18 September 2018

Tone-deaf to people’s real needs

Why is an innovative indigenous health program on the cusp of
full implementation now likely to be mothballed, asks Dr Damien
Howard? It is as if the bullet train railway line has been
decommissioned, forcing a return to bicycles. A task that can be
complete in seconds will take months, if it is accomplished at all.

We are momentarily outraged about Aboriginal deaths in

custody, about the incarceration of Aboriginal youth for petty
crimes, about the high rates of suicide and the large gap
between the average life expectancy of Aboriginals and the rest
of Australia. The outrage however, is always tempered with a
“yeah, but” …

Signing or spoken language?

Parents of children who are deaf or hard of hearing can often
feel like they need to make a choice whether to pursue spoken
language or Australian Sign Language (Auslan) for their child,
but as Callie’s family have shown, it doesn’t have to be either or.

Hearing aid advertisements misled pensioners

The national consumer watchdog has commenced Federal Court
proceedings alleging that 85 print ads from Oticon Australia and
Sonic Innovations published last year placed a false deadline on
applications for subsidised hearing aids under a federal
government program.

Winners in Australia’s first film festival for deaf

teenagers
The Hear For You Film Festival was an opportunity for secondary
school students to script, shoot and edit a film for a nationwide
competition.

Deafness Forum acknowledges the traditional owners of country throughout Australia, and their continuing connection to land, sea and
community. We pay our respects to them and their cultures, and to elders both past and present. We acknowledge the challenge for Indigenous
leaders and families to overcome the unacceptably high levels of ear health issues among first Australians.
Tone-deaf to people’s real needs, the silos strike back
By Damien Howard

Why is an innovative indigenous health program on the cusp of full implementation

now likely to be mothballed, asks Dr Damien Howard?

The audience at a recent national conference on Otis Media – the ear condition that causes
conductive hearing loss – were impressed by a presentation about a ground-breaking new
collaborative initiative developed by the NT Hearing Project/Portal, iHearing. The system uses
cutting-edge digital systems to integrate and share health and education data between
professionals in the field and has the potential to revolutionise support for the many Indigenous
children suffering disadvantage due to hearing loss.

The system is transformative and akin to a transport system in which bicycles are replaced by a
bullet train. But buried in the ‘fine print’ of the presentation was the information that, on the cusp
of full implementation, the project may be mothballed.

“For managers elbow deep in the entrails of budget projections, pressures to preserve their own
silo are intense. Collaborative projects can glisten as ‘fat to cut’.”

IHearing relies on the NT Health Department Hearing Health Information Management Program
(HHIMS), which feeds hearing health information into it. But that program, transformative in
itself, has been terminated. And without it, health and education professionals cannot effectively
collaborate.

To extend the railway metaphor, it is as if the bullet train railway line has been decommissioned,
forcing a return to bicycles. They will have to slowly collate hard-to-access reports and data and
get that information to where it is needed. A task that HHIMS and iHearing would let them
complete in seconds will still take months, if it is accomplished at all. Health and education
professionals will return to working in poorly connecting silos.
Indigenous ear disease and hearing loss exemplify a classic interdisciplinary problem. The health
issue occurs in early childhood when children’s ear health issues are a responsibility of health
agencies. These agencies are blind to the educational needs of the children. Schools and
teachers are often unaware of hearing problems that affect children’s classroom engagement.

Indigenous children with conductive hearing loss attend school less, often do not engage well
when there, and are regularly excluded from classrooms because of disruptive behaviour. Around
Australia, policy has dictated that children with conductive hearing loss receive less educational
support than children with sensorineural hearing loss. This is based on assumptions about the
minor influence of conductive hearing loss, that are increasingly being shown to be a fiction.

Given Indigenous children experience much more conductive hearing loss this creates an
apartheid-like outcome in terms of educational support. So doing as much as possible with the
limited educational support available for Indigenous kids with conductive hearing loss is crucial.
Bicycle paths are not enough.

By adolescence, the limited educational engagement and disruptive behaviours routinely escalate
at school, until the students reach school leaving age, ‘solving’ school’s problems. With limited
literacy and numeracy skills, these adolescents often settle into unemployment and welfare
dependence. Too many also come to the attention of criminal justice agencies.

