-
For all your hearing optionsHQ
Apr - Jul 16
MEET THE SUPERHEROES
ON A HEARING MISSION
hearing
NEWS ALERTWhat's next forAustralian Hearing
NAVIGATING THE
NDIS
Cochlear Implant DiaryWas surgery a success?
AFLs Jason Akermanis: A life changed by hearing
lossEXCLUSIVE
SPORTING CHANCEThe 2016 Olympics & beyond
ASK THE EXPERTS Sudden hearing loss explained Getting used to
hearing aids Do I need an audiologist?
-
1800 826 500hearing.com.au
As seen on Channel 9
Now a broader range of hearing aid wearers can experience the
outstanding performance binax has to offer.
Make an appointment to trial the latest technology, or check if
you are eligible for Australian Hearing service today.
Call 1800 826 500 or visit hearing.com.au
In a world first, wearers are now able to experience binaural
directionality in instruments with a single microphone.
Wearers can experience enhanced speech intelligibility and sound
quality, even in challenging listening situations.
AH06
85 0
5072
015
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Hearing HQ Apr - Jul 16 3
Sharan WestcottClinical Manager, SCIC
Adjunct Prof Harvey Dillon Director of Research, NALDr Dillon
has researched many aspects of hearing aids, effectiveness of
rehabilitation, auditory processing disorders and methods for
preventing hearing loss. He has designed hearing aids, authored
over 160 articles and his text on hearing aids is used
worldwide.
Principal Research Fellow of Melbourne University, A/Prof Cowan
has researched and published extensively in the fields of
audiology, cochlear implants, sensory devices and biomedical
management. He holds the '06 Denis Byrne Memorial Orator Award.
Former principal audiologist for Australian Hearing, Sharan
Westcott has provided audiology services to children and adults for
more than 40 years and now coordinates a team of surgeons,
audiologists, speech pathologists and social workers at SCIC.
Assoc Prof Robert Cowan, CEO HEARing Cooperative Research
Centre
MAA focuses on identifying practical, real-world solutions for
people with disabilities to access audiovisual content to empower
people to be independent. They provide advice to government,
industry, educators and individuals.
After 45 years of profound deafness Dr Lockhart received a
cochlear implant in 2005. His involvement in the cochlear implant
support group CICADA and his technology background (retired senior
CSIRO scientist) led him to become editor of CICADA Magazine (now
Hearing HQ).
Profoundly deaf from birth, Olivia Andersen started Hear For
You, a not-for-profit organisation to help young deaf people
achieve their life dreams. The birth of her first child prompted
her decision to have a cochlear implant.
Alex Varley, Chief ExecutiveMedia Access Australia
Dr Neville Lockhart
Olivia Andersen, Founder/Director Hear for You
Prof Gibson held the Chair of Otolaryngology at The University
of Sydney until August 2013 and was head of ENT at The Royal Prince
Alfred Hospital. He is the founder and director of the Sydney
Cochlear Implant Centres, and still sees patients privately. He is
also currently undertaking research into Menieres Disease.
Emeritus Prof William Gibson AM
The Editorial Advisory Board provides guidance and expertise on
a voluntary basis. They may not review every article and make no
warranty as to the scientific accuracy of the magazine. They are
not responsible for any errors published and do not endorse
advertised products. If you have questions about product
suitability for your specific needs, we recommend you consult an
audiologist or doctor. Any person with health issues or medical
concerns should first take advice from a health professional.
editorial advisory board contentsHEARING SUPERHEROESMeet the
'superheroes' on a mission to help disadvantaged people hear.
FEATURES
8
11 THE NDIS & AUSTRALIAN HEARINGWhat's changing and how it
affects you.
contents
NEWSBITES Research, innovationsand news items.
ASK THE EXPERTSProfessional advice on readers' questions and
concerns.
REAL PEOPLEA couple whose son has hearing loss navigate the
NDIS.
REGULARS4 25 ALL ABOUT
The Earbus Foundation of WA.
PRODUCTS & SERVICES Information at your fingertips.
HERE TO HELP Organisations providing advice and support.
20
22
26
14 SPORTING CHANCEGet inspired this Olympic year as Australian
athletes push aside auditory issues and go for gold.
27
Published by The Tangello Group Pty Ltd
EDITOR Rebecca Barker, [email protected] Assoc.
Prof. Melville da Cruz, Emma Scanlan, Roberta Marino, Jawan
Sayed
CONTRIBUTORS Liz Efinger, Paul Higginbotham, Mark Wyburn
ADVERTISING SALES MANAGER Sally Davis, [email protected]
0438 177 036
PUBLISHER Lucinda Mitchell, [email protected] by
Offset Alpine
17 EXCLUSIVE: TRANSFORMING LIVES THROUGH SPORTAFLs Jason
Akermanis reveals how sport and family hearing challenges changed
his life.
Hearing HQ Magazine is published by The Tangello Group Pty
Limited 'The Tangello Group' (ABN 38 155 438 574) PO Box 1054, Lane
Cove NSW 1595 and subject to copyright in its entirety. The
contents may not be reproduced in any form, either in whole or
part, without written permission from the publisher. All rights
reserved in material accepted for publication unless specified
otherwise. All letters and other material forwarded to the magazine
will be assumed intended for publication unless clearly labelled
not for publication. Opinions expressed in Hearing HQ Magazine are
those of the contributors and not necessarily those of The Tangello
Group. No responsibility is accepted for unsolicited material. No
liability is accepted by the publisher, the authors or members of
the editorial advisory board for any information contained herein.
All endeavours are made to ensure the accuracy and veracity of all
content and advice herein but neither Hearing HQ Magazine, its
publisher, contributors or editorial advisory board members is
responsible for damage or harm, of whatever description, resulting
from persons undertaking any advice or purchasing any products
mentioned or advertised in Hearing HQ Magazine or its website.
SUBSCRIBE TO HEARING HQPersonal orders: $25/year for 3 issues
posted to your homeMultiple copies- Small Bulk: $35/year for 3
issues (5 copies of each issue)- Large Bulk: $55/year for 3 issues
(45 copies of each issue) For all orders you can subscribe - online
at www.hearingHQ.com.au - post the form on page 26 toHearing HQ, PO
Box 1054, Lane Cove NSW 1595
HQhearing
Cover image courtesy of Warner Bros.
18 COCHLEAR IMPLANT DIARYIn the final instalment of her diary,
Liz Efinger reveals whether implant surgery was a success.
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newsbitesnewsbitesBig changes are happening to Australias
disability and hearing services. But how will they affect you?
This issue, we look at the impact of the National Disability
Insurance Scheme (NDIS) and clarify the implications of a possible
sale or transfer of Australian Hearing, the Governments hearing
services provider. As anyone with auditory difficulties knows,
change can be
challenging but with the right support and information, you can
move forward positively. One couple, who live in an NDIS trial
site, did just that as they navigated the new system with their son
(see Real People Real Stories on page 22). They hope their story
will help others looking to access and understand the scheme.
With suitable equipment and support, anything is possible - as
the incredible athletes in our Sports special reveal in the lead-up
to the 2016 Olympics and Paralympics. Plus our cover story
celebrates more homegrown 'heroes' and their celebrity supporters
who are transforming lives through hearing missions in less
fortunate countries. As the saying goes, nothing great ever came
from sitting in your comfort zone.
Finally, our Publisher Lucinda Mitchell and I would like to say
a big thank you and farewell to Alex Varley who has been an
important member of our Editorial Advisory Board since Hearing HQ
began in 2012. After 20 years at the Australian Caption Centre and
its renamed successor Media Access Australia, Alex is pushing past
his comfort zone to explore new horizons. We wish you all the best
Alex.
ed's letter
Rebecca BarkerEditor
To have your say contact: [email protected]
The Royal Institute For Deaf and Blind Children (RIDBC) is
leading a proposal to take over the Government's hearing services
provider, Australian Hearing (AH). The RIDBC joins Cochlear Limited
and Sydney's Macquarie University, a leading centre for hearing
research, in a consortium being considered by ministers to take
ownership of the organisation and its Sydney-based research arm the
National Acoustic Laboratories.
It is expected that AH will have increasing competition from
private hearing service providers as part of the introduction of
the National Disability Insurance Scheme, shrinking its monopoly on
many services. In a statement to the Sydney Morning Herald, Chris
Rehn, RIDBCs CEO said ideas include extending Australian Hearings
services to include cochlear implants for the severely deaf,
therapy, education and rehabilitation. He said the consortium wants
to avoid AH being sold to a private equity firm or hearing aid
manufacturer. We want to see patients needs met in a way thats not
about profit orientation, its about better serving the needs of
Australians with hearing loss, says Rehn.
