In the age of communication the ability to hear can be for all

Alison was diagnosed with profound hearing loss when she was 14 months old.

“We took the kids to a concert and we realised she hadn’t heard the music,” says her mother, Dr Di Winstanley.

Then they noticed she didn’t hear the alarm clock.

She had been through all the normal health checks – Plunket, their GP – but it still took over a year for Alison’s deafness to become apparent.

Apparently this is not unusual – in Alison’s case she was surrounded by noisy siblings and the family had wooden floors; she would have been able to register some sound through the vibrations.

But she is now a hearing eight-year-old with age-appropriate speech – all thanks to the cochlear implants she was given shortly after she was diagnosed.

The success of these implants depends very much on how early they are given to a child with hearing loss.

Unfortunately, many children in New Zealand are not picked up as being deaf until they are three or four. At this stage it is still possible for children to learn to hear and speak at an age-appropriate level, but the battle is that much harder.

Earlier this month there was a key stage in the rollout of early screening for hearing loss for New Zealand children.

The National Screening Unit is attempting to screen all children at birth for medium to profound hearing loss through a scheme called the Universal Newborn Hearing Screening Programme.

The programme was announced in 2006 and hopes to benefit the 135 – 170 babies that are born in New Zealand with mild to profound hearing loss every year.

Their website www.nsu.govt.nz is clear about the need for the screening:

“The first six months of a baby’s life is a critical period for learning communication. Lack of exposure to language during this time can affect a child’s development, communication skills, educational and career achievements. The early detection of hearing loss, and the application of early interventions, has been demonstrated to significantly improve long-term language skills and cognitive ability.”

And this early screening will also vastly improve a deaf child’s chance of being able to use cochlear implants and achieve age-appropriate language.

“The age of the diagnosis is the critical first thing in terms of getting outcomes. After that it is quality intervention and parental input – but age of diagnosis is critical,” says CEO of The Hearing House Scott Johnston.

Shona Gilby’s older son was diagnosed in the UK as being deaf through a similar scheme. Consequently, her young daughter Isla was picked up as a baby and is now undertaking the first stages of learning to use a cochlear implant.

“If she had been born here without having an older brother diagnosed in the UK – we wouldn’t have a clue she was deaf – but here she is already starting to hear,” she Ms Gilby.

Spotting the signs of deafness early is important as the young child’s brain has a high level of neuroplasticity at this age. A foetus starts processing sound in the womb at twenty weeks and some studies show that as early as an hour after being born a baby recognises its mum’s voice over anybody else’s.

If the nerves in the middle ear do not receive stimulation, the brain will not develop the ability to process auditory signals.

However, if a child is given a cochlear implant at the earliest possible age the middle ear will be stimulated by sound and will develop in the same way a hearing child’s ear.

The relevant nerves will form connections and the child will be able to process auditory information as well as a hearing child.*

In older children the brain is less ‘plastic’ and the process of forming these neural connections is harder.

“That is why screening is so important – it will lead to extraordinary outcomes in four or five year’s time when most deaf children will go to mainstream school with age-appropriate language,” says Mr Johnston.

But the road is not easy – training a child with a cochlear implant to process auditory signals is a full-time job.

Parents receive one hour of therapy a week from the Hearing House and are trained to be the therapist at home.

“It’s like being a mum with bells on,” says Amanda Smith, mother of exuberant toddler Ben.

“A normal mum might say ‘let's go to dinner’ in a normal manner. But I will say ‘let's go to dinner’ with a lot of emphasis on the sounds.”

Everything in life becomes a potential talking point and an opportunity to improve the child’s ability to hear.

“We are Auckland’s biggest users of the library,” says Dr Winstanley.

A fallen tree to most people is a novelty or an inconvenience – for Dr Winstanley and Alison it is an opportunity to talk about the tree, why it might have fallen and to go to the library to find more resources on trees so that they can talk about it even more.

Unsurprisingly, the parents at the Hearing House say their children become excellent listeners.

Alison is a remarkable girl and a testament to the power of cochlear implants – she reads from a children’s book about an unfortunate duck. Her voice and pronunciation are crystal clear – she is a confident and entertaining reader.