When worse is better – the tragedy of mild hearing loss

Children with mild hearing loss and other overlapping conditions aren’t getting the help they need – despite severe learning difficulties. Jane Blaikie reports

Luca’s family would dearly love to turn back time. In hindsight, they would have kept him in kindergarten for another year; at school they would have lobbied harder for help; they would have moved him to his new school sooner.
Luca*, now 11, is a big jumpy boy, with few friends and poor self-confidence. He’s well behind at school, but since he’s moved schools – “at least the anger’s gone”, says his grandmother. She’s cut back her work hours so she can drive him across the city to a mainstream primary school with specialist skills in deaf education. Academic progress is slow.
As a young child, Luca suffered glue ear as well as difficulty with attention and concentration. But hearing tests showed only mild impairment. “He ended up playing with the ‘naughty kids’ at school, and new immigrants who were also behind – becoming the class clown, and hiding his lack of achievement that way,” says his grandmother. She believes the school focused on high-achieving children (it was a high decile school) because of parental pressure.

Auditory Processing Disorder
But Luca has also recently been diagnosed with Auditory Processing Disorder (where pathways between the ear and the brain and auditory processing in the brain are impaired). For practical purposes, Luca’s hearing is much worse than straight hearing tests would suggest. He now has aids, which help, although being older he doesn’t like to wear them.
Luca’s case is not unusual, says itinerating deaf educator Clint Green. Children with mild and overlapping needs can be in a worse position than those who are diagnosed as severely or profoundly deaf at a young age – and they can take a long time to catch up.
“No system is foolproof. I work with a young boy who applied for ORS funding for hearing loss, and because he has other learning difficulties, his needs are quite severe, but he didn’t get the funding. The downfall of any contestible system is there has to be some kind of benchmarking.”
However, Clint, who’s one of 200 specialist deaf teachers in New Zealand, says he will continue to work with the boy and – “what we do for him for hearing loss is going to work with his other learning difficulties as well.”
He says deaf educators, with the huge improvements generated by cochlear implants (for profoundly deaf infants) and new technology (lightweight aids, texting, emailing), are increasingly becoming language development specialists. “We have to know the stages of language development, levels of function – and set learning goals around that.”
He’s hopeful that changes about to sweep though the sector will continue to improve deaf education. “I think the new model will mean we also work more with those with moderate needs, as well as those with severe needs – I hope it will better reflect the work we actually do.”
Changes to deaf education have been in discussion for the past decade or more. Last year reviews of special and deaf education culminated in a new model that will see, among other changes, the strand of ORS funding that currently goes to schools for 0.1 and 0.2 teachers taken from schools and given to the two deaf education centres, Kelston in Auckland and Van Asch in Christchurch.

Trail blazing
These two centres will employ more specialist itinerating teachers, and step up professional development for teachers in schools. At this stage, ORS funding for teacher aides is expected to stay with schools for only another 12 months. This type of model is being touted as a pilot for the delivery of special education funding in other areas.
Head of Kelston, David Foster, is very optimistic about the changes. “It’s trail-blazing. With the new Success for All policy, a national database of the students and their achievements starts to create the opportunity for us to make even more refined judgements about how to customize services.”
The Kelston centre includes a school for deaf students, many of whom are now achieving at the same levels as students with normal hearing in mainstream schools. David says nationally, however, around two-thirds of hearing impaired students are behind at school, and that the quality of deaf education in schools is mixed – some do it very well, others aren’t up to speed.
“We’re aiming for early, effective, consistent and equitably available services that are nationally coordinated. We’ll be providing more professional development for mainstream educators so they can identify programming for the needs of individual children – it’s a massive ask for classroom teachers.
“The size of it makes it daunting, and some of the timeframes are short – but it’s really positive.”

Standards won’t help
Some have suggested that National Standards would help to pick up children like Luca earlier. But NZEI national president Ian Leckie says, “Luca would just have been lumped in with tens of thousands of other children labeled as ‘failing’ – most of whom aren’t.”
Ian says that with Natioanl Standards Luca would be lost amongst kids who are working hard and catching up; with kids who are on-track but get labeled otherwise because the standards have been set too high; and with kids whose parents are letting them learn at their own pace rather than in artificially imposed annual increments.
“Catching children like Luca at a young age is actually very complex, and National Standards are simply too blunt an instrument. The tragedy is that the resources being sucked up to impose the standards on schools comes at the expense of children like Luca who need more.”


Does that ‘naughty’ child have hearing loss?
Many children come to school with hearing impairment, and some may not be picked up – hearing loss can begin at any time. As well, Auditory Processing Disorder (where the ear processes sound normally but the brain has difficulty interpreting what is heard) is still not widely recognised.
The National Foundation for the Deaf suggests educators look out for these signs:
-    speech is delayed compared to other children of a similar age
-    the child talks loudly
-    poor attention and behaviour
-    does not follow or understand verbal questions and instructions.
Children with APD benefit from hearing aids and an FM receiver that gives high quality sound. “Surround sound” speaker systems that deliver high quality sound to all parts of a classroom also help.
David Foster from Kelston Deaf Education Centre says, “If you have any child in your classroom who’s exhibiting high frequency, low intention off-path behaviour, ask yourself, ‘Can this child access what’s going on in the classroom? Can they see, can they hear properly? Is there anything about their behavioural attention that is in deficit? How do they learn? What’s their learning preference? And as a school – make it your business to ask, ‘Can all our children see and hear properly?’”
For more help, contact special education advisors at the Ministry of Education.
To find out more about Auditory Processing Disorder (which research suggests may affect up to 5% of students), visit www.soundskills.co.nz
Families of deaf children can get support from the Federation of Deaf Children, www.deafchildren.org.nz


Safe Sound Indicators
Some early childhood centres have dangerously high noise levels that can damage hearing, so the National Foundation for the Deaf is keen for every site to have a Safe Sound Indicator. The SSI works like traffic light – glows green when the noise is ok, amber when getting too high, red for stop right now. It’s been shown to help children moderate their own noise levels. More at - www.nfd.org.nz


Key points
8% of children arrive at school with hearing impairment.
Changes to the delivery of deaf education will see more specialist teachers and more training for mainstream educators.
Educators are cautiously optimistic the changes will help. They’re seen as a pilot for the delivery of special education in other areas.

* Name changed to protect identity.