Unexpected journey is played by the ear

MBOMBELA – Hilary Marx, the proud mother of hearing impaired John-David (6) compares her experience of raising a child with a disability to the well-known poem, Welcome to Holland. “When you’re going to have a baby, it’s like planning a fabulous vacation trip – to Italy. You buy a bunch of guide books and make your wonderful plans. The Coliseum. The Michelangelo David. The gondolas in Venice. You may learn some handy phrases in Italian. It’s all very exciting. After months of eager anticipation, the day finally arrives. You pack your bags and off you go. Several hours later, the plane lands. The stewardess comes in and says, ‘welcome to Holland’.”

John-David was born deaf, but only diagnosed at the age of 18 months with profound sensory neural hearing loss. “At 18 months, John-David had not started walking yet. Only then did we realise that he had a hearing problem. I want to request every parent to take your newborn for a hearing-aid test as soon as he is born. If I knew earlier, things would have turned out different.” Hilary said that one in 17 babies are born daily with hearing loss in South Africa.

John-David’s type of hearing loss is so severe that conventional hearing aids couldn’t amplify sufficiently and he was placed on the Cochlear implant waiting list. Thanks to excessive fund-raising, John-David was able to receive two implants within 27 months.

Even though the family intervened as soon as they could, those 27 months without auditory stimulation severely affected John-David’s development. Research has shown that, by the age of 24 months, the language centre in the child’s brain has formed.

In October 2011 he got his first cochlea implant in his left ear. Six months later after a fund-raiser they could implant another device to his right ear.

It has almost been four years that John-David can hear his mom’s voice, small things they take for granted like when she calls him to brush his teeth instead of having to go to him and assist him to the bathroom. “I have learnt not to take anything for granted and to talk to him more, to be patient and slow down. We are so grateful – 20 years ago we would have had to learn sign language.”

John-David is currently in preprimary school at Montessori and has been accepted for grade one at Flamboyant. “We are very privileged. It has been a bumpy ride. He is ready to learn more, read more and to listen more. But every day is still challenging.

He is so happy and such a cool kid. God knew that I would not have been able to handle a deaf and a difficult child,” Hilary said with a smile.

“And for the rest of your life, you will say, ‘Yes, that’s where I was supposed to go. That’s what I had planned’.”

October is infant and child deaf awareness month. Lowvelder asked Nicole da Rocha-Field of the Nelspruit Ear Institute to tell us a bit more about what causes hearing loss in a child, the screening and intervention, and prevention.

What causes hearing loss in a child?
A baby may be born deaf, lose his or her hearing as a result of meningitis or an ear infection, or the cause may be hereditary.
The ear has three parts: The outer ear is made up of the pinna (what you see on the outside of the head) and ear canal, the middle ear comprises the eardrum, middle-ear bones and Eustachian tube, and the inner ear is made up of the cochlea (organ of hearing), semicircular canals (help with balance) and part of the auditory nerve.

Depending on the part of the ear that is affected, there are different treatment options.
• Conductive hearing loss is caused by problems in the outer/middle ear. There is an interference with the transmission of sound through the outer and middle ear, but sound still reaches the cochlea. Softer sounds will not be heard and sound quality may be compromised. This type of hearing loss can often be treated medically or surgically.
• Sensorineural hearing loss is caused by problems in the inner ear including the cochlea and auditory nerve. Most common cause is damage to hair cells in the cochlea so that nerve cells cannot send signals to the brain. This is a permanent hearing loss and cannot be treated medically/surgically.
• Central hearing loss – sound is transmitted to the auditory nerve but it is not processed normally along the auditory nerve and/or in the brain.

Early hearing screening and intervention
Hearing loss can affect a child’s ability to develop speech, language, and social skills. The earlier they get help, the more likely they are to reach their full potential. If you think that a child might have hearing loss, ask the child’s doctor for a hearing screening as soon as possible. Don’t wait.

What is hearing loss?
It can happen when any part of the ear is not working the way it should. This includes the outer ear, middle ear, inner ear, hearing (acoustic) nerve, and auditory system.

Signs and symptoms
These differ in each child. If you think that your child might have hearing loss, ask the child’s doctor for a hearing screening.
Even if a child has passed a hearing screening before, it is important to look out for the following signs.

Signs in babies
• Does not startle at loud noises.
• Does not turn to the source of a sound after six months of age.
• Does not say single words, such as “dada” or “mama” by one year of age.
• Turns head when he or she sees you but not if you only call out his or her name. This sometimes is mistaken for not paying attention or just ignoring, but could be the result of a partial or complete hearing loss.
• Seems to hear some sounds but not others.

Signs in children
• Speech is delayed (first words /mama/papa by 1 to 1,5 years)
• Speech is not clear.
• Does not follow directions. This sometimes is mistaken for not paying attention or just ignoring, but could be the result of a partial or complete hearing loss.
• Often says, “Huh?”
• Turns the TV volume up too high.

Prevention
Following are tips for parents to help prevent hearing loss in their children:
• Have a healthy pregnancy.
• Learn how to prevent cytomegalovirus (CMV) infection during pregnancy.
• Make sure your child gets all the regular childhood vaccines.
• Keep your child away from high noise levels, such as from very loud toys. (vuvuzela).