (yet another group in France engaged in the area in addition to the team of University of Paris that developed 12-channel Chorimac implant and is the leader of the cochlear implant research in France). The team uses a single channel extracochlear device PRELCO. Including patients operated by other groups, the number of implantees reaches about twenty by 1986. The merit of the technology is that the device can be inserted under local anesthesia and the implantee can start rehabilitation in a few days.

1986 U.S.; Dr. Tyler of University of Iowa conducts a comparison of speech recognition ability between implantees with cochlear implants of several manufacturers and reports that the N22 of Cochlear Ltd. stands out among the rest.

December 8-12, 1986 Abroad; The 1st Asia-Pacific Congress on Deafness is held in Hong Kong.
Chairperson of the Hong Kong Congress: Mr. Bau (Hong Kong School for the Deaf Principal); countries participating: Asian, Western countries, Nigeria, etc.; number of participants: over 600 people (of which 40 are from Japan).

1987 Japan; Committee for Political Rights of the Deaf established.

1987 Japan; Tsukuba College of Technology, a three-year university for people with visual and hearing impairments is established.

1987 Japan; Sign Language Research Institute is established by the Japanese Federation of the Deaf.

March 1987 U.S.; The government through the medical research fund of the NIH (National Institute of Health) gives 1,750,000 dollars to the Department of Otolaryngology of Melbourne University to be used in five years in research on modification of the cochlear implant technology so it can be used by young children and find out the effects of use of cochlear implants on the growth of the cranium and the nervous system.

1987 Abroad; During International Cochlear Implant Symposium, a number of reports state that the 22-channel implant allows for more efficient improvement of speech recognition ability compared with other multi-channel methods and the single channel method.

April 6, 1987 Japan; Kyoto University conducts its first cochlear implant surgery.

April 1987 Japan; Clinical trials using N22 cochlear implants by Cochlear Ltd. are launched (the first surgery is made by the Tokyo Medical University Hospital; the number of hospitals participating in the trials quickly increases, and by 1989, the year the trials were completed, there are eight hospitals participating). In 1978, Tokyo Medical University Hospital leads the way followed by Toranomon and Kyoto Universities; 13 people receive the implants.

1987 Australia; Melbourne University conducts the first surgery giving a cochlear implant to a child with congenital deafness. It is a girl named Colleen, who is both blind and deaf.

1987 Australia; Dr. Gibson of Sydney University conducts surgeries giving cochlear implants to a 4-year-old child and a child with congenital deafness.

1987 Japan; Bulletin of the Oto-rhino-laryngological Society of Japan carries "Speech recognition ability of patients with 22-channel cochlear implants by Cochlear Ltd." by Funasaka et. al.

1987 Japan; Ministry of Health and Welfare receives a complaint from Nucleus Ltd., Australia regarding clinical trials.

1987 Japan; Japanese government receives a protest from the Prime Minister of Australia regarding the above-mentioned trials, Dr. Funasaka through a member of the Diet from the Liberal Democratic Party makes a request regarding clinical trials of N22, and the Ministry of Health and Welfare approves the trials "in five institutions, thirty surgeries, covering expenses for fifteen of them".

1987 U.S.; FDA expands the eligibility for N22 cochlear-implants by Cochlear Ltd. to children under 18.

1987 Japan; Teikyo University conducts surgeries implanting single channel cochlear implants (by 3M Corporation/House) (the 4th and the 5th cases).

November 1987 Japan; Journal "Let's understand the deaf (1)" published on November 12 by the Zennancho (All Japan Association for Hard of Hearing People) carries an article Michiyo Tsuna entitled "Electronic ear - good news for people with internal ear-related disabilities (perception deafness)" on the first single channel cochlear implant surgery in Japan (the article is a reprint from the July 15 issue (No. 31) of New Tomorrow, official newspaper of the National Liaison Council for the Hearing-impaired Persons, predecessor of the Zennancho (All Japan Association for Hard of Hearing People)

1987 U.S.; 3M Corporation discontinues single channel cochlear implant. The reason for it is that multi-channel cochlear implants enable the implantee to recognize words without speechreading at the same time (multi-channel implants were developed in Western countries also, but the achievement made by Melbourne University, Australia with its N22 implant were especially large), while with single channel system, the majority of the implantees could not recognize words using just the auditory sense, which proved the superiority of the multi-channel type.

1987 Japan; The Hearing Impairment Magazine carries the following papers. January issue: this month's word is "Contemplating difference between 'listening' and 'hearing' by Yoshisato Tanaka, research paper by Hisashi Asano, "School physician's treatment of children with hearing/speech impediments - centering on treatment of infants in preschool period", February issue: lecture by G. W. Fellendorf "How to enrich understanding of hearing impairment among people in the community", April Issue: "Using ears of children with hearing impairments" (Volta review), July issue: this month's word is "Total communication and oral communication" by Tatsuo Hoshi, August issue: Ryoji Beppu "Practice of auditory learning in my school's infant section", introductory piece "Verbo-Tonal Method of the Sophia Research Center for Speech and Hearing Disorders", September issue: "Trends of total communication" by Shinro Kusanagi, "Schools for the deaf and total communication" by Kimimasa Ochi, "On the issue of communication media - role of the parents" by Shigeo Okabashi, "Program of the 10th Anniversary Convention of the Study Circle of Total Communication (TC-ken)", October issue: this month's word is "On special issue on communication media" by Tatsuo Hoshi, "On oral communication" by Hiroichi Sugawara, "On simultaneous communication" by Tochigi Prefectural School for the Deaf, "One aspect of oral communication as seen in introduction of sign language method in the U.S." by Masuo Ueno, December issue: "Ronsard Le Havre Class for children with severe hearing impairments, France" by Seiroku Sato, "Foreign affairs: 16th World Congress of Rehabilitation International", Chikusa School for the Deaf "Education method at Chikusa School for the Deaf."

