The Gift of Hearing

Singapore Health MAY/JUNE 2010
http://www.healthxchange.com.sg/healthyliving/childrenhealth/Pages/The-Gift-of-Hearing.aspx

The phone rings. Julius Goh, five, answers on the second ring. A voice from the receiver tells him to pick up a plastic frog on the table, which he triumphantly does. Then he sets it down and proceeds to pick up a colourful clown, a grey mouse and a host of other toys, all while his mother watches with bated breath.

This scene seems like a typical children’s game, except for two important details. First, it took place at Singapore General Hospital’s (SGH) Ear, Nose and Throat (ENT) Centre. Second, Julius was born with Large Vestibular Aqueduct Syndrome, which means that one of the channels in his inner ear responsible for conducting sound is larger than normal. For Julius, hearing others was like listening to an underwater conversation.

Learning to listen

Given Julius’s condition, being able to understand even a simple telephone conversation is something of a miracle for his mother, Ms Flora Quek, who left her job three years ago to help Julius manage his condition.

At the age of two, Julius had a cochlear implant. An electronic device was placed under the skin behind his ear to help him do what his own ears could not – pick up sounds and convert them into electrical signals. These signals are then sent to the brain via the hearing nerve.

Although it simulates the way a normal ear functions, hearing through a cochlear implant is different from normal hearing. Patients still need to learn to associate different signals from the implant with speech and sounds around them, a process which can take months or even years. To get to where they are today, Julius and his mother have been attending weekly Auditory-Verbal therapy sessions for the past three years. “I took one year off work just to talk, read and play with him every day after the operation,” said Ms Quek. “Julius learnt very quickly. Three months after getting the implant, he could say ‘Mama’ and ‘Papa’. Six months later, he could say a lot of words.”

Word play

Unlike other children his age, “play” for Julius involves a series of structured games with the aim of achieving specific objectives.

“The goal is not just to give him hearing, but also to develop his listening skills, so as to build up spoken language and communication competence,” said Ms Stephanie Lim, Principal Auditory-Verbal Therapist, ENT Centre, SGH.

Besides reinforcing language concepts such as “through” and “under”, Ms Lim engages Julius in speech babble such as “lalala”, “dadada” and “assspa”, punctuating them with real words such as “change” and phrases such as “a special day”. The goal of these exercises is to develop hearing as an active sense so

that the child can seek out sounds in life. Other activities, which reinforce listening and reasoning abilities, are aided by colourful toys and can be replicated at home by parents.

Although the sessions are generally fun-filled for mother and child, this is not the only reason Ms Quek values them. “I wish I’d gone for Auditory-Verbal therapy with my other two children, even though they don’t have hearing problems. Julius is doing better than them when they were the same age in terms of vocabulary, general knowledge and cognitive abilities!” said Ms Quek. “But more than that, it’s such a great bonding experience.”

Hearing loss:The facts

• Eight per cent (or some 300,000) of Singaporeans suffer from hearing loss. Of these, six out of 1,000 are born with it, and 50 per cent are aged 70 and above.
• Hearing loss affects children’s language abilities and social skills, and understandably causes the elderly to feel depressed and anxious.
• Singapore General Hospital installed a Hearing Arcade more than four years ago with various panels that simulate the muffled sounds hearing impaired people hear. The arcade has helped many members of the public understand what it is like to “experience” hearing loss.
• Auditory-Verbal therapy helps children with hearing devices learn to listen, understand speech and talk without sign language or cued speech. Through a series of structured activities, natural play and parent training, children are encouraged to develop listening, language, cognitive, speech and communication skills.
• For children with hearing loss, early intervention is crucial. As the child grows older, the brain is not as pliable and cannot develop speech as well, or effectively learn a second language. Hence, therapy usually begins as soon as the infant/child is fitted with a hearing device.