Support groups Parents of Deaf Children, the Deafness Forum of
Australia and Aussie Deaf Kids want clarification on the
implications of a new provider as many are happy with Australian
Hearings services. Right now, we need answers to many questions
about the consortium proposal and how it will impact on the range
of options that are currently available, says Anna Messariti,
president of Parents of Deaf Children NSW.
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newsbitesnewsbites
Hearing HQ Apr - Jul 16 5
i
THE FUTURE OFWhile spectacles have become a sought-after fashion
accessory, hearing aids have not gained the same cachet until now.
Japanese designer Tatsuya Honda has created a fashionable device
after watching the struggles of deaf children at his school in
America. As a student, he went on to develop a stylish,
illuminating hair clip/or earring, called the Ontenna, that conveys
sound to the wearer as vibrations. It allows the wearer to feel
sound through their hair kind of like how cats can sense movement
in the air with their whiskers, explained Honda to American
technology website Venturebeat. Using circuit board technology,
sounds in the 30dB to 90dB range can be translated into 256
different levels of vibration and light on the clip. In this way,
rhythm, pattern, loudness and other sound qualities can be conveyed
to the user. After being trialled, Honda hopes athletes at the
Deaflympics will roadtest the device. Feedback so far has been
positive with users saying they were able to distinguish between
the sound of the intercom and telephone and realise when the vacuum
cleaner had become unplugged. Track and field players could use
Ontenna when working on the timing and rhythm of their strides to
possibly improve their record, says Honda.
Aid to accessorise
Jeweller to the stars Jan Logan is brightening up the lives of
people with tinnitus by helping raise funds for a telephone support
line. The matriarch of a Sydney jewellery business which has
adorned Hollywood stars such as Jennifer Lopez says her own
struggles with tinnitus the ear-ringing condition that affects one
in 10 Australians prompted her to collaborate with Better Hearing
to raise funds for a phone line to comfort, advise and educate
people who are affected by ear noises. Fifteen per cent of sales
from Logans Arcadia earring range will go towards the campaign and
supporters can make a donation at the website
www.myearringsforpeace.org.au. Victoria Didenko, a board member
with Better Hearing Victoria, brought about the collaboration after
enduring three years with tinnitus. I was galled to be told by the
medical profession that there was nothing that could be done to
stop the ringing so I decided to launch a campaign to help myself
and the two million Australians who also struggle with this
auditory torment, says Didenko.
for ear ringing
For most people, hearing loss has a profound effect on quality
of life.
This can be further intensified if the person has a
passion for music or works in this industry. Many hearing aids
are adjusted to maximise the clarity of speech but in recent years
auditory devices have become increasingly sophisticated offering
specific programs that make listening to music clearer and more
enjoyable.
Musical acoustics differ from speech as there is such a large
variation of sound frequencies. Hearing aid users often get
confused by instrument sounds, wrongly identifying them as feedback
or irritating interference.
Researchers at National Acoustic Laboratories at Macquarie
Universitys Australian Hearing Hub are working with the HEARing
Cooperative Research Centre to fine-tune these in-built music
programs in a new study. Experiments will aim to determine how the
acoustics of music vary in
ways that might affect hearing capabilities, what amplification
characteristics are preferred for
different styles of music and whether existing signal processing
features disrupt the
listening experience.
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6 Hearing HQ Apr - Jul 16
newsbitesnewsbites
The Australian Deaf Games will be held in Albury-Wodonga in two
years time (January 20-27, 2018), shortening the usual four-year
gap between events to maximise opportunities for athletes to
compete overseas. It is a really exciting time for deaf sports the
change of timing ensures the games are part of the selection
process for international competitions, in order to ensure the best
possible preparation for our athletes, explains Garry West-Bail,
general manager at Deaf Sports Australia.
There have never been more opportunities for the countrys
hearing challenged athletes to hit their goals with New South Wales
Melinda Vernon, 30, aiming to be the first deaf triathlete to
compete at the Olympics later this year in Rio, Brazil. The
incredible achievements of other deaf athletes were recently
recognised at the Adelaide Games, including Samuel Greatorex, 16,
of Glen Waverley, Victoria, who clinched Deaf Sports Australias
male athlete of the year award after achieving four Australian open
records and eight Australian age records in swimming events. Jamie
Howell, 17, of Redlands Bay, Queensland (right), scooped the female
equivalent, winning gold, silver and bronze medals in athletics
events at last years Asia Pacific Deaf Games.
DAMAGE CONTROLAfter launching its pilot study HEARsmart in 2014,
the HEARing Cooperative Research Centre (HEARing CRC) launched a
Know Your Noise website that provides an interactive calculator to
estimate sound exposure. The user selects an activity and the
length of time doing it and a risk rating appears alongside a peer
group norm. With funding from the Deafness Foundation (Victoria),
researchers are now working with two Melbourne music venues to see
if they can keep sound levels within safe limits without impacting
patrons enjoyment. If outcomes are positive, the team will work
with Music Victoria to promote findings and educate other venue
owners about healthy sound levels and the impact on staff and
customers. See www.knowyournoise.nal.gov.au. Also, check out
HEARing CRCs new website www.hearnet.org.au.
Track your hearingA 12-year-old Sydney schoolgirl is behind the
invention of a tracking system that locates lost cochlear sound
processors. Bella Ryan (far left), from Roseville College wanted to
help her sister Lucy (left) who regularly misplaces sound
processors from her two cochlear implants. Current implant models
come with a remote control that adjusts volume and sensitivity but
it cannot pinpoint the exact location of a lost device unless it is
close by. You can only walk around until your lost cochlear comes
inside a three metre radius and then the remote will beep and
flash, says Ryan, who is hoping to use satellite technology to
create a new tracking system. My project is all about giving a
pinpoint idea of where the lost cochlear is and I hope to achieve
this through a Bluetooth connection between a smartphone app and
the tracking device which would be attached to the cochlear, says
Ryan. Her invention clinched second place in the SAP Young ICT
Explorers NSW school competition. The bright student was invited to
Cochlears headquarters at Macquarie University to meet engineers
and discuss her ideas. It has really inspired her to keep going and
develop the concept further, says Ryans mum Natalie.
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Roger is the new digital standard that bridges the understanding
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Highly discreet and hassle-free, Roger devices provide a
solution to individuals who struggle to hear and understand speech
in difficult listening situations such as noisy classrooms, bars
and restaurants, outdoors, in public spaces, and even in the
car.
Learn more at: www.phonakpro.com.au
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A range of dolls are now on offer that celebrate real beauty
instead of Barbie-like perfection. But while these toys (see the US
Lammily doll pictured) show normal flaws like acne, bruises and
birthmarks, there are few playthings that depict disabilities.
British journalist Rebecca Atkinson, who wears hearing aids,
CHALLENGE
aims to change this after smashing a crowd-funding campaign
called Toy Like Me to create a new website that will push for more
toys that mirror youngsters with disabilities. Atkinsons team has
already transformed everyday toys, with hearing aids, guide dogs,
walking sticks and wheelchairs to show large toy manufacturers what
can be done to make the industry more inclusive. Id grown up
wearing hearing aids and never seen myself represented anywhere.
There were no deaf people on TV, in the comics I read or the toys I
played with, explains Atkinson, who launched a Facebook and Twitter
campaign. The toy industry shuts out children with disabilities, we
want to change that, she says. Toy Like Me has already gained the
support of toy giant Playmobil as well as Julia Donaldson, author
of the bestselling childrens book, The Gruffalo.For instructions to
make cochlear implants for dolls visit:
www.lammily.com/how-to-make-cochlear-implants-for-your-lammily-doll/
There have been many attempts to ta
ckle the debilitating
affliction, tinnitus the hissing, whoo
shing, buzzing and
or/clicking noises that can make life a
misery, particularly
after hearing loss. Around 70 to 85 p
er cent of the
hearing-impaired population are thou
ght to suffer from
tinnitus with around 90 per cent of ca
ses occurring after
damage to the auditory system. Resea
rchers are working
on a drug treatment that will cure the
problem. Until
this is approved, sufferers may gain re
lief with tinnitus
counselling, retraining therapy, antide
pressants and in-
built masking programs in their hearin
g aids. However,
researchers at the Charles Stark Drap
er Laboratory in
America offer new hope in the shape
of micropumps and
gels that will deliver drugs to the tiny
inner ear space,
which until now, has been inaccessibl
e to surgeons.
Weve tried directed medication wh
en treating hearing
disorders but the way we do it today i
s very imprecise
and poorly calibrated, says Robert J
ackler, a Stanford
University School of Medicine otologi
st-neurotologist.