1988 Japan; Ehime University conducts surgeries implanting single channel cochlear implants by 3M Corporation/House (the 6th, the 7th, and the 8th cases).

1988 Japan; As single channel cochlear implants by 3M Corporation/House are discontinued, clinical trials are closed after the eighth case. Japan Cochlear Ltd. takes over the postoperative care for the eight patients (equipment repair, cable replacement, etc.)

1988 Japan; Book by Tooru Ifukube (Hokkaido University) Bionic research on design of cochlear implant is published.

1988 Japan; National Hearing Aid Manufacturer Conference and Japan Hearing Aid Dispensers Association are established.

March 1988 Japan; Japan Ergonomics Society in Vol. 24 No. 3 of its bulletin Ergonomics (a special issue on sensory substitution in ergonomics), carries an article by Tooru Ifukube (Institute of Applied Electricity, University of Hokkaido) entitled "Cochlear implant".

April 1988 Japan; ACITA (Association of Cochlear Implant Transmitted Audition, the only national organization of implantees in Japan) is established and holds its first round-table conference. The number of regular members is 16 (as of 31 of April of the same year), among which the ones attending were seven people operated at the Tokyo Medical University Hospital, four people operated by the staff of the Tokyo Medical University Hospital, and two people operated by the staff of the Tokyo Telectronics (predecessor of Japan Cochlear Ltd.) For the time being, the Association conducts its activities centering on exchange of information and friendly gatherings. The first 8-page bulletin is published in 40 copies.

April 1988 Japan; Total of number of hospitals offering cochlear implant surgery reaches 5 (Tokyo Medical University Hospital, Toranomon Hospital, Kyoto University, Sapporo Medical University, University of the Ryukyus), number of implantees reaches 30.

April 22, 1988 Japan; New Tomorrow, official newspaper of the Zennancho (All Japan Association for Hard of Hearing People) on page 25, No.58 (reader's column titled "Common plaza") carries an article by journalist Hideo Kawahara of Saitama on development of conference monitors

New Tomorrow, official newspaper of the Zennancho (All Japan Association for Hard of Hearing People) on page 26, No.58 (reader's column titled "Common plaza") carries an article by journalist Jubun Horikita (from Tokushima Prefecture) on otology. Title is "The many mistakes of ear medicine (1)" (the second half is carried in the following issue published on July 6). The author, who admits that he is not a medical professional, states that he wants to still express his views, and gives the outline of the structure and the function of the ear. The first portion is mainly on structure and functions of the middle ear and external ear (continued in the next number).

June 1988 Japan; Juichi Ito (cochlear implant surgeon at the Graduate School of Medicine, Kyoto University) publishes a leading article (Society of Practical Otolaryngology Journal 81:6:p.779 - 786 June, 1988) entitled "On cochlear implant" describing the history of cochlear implant, explanation of the difference between single channel and multichannel types, requirements, preoperative tests, surgery, postoperative rehabilitation, and the future prospects. In the article, he states that as a single channel cochlear implant only transmits one type of sound, it is not sufficient for language recognition, that, compared to it, multi-channel implants, particularly the 22-channel device developed by Melbourne University excel in the language recognition aspect, and mentions the fact that over 400 people are using this type of implant across the world as of 1988.

June 1988 Japan; Japan Ergonomics Society in its bulletin (a special issue on sensory substitution in ergonomics), carries an article by Tooru Ifukube (Institute of Applied Electricity, University of Hokkaido) entitled "Cochlear implant".

1988 Japan; The Hearing Impairment Magazine carries the following papers. June issue: "Study Circle of Total Communication (TC-ken) Convention", July issue: this month's word is "Accepting the disability" by Ken Baba, "Shuji Izawa and pronunciation training" by Masuo Ueno, lecture by W. E. Castle "Importance of social adjustment", news: Shuichi Obata "Gallaudet University Center on Deafness is established in University of Hawaii."

July 3- 8, 1988 Abroad; International Congress of the Hard of Hearing held in Montreux, Switzerland. 800 participants from 34 countries assemble. Delegation from Japan consists of 40 people. In addition to hard of hearing people, people representing hearing-aid manufacturers, audiologists, doctors, teachers, psychologists, and caseworkers also attend the Congress. The meeting is taken up by the NHK Educational channel TV in its "Persons with Hearing Difficulties Hour" program. (Report of the Congress appears on the first page of No. 60 issue of New Tomorrow, official newspaper of the Zennancho (All Japan Association for Hard of Hearing People) published on 1988.9.7.




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The original text is prepared by TANAKA Takako.
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