As one judge commented during the trial of a young man with hearing loss who had caused
criminal damage worth hundreds of thousands of dollars:

“Although a hearing problem was identified early in (the defendant’s) life and identified again
during his childhood, it appears he has not had access to a range of services, including the
possibility of surgical intervention, amplification, speech therapy, and special education, that could
have minimised the communicative, social and psychological impact of these problems … these
communication difficulties have been a major contributor to the development of serious social and
psychological problems.”
Corrections agencies have limited capacity to support ongoing ear health issues or improve
educational outcomes. Supervised visits to health appointments for individual inmates cost
money. For overwhelmed and underfunded corrections systems, the provision of remedial health
and educational support is unaffordable.

Meanwhile, the annual incarceration cost in the NT is around $100,000 a year for an adult and
$200,000 a year for a young person with 50% returning to detention within two years of release.
It may seem shortsighted to avoid spending a few dollars on accompanied visits to health
professionals, for a new ear drum or hearing aids that may reduce the risk of re-offending. But
managers must deal with current budgets with no incentive to minimise future costs.

“Perhaps governments should embed a ‘collaboration bonus’ in service delivery and research
funding models, to counter the powerful forces that give preference to silo-based thinking.”

The silo-ridden research sector have not helped criminal justice agencies to consider rehabilitative
opportunities around hearing loss. Applications for funded research into Indigenous hearing loss
have long been rejected by criminal justice research programs because they saw it as a health
issue. Health research funders have done the same, seeing it as a criminal justice issue. By
staying within their own silo, agencies can avoid engagement in these issues. I remember letters
I once wrote to ministers of health and corrections in the same jurisdiction pointing out the
interrelated problems their departments shared around Indigenous hearing loss. The ministers
each referred their letter to the other.

Even when interdisciplinary programs like HHIMS and iHearing are established, they are still
vulnerable. For managers elbow-deep in the entrails of budget projections, pressures to preserve
their own silo are intense. Collaborative projects can glisten as ‘fat to cut’, with fewer internal
ramifications.

New collaborative projects that haven’t been fully launched are especially vulnerable. Successful
programs are also hungry for further funds. They risk creating future, difficult to manage, funding
demands. Moderately successful or even failing programs are less financially ‘risky’ in terms of
future demands. Such logic is idiotic when considering the big picture. But it can seem sensible
when viewed from within cash-strapped silos, trying to juggle the existing internal competing
interests. Preventing the default to silo thinking is difficult. Medicare found it prudent to pay GPs
for case conferences with other professionals – better patient outcomes at lower long term cost
resulted.

Perhaps governments should embed a ‘collaboration bonus’ in service delivery and research
funding models, to counter the powerful forces that give preference to silo-based thinking. It
could mean that more ground-breaking programs for transdisciplinary problems are developed,
and implemented.

The area is also ripe for justice reinvestment. The cost of keeping a few youths out of detention
would more than pay for the ongoing costs of these programs and the better educational support
the programs would enable. Justice reinvestment could also fund long-neglected research into
these issues.

The author, Dr Damien Howard is a psychologist who over many years has researched how
widespread Indigenous peoples’ hearing loss contributes to Indigenous disadvantage and what
can be done to mitigate these effects.

From The Mandarin, https://www.themandarin.com.au/98477-tone-deaf-to-peoples-real-needs-the-silos-strike-back/

58% is the percentage of Indigenous children aged 0-14 years with poor ear health living in
remote communities in Queensland. In 0-4 year-olds it’s 85% - in these years the auditory link
with the brain develops.

4 times - a child with hearing loss is 4 times more susceptible to sexual abuse.
90% is the percentage of Aboriginal inmates at Darwin Correctional Centre with hearing loss.
For male Aboriginal inmates in Alice Springs it’s 95%.

10 times - Aboriginal people are 10 times more likely to suffer from ear disease and hearing
loss than non-Indigenous people.

7% is the percentage of Aboriginal children in remote communities with healthy ears. 93% of
Aboriginal children suffer from middle ear infections in early childhood. In remote NT
communities this ranges from 8% to 50%. The World Health Organisation regards 4% as a
'massive public health problem'.

32 weeks is the average time that Aboriginal children and young adults aged 2 to 20 years
suffer from middle ear disease. For non-Indigenous children it’s 2 weeks.