The idea is for a person suffering fro
m a balance disorder
or tinnitus, for example, to carry a wi
reless remote control
with them and simply tap a button to
release a therapeutic
drug whenever the symptoms whet
her disorientation
or ringing in the ears become unbea
rable, Jeffrey
Borenstein, a senior biomedical engin
eer at Draper, told
Scientific American magazine.
UPDATE: Tinnitus treatment
-
8 Hearing HQ Apr - Jul 16
HEARING SUPERHEROES
Australia has some of the best hearing
services in the world but what
is being done to make auditory care accessible across the
globe?
With debate raging over the privatisation of Medicare payments
and the rollout of the National Disability Insurance Scheme, it is
easy to forget that we are lucky to live in a country with
world-leading healthcare. Free and subsidised hearing services are
accessible to the most needy. But with World Health Organisation
statistics showing 360 million people suffer from disabling hearing
loss, more needs to be done to make hearing aids, care and training
available to all, wherever they may live.
A number of celebrities are putting their weight behind the
battle to
heal the world of its hearing woes. Away from his day job as the
dark knight in the recent movie, Batman v Superman: Dawn of
Justice, actor Ben Affleck founded the African project Eastern
Congo Initiative, for which Starkey Hearing Foundation recently
distributed free hearing aids. Hollywood stars Johnny Depp and his
wife Amber Heard also joined the foundation in Rio, Brazil, last
year to hand out free, customised hearing aids to 200 recipients.
As a member of former US President Bill Clinton's global
initiative, the foundation has pledged to fit more than one million
hearing aids
to people in need this decade alongside battery makers
Rayovac.
Meanwhile Swiss Sonova-led Hear The World Foundation has 60
projects on all five continents. It is supported by more than 80
celebrity ambassadors including Spiderman actor Tobey Maguire and
musicians Bryan Adams and Annie Lennox.
Closer to home, ordinary people are making an extraordinary
difference in Papua New Guinea, Samoa and Fiji. Sydneysider Bronwyn
Carabez has devoted her life to helping Fijians with hearing loss
after her daughter Virginia was diagnosed deaf aged two.
-
Hearing HQ Apr - Jul 16 9
the first indigenous people to practice professionally.
While great efforts are being made to improve audiology in
developing countries, any new hearing services need to be
affordable, accessible and sustainable to succeed, says Gitte
Keidser, senior research scientist at the National Acoustic
Laboratories (NAL).
While manufacturing cheap, effective hearing aids is possible,
many projects come unstuck when it comes to funding and providing
ongoing care and rehabilitation or when clients need repairs or new
batteries. When handing out free hearing aids, the key is to have a
robust device thats not too sophisticated. You can produce quite
good devices that dont cost more than $100. The problem is setting
up a sustainable model, says Keidser. As a charity, Ears Inc is
able to
Above: Watched by friend and musician Alice Cooper, actor Johnny
Depp fits a hearing aid to a young girl in Rio, Brazil.Left: Tobey
Maguire supports Hear The World Foundation and (below left) as
Spiderman.Below: Ben Affleck discusses the work of his charity the
Eastern Congo Initiative.
Mai
n p
ictu
re o
f Ben
Affl
eck
cour
tesy
of W
arne
r B
ros,
To
bey
Mag
uire
(cen
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s
Through the Carabez Alliance, she has helped raise more than $5
million for the cause. This has led to audiology, hearing services,
teacher training, speech and language programs being offered in a
country that did not have anything for people with auditory
problems. "It was unheard of that a deaf and hearing-impaired child
go to mainstream education, let alone university," says Carabez,
who also initiated audiology services in Samoa. "We have seen six
children in our program go to university and 20 of our children
mainstreamed by giving them intensive rehabilitation over the past
12 years," says Carabez. During this time, the alliance has been
supported by hearing device makers Phonak, Unitron and Cochlear as
well as ABC Tissue millionaire Henry Ngai, who donated 1700 hearing
aids. On the Fiji projects, Emeritus Professor William Gibson,
founder of the Sydney Cochlear Implant Centres, trained surgeons in
bone anchored hearing implants and distributed sustainable hearing
aids with rechargeable batteries.
Melbourne-based, not-for-profit organisation Ears Inc also
provides training and support to local workers in clinics,
hospitals, deaf schools and mission groups in developing
countries.
In Fiji, Ears Inc audiologist Donna Carkeet launched the first
newborn screening for auditory brainstem response as well as
distributing free second-hand hearing aids and helping to train one
of the countrys few audiometrists, Sevanaia Ratumaitavuki (or
Tukana as he is known). The work is exhausting and never-ending -
but hugely rewarding. I find it hard to believe Tukana works in
three towns in Fiji. To work in Suva he is away from his family
overnight once a week and travels five to six hours each way, says
Carkeet.
David Pither, President of Ears Inc says hearing aid
manufacturers lag far behind demand. The industry made 12 to 13
million hearing aids last year and 40 per cent of those went to
people who already had devices. With 360 million suffering from
disabling hearing loss, we simply arent keeping up, says Pither,
whose team tests, fits and supports people with hearing loss around
the world. One Ears Inc project in Malawi helped fund two local
students to train as audiologists at a university in England. They
will be
-
bulk-buy hearing aids from an American company at $50- $60
each.
Nowadays, many of the parts for hearing aids are cheaply made in
Asia. The recent rise of self-fitting hearing aids which can be
tuned without an audiologist, sound like an affordable, quick fix,
but may be dangerous or unsuitable for some. Apart from potentially
missing health issues - such as tumours - which may need urgent
medical attention, these products rely on the user being able to
follow instructions
and use technology. A study by NAL researchers in the
HEARing CRC shows a technological barrier remains for older
users, although it is steadily improving. In a study of 40 people
who self-fitted hearing aids, 55 per cent were able to get through
the process satisfactorily but the rest needed assistance. NAL
researchers hope to come up with a questionnaire which will help
clients work out if they will be capable of fitting and customising
their own hearing aids. If you have old age
deafness, some self-fitting devices could work really well but
if you have damage from disease, viruses, noise pollution or a
medical condition, it could be useless or even dangerous to
self-fit hearing aids. We strongly recommend that people have a
proper assessment before having hearing aids fitted, says
Pither.
One Canadian organisation blazing a trail in the developing
world is World Wide Hearing (WWH) which has projects in Vietnam and
Guatemala. "We are working with a manufacturer to create a portable
headset that creates a perfect ear mould in four minutes, rather
than the average two weeks, using rapid-setting silicone, says a
WWH spokesperson.
With such advancements becoming available to people in poorer
countries, there are likely to be more success stories like those
recently witnessed by Ears Inc volunteers. One person we fitted
with hearing aids in the Dominican Republic has gone on to study
medicine. So I look forward to the day when we see a President or
Prime Minister emerge after being fitted with our hearing devices,
says Pither.
Audiometrist Tukana attends to a client in Fiji.
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HQ
-
Hearing HQ Apr - Jul 16 11
The Government is considering a proposal to transfer Australian
Hearing to a consortium led by the Royal Institute for Deaf and
Blind Children (RIDBC) together with implant maker Cochlear Limited
and Macquarie University. At the time of writing, the proposal had
been submitted and was under consideration. It is unclear how long
it will take or whether it will be a sale or transfer.
Regarding timing, RIDBC told Deafness Forum of Australia, We are
aware some stakeholder groups are concerned that Government intends
to make further announcement regarding Australian Hearing as part
of the May Federal Budget, however we are not aware of any
intention from Government to rush through a formal due diligence
and assessment process.
Concerns have been expressed about the consortium on issues such
as conflicts of interest, financial management and standards under
a new combined NDIS and Australian Hearing program. Also, how will
people with hearing disorders such as tinnitus or those in remote
areas be supported and serviced? One point the RIDBC consortium has
confirmed is that device repairs including loan equipment
Significant changes are happening in the hearing health industry
which will affect thousands of Australians with auditory
difficulties. This is due to the start of the National Disability
Insurance Scheme (NDIS) and the possible ownership transfer of the
Governments hearing services provider Australian Hearing (see p13
Hearing services whats changing).
The mechanics of how the NDIS will provide hearing aids and
auditory care are still being confirmed and this has caused much
debate and uncertainty about the future of these services for
hearing-challenged adults, babies and children. In 2013, the
Government decided that eligible hearing services program clients
would transfer to the NDIS, together with funding for those
clients. The Australian newspaper has reported the scheme is
expected to cost $22 billion by 2019-2020 with just more than $11bn
from the Federal Government and the rest from states and
territories.
Hearing HQs editor Rebecca Barker clarifies the implications of
important changes to national hearing services.
