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Hearing and Literacy

The context
The issue
What happened?
The results

The context

One of the Strategic Results Projects set out to provide the intervention required to reverse or remediate the consequences of ear disease and hearing loss among a target group of Indigenous students in six schools across the Northern territory, and improve their literacy.

More specifically, it was intended to demonstrate the link between otitis media with effusion (OME, sometimes called 'glue ear'), conductive hearing loss (CHL: a preventable type of hearing loss caused by ear disease) and levels of English literacy.

Al Yonovitz, now District Manager for Australian Hearing in Darwin, was the project officer. You can read Al's answers to a variety of interview questions by following the links below.

     
 

The issue

Research has established that Indigenous Australians have a very high prevalence of upper respiratory problems and related diseases, including OME. During the critical years for speech and language development, as well as for growth and elaboration of the nerve pathways between the inner ear and the temporal cortex of the brain, the great majority of Indigenous children are experiencing fluctuating hearing loss. Such sensory deprivation during the developmental period subsequently makes it much more difficult for these children to learn English as a school language.

OME in advantaged populations around the world is approximately 5% in childhood, falling to lees than 1 percent after age 12. The prevalence of OME among Indigenous Australian children living in remote communities has been found to range from 40%-70%, with younger children experiencing more frequent infectious episodes.

Eardrum perforations and ruptures typically begin within the first three months of life. With repeated ruptures, healing, and re-ruptures, the eardrums become scarred and thickened. In many cases the ruptures become too large to heal and require reconstructive surgery to repair. In rare cases, reconstructive surgery is not possible, but bone-conduction hearing aids can be provided with excellent speech perception results.

The middle ear disease that causes CHL is medically treatable, and in appropriately managed cases there should be no persisting hearing loss.

How bad is the problem?…

     
 

What happened?

Ear examination and hearing testing was provided for 1032 students. Those students found to have active ear disease were provided with medical treatment, in cooperation with families, schools and community clinics.

In summary, 79% of this group of Indigenous students were found to have an educationally-significant hearing disability. Findings in more detail were as follows.

Forty per cent would conventionally require physician services to treat active middle ear disease and/or provide reconstructive ear surgery — 16 percent had persistent and significant conductive hearing loss in both ears; 24 percent had conductive hearing impairment that would cause major difficulties for students learning English as a foreign language.

In addition to those above, 38% had indication of a Central Auditory Processing Disorder (CAP-D) displayed by poor speech discrimination scores and intolerance of background noise.

How do these problems show themselves?…

Workshops were held at each of the six schools, for teachers and assistant teachers, community liaison officers and other staff. This covered topics such as: ear disease, auditory deprivation and language development; implications for schools and support services for students with hearing disabilities; phonological awareness (PA) intervention program for Indigenous language-users who are speakers of English as a foreign language; classroom acoustics, and FM classroom hearing aids and speaker systems; structuring learning environments to promote inclusion of students with hearing disabilities. The in-service program concluded with a negotiated plan for how each school would be involved.

FM sound field amplification systems were provided to all schools where appropriate, except one which already had the equipment and one which had design issues likely to make the equipment of doubtful benefit.

What did you do?…

Aren't hearing aids for kids a bit of a 'shame job'…

     
 

The results

Students' literacy and phonological awareness levels were tested at the beginning and end of the project to measure the impact of the school-based intervention program.

Note: The scores reported are those of students who attended at least 75% of school days in 1998 and were available for both pre- and post-testing. Across all six schools, 21 percent of students (n= 212) met these criteria, but none of the students in the Primary (5-11 year-olds) category did. Thus, this became an analysis of the literacy progress of secondary-aged students. Ear disease and hearing loss are much more prevalent in younger children and can be associated with their generally poor health and poor school attendance.

The first (pre-test) and second assessments (post-test) were separated by approximately eight months.

Spelling Age Scores (years):
   
Pre-test:   Post-test:   Progress: 0.95 yr. (11 mos.)
Mean: 8.33   Mean: 9.28    
Range: 5.67-10.75   Range: 6.67-11.00    
     
Reading Age Scores (years):        
Pre-test:   Post-test:   Progress: 0.99 yr. (12 mos.)
Mean: 8.67   Mean: 9.65    
Range: 6.08-10.67   Range: 6.67-11.00    
       
Phonological Awareness Scores (percent):    
Pre-test:   Post-test:   Progress: 17% (18 mos.)
Mean: 65%   Mean: 82%    
Range: 0%-97%   Range: 10%-100%    

Data also exist for the six schools separately. These indicate that the cohort of students in the school with predominantly older Indigenous students (who are therefore more likely to have stayed in school longer) is more likely to achieve above Intensive English Level. This is evidence that students' persistence in returning to school from year to year, in addition to their daily attendance during each year, is related to their ear health, hearing status, achievement level and literacy progress.

What were your main findings?…

     
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