95% is the proportion of male Aboriginal prisoners in Alice Springs prison who suffer from
hearing loss. In Darwin it’s 92.5%.

Source: https://www.creativespirits.info/aboriginalculture/health/ear-health-and-hearing-loss

We are momentarily outraged about Aboriginal deaths in custody, about the

incarceration of Aboriginal youth for petty crimes, about the high rates of suicide and the large
gap between the average life expectancy of Aboriginals and the rest of Australia. The outrage
however, is always tempered with a “yeah, but”, then we start talking about alcohol and spousal
abuse, incest and pedophilia, we call them lazy bludgers and welfare abusers, we ease our
discomfort for their plight with the view that it’s just how it is and, though it’s sad, there’s nothing
we can do about it, it’s just the way they are …

Why can’t they be more like us? Hmm …

The truth is, there’s a lot we can do.

We can stop telling ourselves that the injustices of the ‘stolen generation’ were well-intentioned,
but poorly executed attempts at social integration because equality and a level footing with white
Australia was never part of the plan.
We can stop being outraged about Aboriginal people receiving government support and stop
viewing remote communities as needing to be self-sustaining, we can choose to embrace their
difference and acknowledge that almost ninety per cent of Aboriginal people died within the first
few years of European settlement.

We can teach our children real Australian history because, just like ‘the convict stain’ that until
fairly recently we didn’t want to admit was in our blood, the atrocities committed against the
Aboriginal people of Australia was a very real thing. We hunted them like they were foxes from
old England, pests and sexual playthings in a country where white women were few and far
between and destroyed them for acting in ways we could not understand.

Wholesale slaughter of the Aboriginal people was common and rarely punished. Poisoned flour
and tea was given to them freely and generously, as deaths from sickness in the Indigenous
population was something never investigated by the government.

Should Aboriginal people just forget about it? Forget that until fifty years ago they were
considered more akin to livestock than humans according to governmental policy, their existence
legislated under the Flora and Fauna Act, instead of the Constitution like the rest of us.

We have forgotten or never accepted the fact that we have created the world they now live in
and, though we want them to accept responsibility and fix the problems that exist in their division
of society, we refuse to allow them the tools and mechanisms to make this possible.

An extract from ‘Aboriginal Australians are a problem for our society’, an essay by Anthony
Andrews, https://theaimn.com/aboriginal-australians-problem-society/

Meniere’s research meeting

Saturday 3rd November 2018, 10.00am to 12.30pm.
The Conference Room, Sydney Cochlear Implant Centre, Old Gladesville Hospital, Punt Road
Gladesville NSW.

Program highlights
 Tissue culture and nanotechnology: the possibilities for Meniere’s disease
 Hearing rehabilitation to improve quality of life for patients with Meniere’s disease
 New tests of vestibular function for diagnosis of Meniere’s disease
 Research project to determine if there is a possible viral cause of Meniere’s disease
 Latest findings from the Meniere’s Research Laboratory

Please register for catering purposes by Friday 26 October.

Contact Professor Bill Gibson, Bill.Gibson@scic.org.au

Loud Shirt Day helping kids get ahead

Triplets Paula, Demi and Amalia love doing everything together.

“Although Amalia’s the leader — always telling the others what to do and how to do it — her
sisters are always there at her side, to look after her and make sure she’s OK too,” the four-year-
old siblings’ mother Aspasia Paspaliaris said.

The care they have for Amalia is not just sibling love but because Amalia was born with a genetic
condition that had left her profoundly deaf. Amalia was diagnosed with hearing loss at three
months. But, with the support of her parents and the Cora Barclay Centre, she is now fully
hearing and speaking after receiving cochlear implants.

“We’ve been at the Cora Barclay Centre since 2016 and they have been extremely supportive,’’
Mrs Paspaliaris said. “They’ve also been welcoming of my other daughters and let them join in on
activities so Amalia doesn’t feel different to her sisters.” Mrs Paspaliaris said it had always been
the goal to get Amalia into a mainstream school with her sisters.

Amalia has intensive one-on-one auditory-verbal therapy at Cora Barclay, as well as participating
in group sessions where the therapy is reinforced through music and play. It is also a chance for
parents to share tips and bond with others.

“Amalia is doing remarkably well,’’ Mrs Paspaliaris said. “She is now saying sentences, can
understand a conversation, knows colours and shapes and can count.”