THE FACTS:
NDIS the& Australian Hearing
Trials of the NDIS started in pockets of Australia in 2013 but
national rollout begins on 1 July, 2016. Eligible people can sign
up as the NDIS is rolled out in their area. (see www.ndis.gov.au
for your area).
Clients of the Governments hearing services program who are
eligible for the NDIS will transition to the scheme by 2019-20.
Community Service Obligation program (CSO) clients of Australian
Hearing will continue to receive the same services under NDIS until
mid-2019. Then they may opt to choose another provider, approved by
the National Disability Insurance Agency (NDIA), to deliver similar
services.
Registering with NDIS will not change your level of access to
hearing services during this interim period and might provide a
more flexible range of services.
For the first time, Australians between 26 and 64 with permanent
hearing loss and functional impairment may become eligible for
funded assistance.
what youneed to know
-
12 Hearing HQ Apr - Jul 16
will continue to be available. Under the NDIS, there will be a
choice of service provider for CSO clients from mid-2019 -
Australian Hearing (or its replacement) or other private
clinics.
In Australia, all children with hearing impairment receive
services through Australian Hearing, while seniors, veterans and
other eligible adults have a choice of service provider from
Australian Hearing or from private providers under the Hearing
Services program of the Commonwealths Office of Hearing Services
(OHS). While the OHS program provides a regulatory framework for
eligible clients, there is currently no Government regulation of
the audiology sector. However, Audiology Australia, the peak body
representing the majority of audiologists, ensures its members are
bound by a code of conduct and a code of ethics.
The absence of Government regulation potentially leaves holes
for unsafe, unethical and poor practice. Steve Williamson, of the
Deafness Forum of
For information on the NDIS transition plan visit
www.hearingservices.gov.au or phone the NDIS on 1800 800 110.
Australia, is supportive of the idea of client choice but is
concerned about an 'untested' private market delivering services to
children, when they have been solely delivered by Australian
Hearing. The Forum recently interviewed the consortium bidding for
Australian Hearing in its newsletter One in Six. See
www.deafnessforum.org.au for detailed questions answered by the
consortium.
An RIDBC spokesperson says consortium members agree it is
important that the new entity has a non-profit orientation and that
any profits be reinvested in the entity in order to provide
continuous improvement and access to hearing services for all
Australians.
At time of publication this was the most up-to-date map
onwww.everyaustraliancounts.com.au/about-ndis/rollout/
-
Hearing HQ Apr - Jul 16 13
HEARING SERVICES whats changing?
The Australian Governments hearing services program,
administered by the Office of Hearing Services (OHS), is
long-standing and highly regarded around the world. From 2014 to
2015, 669,793 people accessed the program and 363,598 OHS hearing
aids were fitted. Services for eligible adults with an age,
disability or veterans pension are provided by Australian Hearing
and accredited private audiology clinics through a voucher system.
Its subsidised audiology services to children and adults under 26
years old are provided via the CSO program by Australian Hearing
(AH).
More than 3.55 million Australians are believed to have hearing
loss and nearly half of them are aged between 16 and 64. Most of
those older than 26 and younger than 65 are ineligible for
Commonwealth assistance, meaning more than 1.5 million people with
hearing difficulties who could be working receive no public funding
for services and technologies that would help them communicate to
their best ability. This is expected to change and more people in
this age bracket should become eligible for hearing aid funding as
the program is transferred to the National Disability Insurance
Scheme (NDIS). As the threshold for participation in the NDIS is
much broader than the eligibility requirements to access services
through the hearing services program it is
reasonable to expect that more people aged in this demographic,
in particular those with binaural hearing loss, will be able to
access funded hearing services through the NDIS, says Sharyn
McGregor, director of policy and planning at the Office of Hearing
Services.
Many questions remain though over how the scheme will work in
relation to hearing services and care. Confusing the issue is the
Governments decision on whether to transfer ownership of its
hearing services provider Australian Hearing. But overall, the NDIS
is expected to open up an element of choice of provider for more
people. McGregor explains: Voucher clients receiving services from
Australian Hearing can already choose to relocate to another
contracted provider, whereas CSO clients can only receive services
from Australian Hearing.
One of the main changes, which will be brought about by the
rollout of the NDIS in mid-2019, is that CSO clients under 26 years
who transfer to the NDIS will generally be expected to be able to
choose to stay with Australian Hearing or choose another provider.
Concerns from hearing support groups include how standards will be
upheld and maintained and what will happen to people in remote
areas. The group most affected by this change is hearing impaired
deaf children and M
ain
imag
e: iS
tock
their families What is concerning is the private market is
untested in the delivery of services to children with hearing
loss.
"The introduction of contestability introduces significant risks
in terms of access, expertise, quality, standards and client
outcomes, explains Steve Williamson, chief executive of the
Deafness Forum of Australia. If services are spread across multiple
providers it will be difficult for the clinicians to maintain their
skill level which puts the client outcomes at risk, he says.
Concerns from hearing support groups also include whether the
safety net of the Government hearing services provider will
continue to be made available. As the Government continues to work
through the finer details of the scheme, more will become clear.
HQ
-
14 Hearing HQ Apr - Jul 16
With 10,500 athletes set to take part in the Olympic Games in
Rio in August and another 4,350 expected to compete in the
Paralympics a month later, it looks set to be a year of outstanding
sporting achievements. But how many athletes bound for Brazil will
have hearing difficulties? The answer is, very few.
In the 2012 London Paralympics, one of the rare exceptions was
equestrian Laurentia Tan who scooped silver and bronze medals.
British athlete Olivia Breen, who has cerebral palsy and wears
hearing aids competed in the London Paralympics 100m T38. However,
she failed to hear a false start being called in the first round,
sprinted to the finish and the race was postponed for an hour so
she could recover and run again.
With more support and awareness for these situations, sports
opportunities would be greatly improved for hearing-challenged
athletes. Most elite competitors with auditory issues compete in
the World Deaf Games and Deaflympics, as another disability is
required for them to participate in the Paralympics. Decathlete
Dean Barton-Smith, who is one of only two deaf Australians to have
competed at the mainstream Olympics in Barcelona in 1992, (the
other was fencer Frank Bartolillo in Athens in 2004), says more
needs to be done to educate people about
the competitive potential of deaf athletes. There is still a
stigma in regards to whether a person who is deaf or hard of
hearing can participate let alone have the ability to learn skills,
says Barton-Smith. Having a greater awareness and understanding
about hearing loss can go a long way to look at the person on what
they can do, not what they cant, he explains. But the tide is
turning and a new generation of deaf competitors is pushing for
Olympic recognition.
Australias Melinda Vernon, 30, is aiming to become the first
deaf triathlete to make the Olympic Games. Not only has she dealt
with hearing difficulties to compete but the road to Rio has been
fraught with frustrations. In November last year, I was involved in
a freak bike accident in which I dislocated and broke three fingers
and sustained a slight spinal fracture and nerve injury, explains
Vernon, who is ranked 142nd in the world and is more intent than
ever on achieving her goal having enlisted new coaches. Im really
excited about the future. There are ways to overcome certain
barriers you just have to be proactive to putting strategies in
place in order to achieve whatever goals you have in mind, she
says.
Following rules for elite deaf sports events, Vernon usually
competes without hearing equipment. But technology is giving her an
edge at Olympic level, where there is no restriction on the use of
hearing devices. I have been brought up competing in sport all my
life, so from a young age, I learnt how to compete to
Hurdling the challenge of hearing loss, these inspirational
athletes are giving Olympians a run for their money, writes Rebecca
Barker.
SPORTING CHANCE
Melind
a Vernon im
ages co
urtesy of D
elly Carr/Sp
ortsho
ot
Deaf triathlete Melinda Vernon competes at elite level.
-
my very best without my hearing aids/cochlear implant. Now it is
like second nature for me and I have strategies in placesuch as
being more visually alert at the start of a race to watch for
reactions/movements to dive into the water without missing a few
seconds, says Vernon, who wears a cochlear implant and an accessory
to keep it dry. Events like the Australian Deaf Games and
Deaflympics use sign language and adapted technology, like a light
being used instead of a starting gun or a referees whistle being
replaced by a flag as well as other visual cues to support
competitors. Athletes at the deaf games in Adelaide in January
proved there are no limits to the talents of hearing impaired
sportsmen and women.
At the age of 16, Deaf Sports Australias athlete of the year
Samuel Greatorex, from Glen Waverley, Victoria, holds four national
open records and eight age records in swimming disciplines, while
DSA athlete of the year Jamie Howell, 17, of Redland Bay,
Queensland, won gold in the long jump at the 2015 Asia Pacific
Games plus silver and bronze medals in the 100m and 200m events
respectively.
