Listen and learn

From: Brisbane Times - Brisbane,Queensland,Australia - May 16, 2007

Fran Molloy

Early intervention is a tricky choice for parents.

For the past four years, babies born in NSW hospitals have been screened for hearing impairment, under the Statewide Infant Screening - Hearing (SWISH) program. This means most children born deaf are identified in their first few months of life, a crucial stage for language development.

However, as technology, especially cochlear implants and effective hearing aids, change the nature of deafness, most deaf children now learn to speak and fewer learn Auslan, the visual sign language of Australia's deaf community. With only 12,000 users of Auslan, many in the deaf community fear for the future of their sign language and their culture. (Each year, about 80 Australian babies are born profoundly deaf and another 80 are classed as severely deaf.)

Despite a strong genetic link for some forms of deafness, about 95 per cent of deaf children are born to hearing parents, who usually want their children to learn to talk.

Professionals say the debate over whether children learn Auslan or English as their first language is not as important as ensuring that children learn some form of language from a young age.

"Our research is showing that the earlier children with hearing impairment get intervention, the better," says Professor Harvey Dillon, director of the National Acoustic Laboratories, the research arm of Australian Hearing.

He says there are two crucial early interventions to enable deaf children to learn spoken language. First, they need access to sound, initially through hearing aids and, for some children, cochlear implants. Deaf children also need structured education so they can understand what they are hearing.

"The signal children get through hearing aids or cochlear implants can often still be poorer than what a child normally would hear, so that has the potential to confuse rather than educate," Dillon says.

The National Acoustic Laboratories are running a long-term research project comparing the language development of about 300 deaf children who are fitted with hearing aids and cochlear implants.

"There are not enough children in that group who have Auslan as their first language to be able to compare the two groups," Dillon says, estimating that fewer than 10 of these 300 children learned Auslan as their first language.

"We have already found that children who have intervention before six months, on average, will develop language normally," he says. The study also shows better results for children who have a cochlear implant before the age of one.

"After 12 months, these children have not developed the normal neural processing ability to understand the sound signals when they arrive so they take longer to develop language," he says.

Lynne Gilchrist's first child, Julia, was found to be profoundly deaf at the age of 17 months. A specialist who confirmed the diagnosis told Gilchrist her baby would never learn to speak and she should teach Julia to sign. Gilchrist says she was devastated, but gained hope when she learned that the Shepherd Centre teaches hearing-impaired children aged up to five to listen and speak, but not to sign.

"I can't imagine what it would have been like for Julia if we hadn't taught her how to speak," Lynne says. "We didn't want to cut her off."

Julia Gilchrist is now 25 and an honours graduate in communications. She attended mainstream schools and now works as a research officer, having never learned to sign.

"I refused to learn. I didn't want to sign because that's what deaf people do," she says. "Hearing impairment is an invisible disability; if you are able to speak, people don't notice you are deaf until you tell them."

Julia had a cochlear implant at age 20 and describes herself as hearing-impaired, rather than deaf.

"When they switched the cochlear on, it was amazing: the difference in sound was astronomical," Julia says. "Now I enjoy music and things I never could appreciate before."

The difficulties Julia faced in first learning how to speak at 17 months are far less common now, says Dr Maree Doble, a speech therapist and the programs director at the Shepherd Centre.

"Since the [SWISH] program was rolled out in NSW at the end of 2002, it has made a huge difference in the age that children start getting intervention," she says.

"The average age of diagnosis has dropped from about 18 months old to one month; the average age for hearing-aid fitting has dropped from an average of about two years to about two months. The greater the hearing loss, the more reliant the child will be on signing," Doble says. "So children who come here learn spoken English as their first language."

However, a small number of children will always struggle with spoken English, she says, and need access to a signing communication system.

Rebekah Rose-Mundy is a deaf Auslan teacher whose three deaf children use signing and spoken English. She disagrees with the policy of not teaching deaf children to sign from birth.

"I find it frustrating there are not enough education options for my children in Sydney and no programs that provide both signing and spoken English," she says. "I wish every parent with a deaf child could see it is beautiful having the best of both worlds."

Rose-Mundy's youngest child, Scarlett-Oceania, now a year old, had a cochlear implant at seven months. "She can hear many sounds, responds to her name and is vocal," Rose-Mundy says.

Tony Clews, a deaf man living in Sydney, says if parents don't give deaf children access to spoken and sign languages, the child will not have the opportunity to decide which they prefer. He has seen people who have come to the deaf community later in life but felt insecure about their Auslan skills because they didn't have the chance to learn to sign when they were young.

The opportunities for parents who want their children to learn signing and speech are greater in Victoria than NSW. Irene Holub is the acting head of the early intervention program at Aurora School, a government deaf school in Victoria - and she is deaf.

"We encourage the use of hearing aids or cochlear implants in the early years as equally as learning Auslan because we do not know the future outcomes for each child," she says.

At Aurora, she says, children are exposed to a bilingual model, learning Auslan and English. A small number of deaf children have auditory nerve damage and cannot be helped with hearing aids or cochlear implants; others find they can't adjust to the implants.

Jessica,* a 16-year-old student at the Victorian College for the Deaf, had a cochlear implant when she was five, but switched it off when she was 10.

"I didn't like the loud sounds and it gave me headaches," she says.

Recently, she resumed use of her implant. "Things sounded strange." She can't understand people's voices though and says she would not be able to communicate without Auslan.

For people like Jessica, the death of Auslan would be devastating.

"Years ago there was a very big gap between the oral and signing deaf communities," Gilchrist says. "But today, I think more people are recognising that regardless of the means of communication chosen, we still face the same difficulties."

* Not her real name.

Let's get loud

The Shepherd Centre, www.shepherdcentre.com.au, 9351 7888
Deaf Education Network, www.deaf.nsw.edu.au, 8833 3630
Aurora School, www.auroraschool.vic.edu.au, (03) 8878 9878
Australian Hearing, www.hearing.com.au, 131 797
Deaf Society of NSW, www.deafsocietynsw.org.au, 9893 8555
Royal Institute for Deaf and Blind Children, www.ridbc.org.au, 9871 1233

Get in early

Emma and Adam Harpham were shocked when their son, Max, was diagnosed with severe to profound deafness at just 18 days old.

"We were devastated," Emma says. "Here was our perfect new baby and suddenly everything about him was different."

Baby Max was two days old when a routine test under the NSW Statewide Infant Screening - Hearing program identified a problem.

Once Max was diagnosed, the Harphams saw several specialists to go through the options available for Max, their second child.

Max was fitted with hearing aids but these weren't enough to give him all the sounds he would use to understand speech.

"When we went to the Shepherd Centre and realised he would be able to learn to listen and talk, we decided to go down that path. We want Max to be a part of our world, the hearing world," Emma says.

The Harphams arranged a cochlear implant for their son. At five months, Max was then one of the youngest babies in Australia with an implant.

"After the operation, when the implant was switched on, his eyes lit up. Before, there had been a blankness there because he couldn't hear anything. It was one of those amazing moments you never forget."

Emma and Max attend the Shepherd Centre for a weekly therapy session and also attend a playgroup.

Already, at the age of two, Max is talking. "It's amazing, he already has more language than our daughter India had at the same age," Emma says.

© 2007. Brisbane Times.