Loud Shirt Day, on October 19, is raising funds for early intervention services and programs for
infants and children who are deaf or hearing-impaired. Running for almost 20 years, it aims to
close the gap in access to critical programs like family counselling, school readiness programs and
music programs, as these services are not fully government-funded. www.loudshirtday.com.au

From The Adelaide Advertiser, https://www.adelaidenow.com.au/news/south-australia/loud-shirt-day-helping-

hearingimpaired-kids-get-ahead/news-story/191b1cfc526400e09639062e40ecaf76
The Disability Standards for Accessible Public Transport are designed to ensure that
public transport operators and providers remove discrimination from public transport
services.

The Transport Standards are currently under review and the public is invited to respond to the list
of questions below. Submissions will close on 30 November 2018.

Questions:
1. Has your accessibility to public transport improved since the commencement of the second
Transport Standards review in 2012?
− How has your accessibility to conveyances changed? (for example, trains, buses and
coaches, trams, ferries, wheelchair accessible taxis and aircraft). Can you provide
examples?
− How has your accessibility to information (for example, maps, timetables,
announcements) changed? Can you provide examples?
− How has your accessibility to infrastructure immediate to boarding a conveyance
changed? (for example, any structure or facility that is used by passengers in
conjunction with travelling on a public transport service). Can you provide examples?
− What do you currently see as the greatest areas of need with regard to accessibility of
public transport for people with disability? Can you provide specific examples?
2. As a public transport user, are there areas of the Transport Standards where you consider
that a more specific requirement for compliance would improve accessibility?
3. To what extent do you feel that the requirements in the Transport Standards address all of
the accessibility requirements for people with disability? Are there gaps in the coverage of
requirements?
4. Have new ways of providing public transport, such as ride sharing or on-demand bus
services affected your ability to access services?
5. Do you find that the current processes with regard to making a complaint or seeking
information are sufficient or sufficiently responsive?
6. What other issues you would like to see addressed?

Visit https://infrastructure.gov.au/transport/disabilities/third_review_tor.aspx
Hearing aid advertisements misled pensioners
Alex Druce writing for Australian Associated Press

Two hearing aid retailers have admitted to misleading pensioners over free hearing aids in a series
of newspaper ads in 2017.

The Australian Competition & Consumer Commission, often called the A-triple-C, and ACCC in
print, promotes competition and fair trade in markets to benefit consumers, businesses, and the
community, according to its website.

The ACCC has commenced Federal Court proceedings alleging that 85 print ads from Oticon
Australia and Sonic Innovations published last year placed a false deadline on applications for
subsidised hearing aids under a federal government program.

The ads, which appeared under the under the AudioClinic and HearingLife brands claimed devices
would connect to devices such as TVs and mobile phones without acknowledging additional
accessories were required at extra cost. The ads promised users would "no longer miss any
conversations", without taking into account the nature of a person's hearing impairment or
individual circumstances.

"Hearing aid advertisements have a powerful effect on purchasing decisions," ACCC commissioner
Sarah Court said.

"The ads must be accurate and truthful, especially given that many of the people buying hearing
aids may be vulnerable due to their age."

The ACCC said Oticon and Sonic, who sold more than 10,000 of the Oticon Ria2 and Sonic
Cheer20 hearing aids, admitted to false and misleading representations, and will refund
customers.

The ACCC said the Federal Court will decide whether to approve a proposed $2.5 million penalty
related to contravention of Australian Consumer Law.

In a statement, HearingLife and AudioClinic managing director of retail, Janet Muir, said the group
accepted that errors were made and apologised to anyone who felt misled by the advertisements.

"We take the ACCC's concerns seriously and accept full responsibility for the advertising errors
that we have made," Ms Muir said.

https://www.news.com.au/finance/business/breaking-news/hearing-aid-ads-misled-pensioners-accc/news-
story/a702f32e32dbb647f2cf0c11667d1022
Winners in Australia’s first film festival for deaf
teenagers
Australia’s first film festival for deaf teenagers, the Hear For You Film Festival, was an opportunity
for deaf or hard of hearing secondary school students to script, shoot and edit a film for a
nationwide competition.

(L-r) David Romanowski (mentor), Richard Moir, David Vane, Raymond Moreno, Teneale Houghton
(mentor), India Cox, Rebecca Stewart (mentor) and Hear For You CEO David Brady.