Meanwhile, Canberra-based Katie Kelly (right), who has Usher
Syndrome, a genetic hearing and visual disorder, is bound for the
Rio Paralympics. She won an outstanding achievement award for
triathlon including gold in the Australian National Para-Triathlon
competition. Garry West-Bail, general manager of Deaf Sports
Australia (DSA), says there is no better time to excel in deaf
sport, particularly with the date change of the next Australian
Deaf Games, which will be held in Albury-Wodonga in 2018. Normally
held every four years, the games moved to every two years to
provide a pathway for athletes through to international
competition, such as the four-yearly Asia Pacific Deaf Games in
2019. Previously, our games were out of step with international
competitions on the elite athletes competition calendar, such as
the Deaflympics, explains West-Bail. By making this one-off shift
for 2018, it allows organisers to use the Australian Deaf Games as
part of the selection process for international competitions and
ensure the best possible preparation for our athletes, he says.
Deaf triathlete Katie Kelly with her guide competing at the
World Triathlon Series grand final in Chicago, America, last
year.
Delly C
arr/Spo
rtshoo
t
Hearing HQ Apr - Jul 16 15
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16 Hearing HQ Apr - Jul 16
Other sports such as cricket and golf are also producing some
top players with Cricket Australia winning DSAs organisation of the
year award and golf, which is in the Olympics for the first time
this year, boasting the likes of Victorias Dean Connell and Callum
Farman, who won gold at the Adelaide Games. Connell has been
fundraising at grassroots level to raise enough cash to compete at
the World Deaf Golf Championships in Denmark in July.
Funding is an ongoing concern for deaf sport. Around $2.5
million still needs to be raised to reach the $7 million needed to
fund the Australian Paralympic team. The Government usually
contributes $50,000 towards the Australian Deaflympic team, which
needs around $400,000 to reach the four-yearly event, which is next
held in Turkey in 2017. Lack of funding and the fact many
hearing-impaired youngsters want to stay in their local team can
make it difficult for them to fully integrate into a sports club.
With this in mind, Deaf Children Australia and South Melbourne
District Sport Club have collaborated to deliver an Auslan Auskick
program for children aged five to 12 this year. (See
www.deafchildrenaustralia.org.au).
The AFL program kicks off on Saturdays at Melbournes Albert
Park, Oval 11, from April 18, between 9am and 10.30am. It came
about after DCA stepped in to fund an interpreter for AFL fan,
11-year-old Malachi Kruse, who suffers from hearing loss. He was
born with CHARGE syndrome, a condition that affects the heart,
airways and growth. Due to being completely deaf in one ear and
having moderate to severe hearing
"Getting an interpreter raises the skills ofthe child because
they are actually gettingcoaching rather than just turning up."
Noel Henderson, Deaf Children Australia
HQ
Wantirna 03 9800 5697Boronia 03 9839 3350Doreen 03 9800 5941Kew
03 9817 4366
Call for an appointment
www.knoxaudiology.com.au
Knox Audiology is a hearing specialist centre supported and
supervised by ENT medical doctors. Opening in 1988, Knox Audiology
continues to serve a broadening Melbourne community across four
locations.
Through hearing tests, diagnostic assessments, and hearing aid
prescriptions, we optimise the hearing future of people of all
ages.
We are passionate about hearing. With a caring, professional
approach, we support, rehabilitate and educate so that you can make
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10599 Knox HQ Magazine Advert V1.indd 2 7/03/2016 4:39 pm
Malachi playing with South Melbourne District Sports Clubs
Auskickers at the Melbourne Cricket Ground during the 2015
season.
Imag
e of M
alachi: Michael W
ilson, A
FL Med
ia
loss in the other, Malachi wears a hearing aid - in his footy
team St Kildas colours. With help from an interpreter, Malachis
skills and confidence have soared. These kids can feel isolated and
they dont hear what the coach is saying. It was easy to assume
Malachi was ok because he was so good. But often kids just watch
what others are doing and copy, says Noel Henderson, Deaf Children
Australias development and fundraising manager.
Getting an interpreter raises the skills of the child because
they are actually getting coaching rather than just turning up and
you see a marked jump in their abilities. His mum said, for the
first time she saw him put his hand up and ask a question, says
Henderson.
Many sports programs across Australia offer opportunities for
those with hearing issues to get active and learn new skills while
making new friends. Some offer interpreters and coaches who are
trained to maximise the talents of people with hearing
difficulties. To find out more about a raft of sports including
cricket, swimming, rugby, tennis, basketball, netball, volleyball,
squash, darts and lawn bowls see
www.deafsports.org.au/sports-committees.
Enjoy sport on the sidelines at these upcoming events:Bowls
Australian Open on the Gold Coast, June 20 to 24. See
www.australianopen.bowlsaustralia.com.au.Deaf Basketball Victorias
National Deaf Basketball Club Championships will be held at Altona
Basketball Stadium, Victoria, July 2 to 3. For more information and
registration see [email protected].
-
Hearing HQ Apr - Jul 16 17
He played footy for 15 years with the Brisbane Bears, Brisbane
Lions and Western Bulldogs and won a Brownlow medal for his
efforts. But father-of-two Jason Akermanis gets his kicks elsewhere
these days.
After moving to coach the North Albury Football Club three years
ago, Akermanis, 39, and his wife Megan, a speech pathologist, have
been helping youngsters with hearing loss live life to the full so
they can reap the social, health and wellbeing rewards from being
involved in team sport. His interest in the deaf community sprang
from Megans parents, who were both born profoundly deaf after their
mothers contracted the viral illness Rubella or German Measles.
Megans dad played cricket, basketball and rugby league at a very
high level and a lot of his close friends came from playing sport,
says Akermanis, who learnt sign language to communicate well with
his parents-in-law. He and his wife have also taught their
children,
Charlotte,11, and Sienna, seven, (above right with their
parents) Auslan and would like to see it being taught and used more
in schools as well as at sports programs across the country.
Megan, who has her own speech pathology practice in Albury and
has worked in the industry for 12 years, says: It would be good to
raise awareness at clubs and just learn a few basics of sign
language. Other ways of helping kids in sports include reducing the
distance between the coach and players, carrying a pen and paper
around and gesturing more, says Megan.
Akermanis has seen first-hand how sport can change the lives of
budding athletes. A young boy who wears cochlear implants does the
scoreboards at his local junior football league. He loves his footy
and has a true sense of belonging and identity in being able to
take part, says Akermanis. One of the footy legends young fans went
from playing Auskick to cricket after being inspired by Akermanis
on the pitch. Jesiah, 15, (above left) the son of pro golfer Brook
Salmon, was born
premature with DiGeorge syndrome, which affects hearing and the
fine motor skills in the bottom lip and jaw. He played Auskick but
because he wears a pacemaker, the physical contact became difficult
and he moved to cricket.
He met Jason at training five or six years ago. Football was his
first passion and now I would say cricket and school are his life,
says Brook, whose son plays in hearing and non-hearing teams. He
wears a BAHA (bone anchored hearing aid) which improved his hearing
from eight per cent to 83 per cent but takes it off for batting,
where Brook sees a difference.
The BAHA has been amazing. He can listen to television at the
normal volume and is involved in conversations both away from and
in sport. But when he is batting, sometimes he gets run out and a
lot of communication is lost. From hand actions as he is running
between wickets, he knows whether to do another run or not,
explains Brook. Overall, the experience has been overwhelmingly
positive. Hopefully, he will never hold back because of fear or
lack of support. He would love to represent Victoria and Australia
and play the highest level of cricket that he can, says Brook.
Australian Football League star Jason Akermanis tells how family
hearing issues led him into deaf sport.
TRANSFORMING LIVESthrough sport Exclusiv
e
Akermanis
HQ
-
18 Hearing HQ Apr - Jul 16
Our cochlear implant services typically require no out of pocket
costs
Public and private clientsAdults & children of all ages
A cochlear implant could help you restoreyour hearing.
Unlike hearing aids, cochlear implants dont just make sounds
louder. They are a complex device that can replicate the hearing
function of the inner ear.
It is never too late to explore your options to improve the
quality of your hearing even if you arecurrently using hearing
aids, you may experience a better result with a cochlear
implant.
Contact SCIC Cochlear Implant Program on 1300 658 981 to find
out more today.
SYDNEY | NEWCASTLE | CANBERRA | GOSFORD LISMORE | PENRITH | PORT
MACQUARIE | DARWIN
1300 658 981 [email protected]
Do you struggle to hear even with hearing aids?
