Equipment & Funding
Amplification and Sensory Assistance for Hearing Impaired and Deaf children in New Zealand. What options are available? By Paul R Peryman, Senior Educational Audiologist, van Asch Deaf Education Centre. Updated March, 2007.
INTRODUCTION
Following the diagnosis of hearing loss in a child by an audiologist, and following consultation with an ear nose and throat surgeon (also known as an otolaryngologist), the audiologist and adviser on deaf children will discuss with parents and families the types of sensory aids available and which would be the most appropriate for their child. This discussion is held with parents and families who choose to pursue support for the stimulation of the auditory system to facilitate listening and spoken language development. All parents and families of hearing impaired or deaf children who are keen for their child to develop spoken language skills and to use their residual hearing to its fullest potential will want to know about the types of sensory aids available.
Sensory aids are wearable electronic devices designed to improve reception of speech and environmental sounds for hearing impaired and deaf children. Sensory aids help children develop spoken language skills and keep them in touch with environmental sounds such as household noises, alarms and traffic noises. Children with loss of hearing sensitivity are less able to follow spoken conversation, hear radio or television, hear on the telephone, or hear sounds in their everyday world.
The discussion below is designed to compliment the "Family Book" (DEANZ & NAC, 2005) and provides basic information to assist parents and families in understanding what sensory aids are, how they work and how they are provided in New Zealand. It should be read in conjunction with publications which address other modes of communication for children who are deaf. It is most important that parents of deaf children are aware of the various sign languages, and of their appropriateness and importance for some deaf children. Advisers on deaf children will be able to discuss aspects of signed communication.
PERSONAL HEARING AIDS
Types
Personal hearing aids are battery powered devices designed to amplify sounds to varying degrees. They are worn externally attached to the ear, head or body. Hearing aids come in various types and shapes but each type of hearing aid is carefully selected for each child, as a result of hearing tests and amplification prescriptions.
Hearing aids are precision electronic instruments comprising a tiny microphone, a volume control, an amplifier, a tiny speaker, an on/off switch and a battery housing. Many hearing aids are fitted with a magnetic pick up coil (sometimes called a tele-coil) which is used in conjunction with other electromagnetic transmission devices. All hearing aid amplifiers have programming facilities to alter their performance.
The sound from hearing aids is delivered to the ear by specially moulded sound tubing arrangements called earmoulds. In-the-ear hearing aids have their electronic components mounted within the earmould. The sound to the ear from bone conduction hearing aids is delivered by a bone conductor worn on the side of the head behind the ear. This vibrates the bones of the skull, stimulating the hearing organ directly inside the ear.
Selection
Hearing aid fitting for children is usually recommended as soon as possible after the confirmation (diagnosis) that a hearing loss is present, but follows parents and families consenting to the process occuring. Fitting is done early to allow listening development to proceed at the youngest possible age when children are normally more ready to learn. Hearing aids do not make hearing normal, and they are not like wearing glasses or contact lenses. Indeed, some very deaf children, despite being fitted with appropriate high powered hearing aids, make slow progress in listening development. Some children appear to make no progress at all despite intensive training, and may become candidates for other forms of amplification such as cochlear implants.
Fitting
Fitting hearing aids to children for the first time is an anxious time for parents and families who may be unsure how well their child will accept the aids and whether they will respond to the amplification. Parents and families will have some feelings about their own acceptance of hearing aids. Also, audiologists who fit hearing aids and advisers on deaf children who support hearing aid use are themselves anxious that children and parents/families will accept and use the devices.
During initial hearing aid fitting, emphasis is usually placed on ensuring fittings are comfortable and that parents/families (and children where appropriate) are acquainted with the operation of the hearing aid. Measurements may also be made of the amplification being provided in the child's ears or of the child's hearing responses with the aids fitted.
Monitoring Progress
Once fitted with hearing aids, the child's progress is monitored by the audiologist and the adviser on deaf children. A follow up schedule during the first twelve months following the fitting may require several visits to the clinic for audiological assessments as well as to the home by the adviser. In fact, the child will remain under the care of the same audiologist and adviser for as long as the child lives in the same area.
The audiologist will monitor the child's hearing sensitivity and be alert to any changes, check the use of and appropriateness of hearing aids and upgrade them as necessary, replace earmoulds as necessary, and liaise with parents/families and advisers about speech, language and educational progress. Audiologists will also be observant for the onset of medical problems to do with the ears and refer to general practitioners or ear, nose and throat surgeons when indicated.
Funding
Hearing aids and earmoulds are presently funded by the Ministry of Health through the Children's Hearing Aid Fund (formerly known as the Special Aid Fund), administered jointly by the National Audiology Centre in Auckland and the two deaf education centres. Fund applications are made by the audiologists fitting the aids.
Repairs, batteries and accessories are currently provided and funded by the two deaf education centres. Parents are encouraged to arrange insurance cover for their children's hearing aids against loss or damage.
References: "The Family Book. Te Pukapuka O Nga Whanau". Deaf Education Aotearoa New Zealand & National Audiology Centre. February, 2005.
USEFUL ADDRESSES
van Asch Deaf Education Centre
Truro Street
Sumner
CHRISTCHURCH 8081
Voice/TTY (03) 326 6009
Fax (03) 326 5346
Kelston Deaf Education Centre
Private Bag 93008
New Lynn
AUCKLAND 7
Telephone (09) 827 4859
Fax (09) 827 8704
Audiologists are located at hospital audiology clinics in the main centres. Some patients choose to see an audiologist in private practice.
Advisers are located at Special Education Services offices in the main centres details of which are available in local telephone books. Advisers based in Christchurch are currently located at van Asch Deaf Education Centre.
Ear Nose and Throat surgeons are currently located either at the local Public Hospital or have an address and telephone number for private practice in the front of the telephone book. You usually need a referral from your family doctor.
Hearing Association - the address and telephone number of the local branch of the Heading Association will be in your telephone book.