Event sponsor Australian Hearing selected the theme, ‘Love @ …’. Hearing loss hasn’t been a
barrier for young people discovering a new sport, relationship, art, career and other life
milestones. The budding filmmakers were asked to focus on their passions by incorporating ‘Love
@ …’ into their story.

The winners were:

– Best screenplay: What Am I Missing? by Karen Nguyen, Samira Cox and India Cox
– Best director: Oscar Lynch for Teddy Bear Love Story.
– Best film: The Bus Stop by Raymond Moreno, Jared Donaldson, and Richard Moir
– Judges’ award: Teddy Bear Love Story by Oscar Lynch

“Life is hard enough for teenagers and if you’re deaf it can be even harder,” says David Brady,
CEO at Hear For You. “Often we find deaf teenagers are isolated and don’t take part in activities
such as filmmaking in school because they aren’t able to keep up with their hearing peers.

“Programs such as this film festival help to validate the young deaf person’s worth, improve self-
esteem, networks and provide ‘lived’ experiences that teenagers can relate to.”

Hear For You employees and volunteers are deaf so through these programs, deaf teenagers have
the opportunity to connect with mentors who have ‘been there, done that.’ The programs and
events give young people support, guidance and the chance to meet other people who
understand what they’re going through.
Signing or spoken language?

The parents of children who are deaf or hard of hearing can often feel like they need to make a
choice whether to pursue spoken language or Australian Sign Language (Auslan) for their child,
but as Callie’s family have shown, it doesn’t have to be either or.

As a newborn, Callie was diagnosed with profound sensorineural bilateral hearing loss, meaning
she has permanent hearing loss in both ears. While it can be challenging for new parents to
understand their next steps, Callie’s parents felt more prepared than most. Both of Callie’s
parents are deaf, and so were able to call on their own experiences, as well as those of their own
parents, to make decisions.

Callie’s mum, Jordanna, grew up using sign language, and immediately knew that a combination
of Australian Sign Language (Auslan) and spoken language were important goals for Callie’s
future. RIDBC Early Learning Program for hearing impaired children can incorporate both spoken
English and Auslan in an integrated program – a feature that, Jordanna says, made her choice
easy.

“I met with RIDBC Early Learning Program Consultant, Katie, and I liked the fact that I could see
she used both speech and Auslan – they were used interchangeably, and I knew that would really
give Callie access to both worlds,” she said.

Not all the decisions Callie’s parents would make were as easy as this one. The decision to get a
cochlear implant was one of the hardest. Jordanna doesn’t have a cochlear implant herself and is
a proud member of the Deaf community. “I don’t feel like I need to hear,” she explained. “I am
proud of who I am and being deaf is part of that.”
In considering their options, Callie’s parents realised that a cochlear implant didn’t mean forgoing
Auslan – Callie could, and would, have both. “There is a mistaken belief that people have to
choose sign language or a cochlear implant. But that’s simply not the case – I want to give Callie
every opportunity - I want to give her the whole world. A combination of speech and signing with
a cochlear implant was, for us, the right way to go. It wasn’t an instant decision, it was a
process. I did a lot of research before coming to a conclusion – and it’s a decision I don’t regret.”

RIDBC’s early learning program team work with each family to set goals and create individualised
plans to achieve the outcomes that are important to them.

Callie began seeing the team at RIDBC as a young baby, when it was all about supporting her
family to help her develop through play.

Katie worked with the family as Callie grew, identifying whether cochlear implants were an option,
and then supporting the family in their decision. Once the decision had been made, Katie and the
team worked with Callie to develop both her Auslan and English skills.

“It’s a unique situation as we are essentially supporting Callie to develop two languages. We work
very closely with the family to do this. For example, sometimes I will read a book to Callie and
then Jordanna will talk to her about it in Auslan,” she explains.

At just three years of age, Callie is now bilingual, fluent in Auslan and English, in which she has
reached equivalency with her hearing peers.

Callie is attending RIDBC Rockie Woofit Preschool, where the RIDBC early learning program team
will continue to work with her to prepare her for the transition to school where Callie will be ready
to take on the next challenge.

From RIDBC newsletter, https://www.ridbc.org.au/signing-or-spoken-language

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