HearingHQ_Ad.indd 3 7/07/2015 9:43 am
''Before leaving for my much-awaited trip - a bridge holiday to
Paris and Copenhagen followed by a cruise via Iceland to New York -
I went for another visit to my cochlear therapists for a final
mapping and equipment check. I needed to organise what to take away
with me. This list includes chargers, a spare battery, and a
back-up processor which I was able to hire in case I got into
trouble with my own processor. I also had a final mapping session
to make a few adjustments to my settings.
I had five settings to choose from. These were my base setting,
plus a slight variation on this, a third program for use in noisy
situations, and two music programs. At this point I was beginning
to feel more comfortable about everything. I had progressed, I was
getting considerable help from my implant and my hearing was in a
better place. I was going to be out of the country on my own for
six weeks with no support from my audiologists.
My next session was not for another three months, after which
the usual routine would be annual checks. I found this daunting.
However, I took off with mixed feelings, excited at the prospect of
a wonderful holiday. As it turned out, some parts of the tour were
wonderful but others were not so good. Highlights were Paris and
New York which is such an exciting city. I was able to meet up with
some dear old friends there. But the cruise was disappointing -
crowded, noisy and frustrating. It was not a wonderful ship and
needed refurbishment. The bridge games were enjoyable but sitting
around the dinner table at night with my group was no pleasure and
chatting was a problem. As
By now, I was six weeks from my six-month assessment. Those
weeks did not bring much change, just more frustration, although my
friends all commented that they noticed I was hearing better. This
was hard for me to register, as the day-to-day changes were
difficult for me to detect. To get to this point, so much intense
concentration is required, and I think my brain is probably less
flexible than a younger persons. It continues to struggle to make
words and sentences out of the jumbled sounds it hears.
The date for my six-monthly check up with my surgeon Associate
Professor Catherine Birman came along. It was at this time I
suddenly found I was hearing some strange sounds in my implanted
ear like a continuous low, loud booming noise. Professor Birman
thought the noises could be tinnitus. However, she considered it
was unlikely to affect my hearing, which was a relief. Otherwise
all seemed to be as expected, although Professor Birman also
commented that she had expected me to be hearing much better. This
didnt make me feel too happy!
Two days later, I went for my big six-monthly audiology
assessment, which compared my current situation with my
pre-operation readings. The reassuring conclusion was that I was
just where they expected me to be.
Music at this stage was still not sounding anything like it
should - still just growling, gurgling sounds. But with my
hearing-aided right ear it was somehow recognisable. I continue to
persevere trying to get better bilateral musical recognition. The
good news was that the loud noises I had heard had stopped, so it
seems I had no tinnitus.
DiaryCOCHLEAR IMPLANTbefore, as soon as a conversation became
several conversations, I was lost.
My hearing on the trip was still a long way from what I was
hoping for and there were many frustrations on the journey. The
final mapping before my departure had only improved things
marginally. This was a great disappointment as I couldnt help
thinking that many people get good results more quickly. My worry
was that maybe I was not going to be one of those wonderful
miracles. Fortunately, my next appointment was only a week
later.
I was still getting lots of grumbly/growling noises over what I
was hearing, disturbing my speech comprehension, and at this stage,
I couldnt hear anything that sounded like music. The mappings are
so important, and as all cochlear implant recipients are different,
adjustments are a bit subjective, relying on the ability of the
recipient to describe in a clear way what and how they are hearing.
Believe me, this is a really difficult thing to do. But some minor
adjustments were made and I went off full of hope that this time it
was going to be good. I was determined to work hard at the computer
exercises and listen diligently to plenty of television and radio
programs.
In the final instalment of her cochlear implant diary, Liz
Efinger reflects on whether surgery has paid off?
Liz (second from right) with some of her tour group on the
cruise.
-
Hearing HQ Apr - Jul 16 19
HQ
Coming back to my choir activities, I was preparing for three
performances of Handels Messiah at the Sydney Opera House, which
for the first time was being accompanied by Auslan interpreters. I
have been doing this event for 20 years, and so have been anxious
to see if its any easier post-cochlear. We got to the final
rehearsal and I suddenly found hearing the conductors instructions
seemed easier. I also felt I could hear the individual instruments
and the different voices around me better. This was sensational -
and definitely a big WOW moment! I have found that what I hear can
be influenced by the environment, the shape, height and size of the
room Im in, and even the floor coverings.
Our performances were extremely well received. But for me, it
was not so wonderful, as I heard mainly strange noises in the
implanted ear rather than the music, which really affected my
participation. Christmas came and went. Having a conversation in
this noisy setting felt as difficult as it had been before the
implant and I found myself sitting like a dummy most of the
time.
But, on a positive note, I know that progress is slow - but -
there is progress which I believe will continue for some time. I am
now nine months post surgery. Some days I notice definite
improvement, but this still requires concentrated listening, and
other days Im bothered by the interference of the grumbling noises.
But I have no regrets.
I now have bilateral hearing which is fantastic and I dont have
to constantly ask people to repeat things. I avoid social contact
less, participate in choir, hear others and myself. Background
noise is still very unpleasant and sometimes intolerable. But I am
able to function in my world without feeling out of the
conversation. I am able to participate.
As I was told so often - everyone is different and my
experiences may be different to anyone elses. Some people get an
immediate response of hearing proper words and others - like me -
take much longer. All in all, I hope this little anecdote may help
someone contemplating a cochlear implant. All I would say to them
is, Go for it! Its definitely worth the hassles on the way!
Our cochlear implant services typically require no out of pocket
costs
Public and private clientsAdults & children of all ages
A cochlear implant could help you restoreyour hearing.
Unlike hearing aids, cochlear implants dont just make sounds
louder. They are a complex device that can replicate the hearing
function of the inner ear.
It is never too late to explore your options to improve the
quality of your hearing even if you arecurrently using hearing
aids, you may experience a better result with a cochlear
implant.
Contact SCIC Cochlear Implant Program on 1300 658 981 to find
out more today.
SYDNEY | NEWCASTLE | CANBERRA | GOSFORD LISMORE | PENRITH | PORT
MACQUARIE | DARWIN
1300 658 981 [email protected]
Do you struggle to hear even with hearing aids?
HearingHQ_Ad.indd 3 7/07/2015 9:43 am
COCHLEAR IMPLANT
Top: Beautiful Copenhagen, Denmark's capital.Liz setting off on
her Europe and New York trip.
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My hearing is deteriorating slightly after a stapedectomy two
years
ago. I already have a powerful aid in that ear and I had a
sudden total hearing loss in it a couple of years ago. Hearing was
partially restored with the help of steroids. Will the stapedectomy
plus hearing aid see me out?
Q
ASK THE
Roberta MarinoSenior AudiologistFiona Stanley Hospital
Associate ProfessorMelville da CruzEar, Nose & Throat
Surgeon
Emma ScanlanPrincipal AudiologistAustralian Hearing
experts
Melville da Cruz: Otosclerosis is a hereditary disease which
affects the
hearing elements derived from the otic capsule (ear cyst). The
otic capsule forms the complex inner ear (cochlear and balance
organ) as well the stapes bone (the third of the three middle ear
bones).
In individuals affected by otosclerosis both the cochlear and
the stapes involvement contribute to the overall hearing loss. In
cases where the conductive hearing loss is the greater component,
due to involvement of the stapes bone, surgery in the form of
stapedectomy (or stapedotomy) is a suitable option for treatment.
If the sensory-neural or cochlear component is the greater
component, then stapedectomy will not be effective in reversing the
hearing loss. A hearing aid will be required in this situation.
In many cases of otosclerosis the hearing loss is mixed
involving both cochlear and middle ear components. Careful testing
of the hearing is required to estimate how much hearing can be
restored with surgery and how much will require sound amplification
with a hearing aid. However, over time the history of hearing loss
due to otosclerosis (and other conditions such as aging and noise
exposure) is for the hearing levels to slowly decline (over years
to decades). Monitoring of the hearing levels in both
A
Jawan SayedPrincipal AudiologistQuality Hearing Care
ears at regular intervals is recommended to ensure the hearing
outcomes are optimised. Decline in hearing following initially
successful stapedectomy surgery also needs particularly careful
testing to understand why the hearing is dropping. Generally, it is
the sensory-neural or cochlear component of the hearing changes
that declines with time, and this component cannot be reversed with
surgery. An adjustment of the current hearing aid or fitting a more
powerful aid will be required.
If the decline in hearing is due to a recurrence in the
conductive component of the hearing loss then revision stapedectomy
surgery may improve the hearing levels, sometimes dramatically.
Rarely, the hearing levels decline to a severe degree which
responds poorly to even the most powerful hearing aids. In this
situation a cochlear implant will be indicated, often improving the
hearing to that experienced several decades before. Careful testing
of hearing and consideration of the type of hearing loss will allow
your ENT surgeon to advise you which pathway is the best for
you.
I had a sudden hearing loss in my right ear a few months ago.
The
other ear still functions well. What could have caused this and
what can I do to hear with two ears again?
Q
Roberta Marino: To help answer this question, Ive enlisted the
help
of Doctor Dayse Tavora-Vieira and Professor Gunesh Rajan from
the Hearing Implant Research Unit in Perth, who are experts in
implantable hearing devices and cochlear implants for unilateral
deafness (UD), or deafness on one side.
A
-
Hearing HQ Apr - Jul 16 21
expertsexperts Send your questions to: Hearing HQ ExpertsPO Box
1054, Lane Cove NSW 1595 or [email protected]
Jawan Sayed: Getting used to hearing aids is a gradual
process
that will take time and patience on the users part. Often people
try and draw a comparison between using hearing aids for the first
time and using glasses for the first time. When you use glasses for
the first time, you see the difference right away and your vision
is restored but with hearing aids you have to get used to hearing
sounds differently.
Although hearing aids will improve your hearing making speech
clearer and louder, it takes time to get used to processing speech
and environmental sounds that you may have not been hearing clearly
for an extended period of time. As a new hearing aid user you may
be aware of sounds that others around you are not noticing and
again this is simply because your attention is being drawn to
sounds that you have not been aware of. This perception will settle
as you adjust to the new sounds around you. Your audiologist will
discuss the acclimatisation process and the best way to get used to
your hearing aids at your fitting appointment.
On a general note however it is recommended that you get
accustomed to your hearing aids gradually. This means when you
begin using your hearing aids ideally try and do so for one to two
hours at home. Progressively begin using your hearing aids for
greater lengths of time daily and in different circumstances (such
as outdoors, meetings, in groups) over the course of a few weeks.
This will help you get used to hearing all the different sound
stimuli including noise.
It is important to keep expectations in perspective and to
understand that although hearing aids will improve your
A
Do hearing aids take a long time to get used to and how do I
adjust to
using them? Q Emma Scanlan: You should always be evaluated by an
audiologist. An
audiologist does not simply test your hearing. They also measure
how well you understand speech and how this may impact on your
hearing device choices. The audiologist will also elicit other
useful information about goal-setting and lifestyle discussions to
establish realistic expectations and assist with making the best
device choices. Once the hearing device has been selected, the
audiologist will adjust it to meet your requirements as closely as
possible.
Many people find they need their device fine-tuned to meet their
individual preferences after they have had a chance to use it in
their usual environments. Others, especially those with additional
needs and more severe losses, may require significant
rehabilitation to build up their listening skills and to make the
best use of their devices.
The aid should be evaluated in the ear if possible to ensure
that its settings are optimally matched for the hearing loss and
that the level of sound going into the ear is safe. The volume and
balance of sound going into the hearing system is influenced by the
shape of the individuals ear and how the aid sits in the ear. This
creates a unique acoustic environment which is taken into account
when you have your aid expertly fitted by an audiologist who will
do validation measures of the aid in the ear. These measures can
also help with trouble-shooting any future issues with the aid.
Hearing aids have many different possible settings and features
and to get the most out of your device, it is helpful to work with
someone who understands how those features work in different
environments and can work in partnership with you to get the
maximum benefit from your device.
A
The incidence of unilateral deafness is estimated to be in the
range of 0.8-2.7 per 1,000 and increases substantially in
school-aged children ranging from one to 56 per 1,000. It is
estimated that 60,000 people acquire UD in the United States per
year, and in the United Kingdom, it is estimated that 9,000 people
develop profound UD each year. Unilateral deafness can be present
from birth or caused from conditions such as mumps, acoustic
neuroma (a benign growth on the hearing/auditory nerve), viral
infections, head trauma, Menieres disease and genetic disorders.
Sometimes there is no known reason for the loss of hearing which
can occur suddenly.
Suffering from sudden unilateral deafness can be traumatic
especially when it is accompanied by the onset of severe tinnitus
(noises in the head/ears in the absence of external noise). The
major disadvantage of unilateral deafness in adults is detecting
the direction of incoming sounds, hearing speech in background
noise and hearing when speech is presented to the deaf ear.
Twenty-six per cent of people with UD struggle with
conversations in quiet and 73 per cent report some level of
handicap. There is no cure at the moment for unilateral deafness
when the cochlea or hearing nerve is affected however different
hearing technologies can assist. These include the CROS
(Contralateral Routing of Signal) hearing aid, bone conduction
hearing aids, bone conduction hearing implants and cochlear
implants. A trial of a bone conduction aid is normally done prior
to consideration of a bone conduction implant for unilateral
hearing loss. From this, a person can attain a good idea of the
potential benefits of a bone conduction implant. If your hearing
nerve is viable, you could consider a cochlear implant for the deaf
ear. This is difficult to determine without a patient undergoing a
full diagnostic evaluation with an audiologist specialising in this
area and consultation with an ear, nose and throat specialist.
The other factor to consider is, if a patient has not had
auditory stimulation to the deaf ear for all of his/her life, this
lack of auditory stimulation makes it difficult to ascertain the
potential
listening benefits. Undergoing cochlear implant surgery is the
only option where the deaf ear is directly stimulated. Research has
shown this can also ease tinnitus. All the other hearing solutions
described work on delivering sound to the better hearing ear. If
there is a viable auditory nerve and the system works well, the
patient would need to participate in an intensive rehabilitation
program.
hearing ability they will not give you perfect hearing and you
may continue to encounter some hearing difficulties in more
challenging environments.
Ive seen so many adverts for self-fitting hearing aids and cheap
aids
for sale on the Internet. I have read good reviews about one
pair that seem to suit my situation. Do I really need to see an
audiologist too?
Q
-
22 Hearing HQ Apr - Jul 16
real peopleReal storiesReal people
Our third child, Luke, was born with moderate bilateral
sensorineural hearing loss which was diagnosed at seven months and
he received hearing aids a month later. His hearing loss was
detected as part of medical checks into delayed developmental
milestones. We embarked on a challenging and emotional journey
which involved accessing hearing care and equipment from Australian
Hearing.
The NDIS commenced trial sites in 2013. Our area Lake Macquarie
gained access to the scheme in July 2014. From a hearing disability
perspective, were still accessing Lukes hearing services and
devices separately via Australian Hearing, and will continue to do
so as it currently happens without the involvement of the NDIS
process. If Luke had been younger, we would have been using the
scheme to utilise early intervention hearing services, such as
speech and language therapy, so our experiences will be directly
relevant to families starting their journey.
Just as everyone's family and child's disability is different,
everyone's NDIS experience and outcome will be unique too. We hope
you gather some helpful information from our participation.
The National Disability Insurance Agency (NDIA), the scheme's
administrator, has the approach: Listen, Learn, Build, Deliver, so
processes and documents change as learning is gained from each
trial site. Also, there may be some variations between each site as
different methods are tried prior to full implementation of the
scheme by 2020. The most important thing to do is educate yourself
and get familiar with the NDIS website (www.ndis.gov.au) which is
the main source of information. The first step in this process is
to find out if you have NDIS eligibility and when your access will
commence. Eligibility and rollout dates across Australia can be
checked on the website at
www.ndis.gov.au/ndis-access-checklist.
From a future participant perspective, there is also information
available on websites such as Every Australian Counts, Carers
Australia, Disability Loop, NDIS Grassroots Discussion Group on
Facebook and specific disability service providers (see links p24).
Also, you can sign up for updates with NDIS and support groups and
attend public information sessions run by the NDIA.
Mark & Roslyn Wyburn live in Lake Macquarie, New South
Wales. They have three children, Nicholas 14, Anna,11, and Luke,
nine, who was born with bilateral sensorineural hearing loss. In
July 2014, Luke was among the first children to trial the National
Disability Insurance Scheme (NDIS). Heres how they navigated the
new system
-
real people''If you are eligible, the next step is to contact
the NDIA and ask for an Access Request form. Unfortunately, there
doesnt appear to be a copy of this form on the NDIS website. You
will need to provide evidence for the primary disability and other
disabilities of your child and legal declarations on
information-sharing, age and residency. Our GP assisted with our
form and it was a big advantage having a doctor who had a long
established relationship with us.
To us, it was a very important document as it asks questions
about the functional impact of the impairment of your child in
undertaking activities. Areas covered included communication,
social interaction, learning, mobility, self-care, self-management
and other information that would assist in understanding a persons
needs. Each question has four tick boxes to pick ranging from no
issues in that area of functional impact, to complete
inability.
This is where our story became a bit more complicated, and this
may not be the case for others. At the time of our application, we
had been participating in a program to assist with Lukes
development for around five years. This program covered a wide
range of his needs, and a component included speech and language.
As the support was through a private service provider, we had been
self-funding the substantial costs for all this time. Our previous
support for speech therapy through non-government charitable
organisations such as The Shepherd Centre and Royal Institute for
Deaf and Blind Children had ceased once Luke was school age.
We believed our application to NDIS would need to justify this
significant funding and we wanted to provide a sound case. There
isnt much room on some of the forms, so if you need to add more
information either download a Word version and add text, or attach
other pages to the original document.
In preparation for NDIS, it is worthwhile taking the time to get
your files and documents in order. We collated a detailed
chronology of Lukes major medical events and assessments. This took
some time to do, firstly because it was very tough going over old
wounds and secondly we had forgotten how much medical review we had
been through in those first years. We also included copies of
medical diagnoses and
assessments, such as those on speech.After submitting these
forms and
our associated documentation, NDIA sent out a confirmation
letter that our request for access to the NDIS had been received
and contact would be arranged within 21 days. We got an NDIS access
receipt number which became our NDIS number. We were then contacted
by phone to arrange meetings at the Hunter area NDIA office. These
were confirmed by letter, with NDIA planning on conducting two
meetings.
Now we were in the planning phase. An NDIS planning workbook is
completed prior to the first meeting. This form is about the childs
daily routine, the people and/or organisations that support them,
equipment required, and your goals for your child in the areas of
education, social participation, independence and health and
wellbeing. You should also consider how you will manage your
supports and funding and take these ideas with you to your planning
meeting. To give you some idea of the way supports are categorised
by the NDIA, and the actual NDIA rates for supports, have a look
under the Providers section of the NDIS website under pricing and
payment.
It is important to prepare properly for your planning meeting
with NDIA. Remember you are the expert on your child and your
situation, not the planner. This is a big exercise in parent or
personal advocacy.
There is a requirement at the first meeting to bring your child
along, after which it was not required. We had four interviews with
NDIA, as our case was complex due to Lukes specialised needs and
our existing program arrangements. The first meeting also set the
date that our NDIS plan and support started and payments were
backdated to then. This was important in our case as the total
process took seven weeks.
As usual, it was a tough time going through our childs issues
with complete strangers and it dredged up a lot of emotion, so we
both went to every meeting to support each other. As with
specialist medical appointments, having two people there allows for
different points to be made and more information to be picked up.
We would strongly recommend you consider having an advocate or
third party with you if you feel extra support would assist
you.
Luke (top) and with his dad Mark (above), who is a committee
member and regional representative for the support group Parents of
Deaf Children.
-
''From all of the information submitted,
and the interview, the planner developed a, My NDIS Plan for
Luke. This is along the same lines as the planning workbook form,
describing Lukes daily life, his supports, his goals, strategies to
achieve these goals, and how progress or achievement will be
measured.
The second part of the My NDIS Plan details what the planner has
determined will be reasonable and necessary supports that will be
funded by the NDIS. Importantly this part of the plan
will tell you the amount of funding NDIA will provide for your
child.
There will be details on how that support is managed. This needs
to be discussed with your planner during your interview, so some
thought needs to be given to this prior to the first meeting. We
chose to self-manage funding as we already had our own system in
place to pay for Lukes support program and really wanted that to
continue. Only a very small proportion of participants manage their
funding this way.
We had to establish a separate bank account in Lukes name to
manage all the financial transactions. The NDIA require you to keep
receipts supporting your claims for five years, and they can audit
you to verify the claims made, so it is very important to maintain
a good financial record system. See the MyGov website Participant
Portal for more information and how to submit claims.
If you believe a proposed NDIS plan or decision is not
satisfactory, you have three months to request an internal review.
Further review after this process is via the Administrative
Appeals
Tribunal at www.aat.gov.au.A year after commencing our
participation, our first NDIS plan review was conducted in July
2015. A plan review was completed by us and submitted prior to
attending a meeting with the planner. We again found it a difficult
process as our planner had changed, requiring a complete
re-education of our situation. Our existing supports were
critically reviewed. We had decided to bring along an advocate to
our second review meeting following some initial feedback from the
planner by phone and our realised expectation that it would be a
challenging meeting. Now we are coming up to our second plan review
in July, which will be conducted over the phone, so it will be
interesting to see how the new process works.
For additional information see: Every Australian Counts
http://www.everyaustraliancounts.com.au/ Carers Australia
http://www.carersaustralia.com.au/ Disability Loop
http://www.disabilityloop.org.au/index.html
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Luke with his mum Roslyn
-
''
Hearing HQ Apr - Jul 16 25
Research suggests Aboriginal and Torres Strait Islander (ATSI)
children have the worst ear health in the world. They experience
ear disease and hearing loss up to ten times the rate of the rest
of the population which can lead to a life of poverty and
disadvantage. A few years ago, a Parliamentary report showed that
middle ear disease (or otitis media) had reached crisis levels with
every child suffering from the affliction in some ATSI communities.
But two years ago, a Government-funded outreach program called the
Earbus Foundation of WA, was launched to take health professionals
into the most affected areas throughout regional and remote Western
Australia. Today, referrals of Aboriginal children with middle ear
disease have been cut by almost 20 per cent.
Ear problems in ATSI babies often occur within the first two
weeks of life. On average, these children and their families suffer
with middle-ear disease for 32 months of the first five years of
life (the comparison rate is three months for non-Aboriginal
children). Potentially, middle-ear disease can affect every aspect
of early childhood development. It can also have a huge, lifelong
impact on speech and language development.
On average around half the Aboriginal children in primary school
classrooms across our country cant hear what is going on. And if
you cant hear, you cant learn, says Earbus Foundation CEO Paul
Higginbotham, a teacher, who has launched every WA Earbus mission
since the concept commenced in 2007. Higginbotham brings his
experience teaching the deaf to a clinical team including an
audiologist, doctor (or nurse practitioner), ear, nose and throat
specialist (ENT) and nurse and Aboriginal health worker.
Previously we had treated sequentially screening first, GP a
week later followed by ENT within the month. This time around we
have the whole team working seamlessly together, treating on the
spot and learning from and supporting one another, he says.
For Earbus Foundation, the best results have come from engaging
with communities through schools,
kindergartens, daycares and playgroups. Most experts agree that
middle-ear disease in Australian Aboriginal children is largely a
result of poverty and social determinants of health. The bacteria
that cause middle ear disease thrive in deprived conditions such as
overcrowded housing, passive smoking, poor hygiene and infection
control, inadequate nutrition, unsustained breastfeeding, and poor
access to primary health care.
For ATSI Australians the exit route from poverty is literally
blocked by the glue in childrens ears. Without a good education,
high school graduation and gainful employment, the cycle of poverty
and disadvantage cannot be broken, says Higginbotham. Last year,
the program won the support of the Starlight Childrens Foundation
which will join other partners including the Royal Flying Doctor
Service and Aboriginal health services in Kalgoorlie and Port
Hedland. The partnerships with Aboriginal medical services provide
on-the-spot access to medications, Aboriginal health workers, a
mobile GP clinic facility, shared data collection and a raft of
cultural and community connections, says Higginbotham, whose mobile
team mostly services at-risk children and adults up to 21 years old
in the East Pilbara and Goldfields regions of WA.
When the programs commenced in February 2014, 54 per cent of
Goldfields
children and 52 per cent of Pilbara children were referred on
for primary care. We have reduced the Pilbara rate by ten per cent
in two years and the Goldfields rate by 19 per cent. says
Higginbotham.
Noahs storyLittle Noah Lockyer lived in a daze until he
discovered the Earbus, says his mother Madona. He was attending a
playgroup next to South Hedland Primary School when his
grandmother, a teacher, suggested he have his ears checked.
Back then, Noah was a bit of a loner. He was late with walking
and didnt talk much. It was like he was walking around in a fog,
explains Madona. Noah seemed cut off from family talks and he was
very quiet. He would sit close to the television and if I called
him, he didnt come, she says. An ear check showed Noah had fluid in
his ears and it was affecting his hearing. The Earbus doctor and
specialist spoke to us about a small operation to put grommets in
his ears to get the fluid out and let the air back in, says Madona.
His operation in March 2015 was a success and he now attends a
speech therapist and has turned into a lively chatterbox. He is
very happy and hears me really well. Since going to school, he
knows all his numbers and the alphabet and likes going to the
library. He is even singing more, says Madona.
all about.all about...The Earbus Foundation
Noah Lockyer aged 4
Imag
e: N
oah
Lo
ckye
r co
urte
sy o
f the
Ear
bus
Fo
und
atio
n o
f WA
-
26 Hearing HQ Apr - Jul 16
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