For children who have developed no language, Cochlear Implants are a miracle. They effectively restore a child’s hearing. However even with new born hearing screening and early implantation, there is a lot of work that needs to be undertaken to teach the child to listen and catch up with their normal hearing peers.
All experts agree that intensive Early Intervention is required.
In New Zealand therapy for children with Cochlear Implants is funded through the Ministry of Education. This is different from the Ministry of Health who fund the cost of one implant.
There is a problem with therapy for Cochlear Implant children in New Zealand.
Fact 1 – 90%+ choose oral language as their sole communications medium
A recent review of Ministry of Education Auckland and Northern under 5yrs data March 2012 for children with hearing loss shows that only 93.6% of under 5 year olds were choosing to use oral language as their sole communication medium. This under 5 year old age group is the critical period for intensive Early Intervention therapy.
Fact 2 – Auditory Verbal Therapy (AVT) is the accepted international best practice
Auditory-Verbal Therapy accelerates the natural way a child would develop language to enable deaf children with a cochlear implant or hearing aid to catch up on the years of listening and language development he or she missed out on before receiving the hearing device. The aim of Auditory-Verbal Therapy is for the child to speak clearly and naturally like their hearing peers and to attend mainstream school by the age of five. In later life the child will experience enhanced education and employment opportunities; enhanced social independence and quality of life; and will be able to fully participate in, and contribute to, mainstream society.
Only the two Cochlear Implant programmes are training their staff in Auditory Verbal Therapy.
In discussions with the Ministry of Education and the Deaf Education Centres, there are no plans to train, recruit or otherwise obtain Auditory Verbal Therapy qualified staff.
Fact 4 – The bulk of deaf education funding goes to providers who are not investing in AVT nor have any plans to do so
- the Ministry of Education Special Education Group – with a focus on under 3 year olds
- the Deaf Education Centres – for 3 to 18 year olds
The amount of funding varies arbitrarily between children and has no transparency. It is estimated to range between $10,000 – $30,000 per year. However we really don’t know what overheads are hidden in the costs. It is possible that some children are funded as much as $50,000 per year.
The Cochlear Implant programmes are funded for 8 therapists who support over 320 children. This is a very small proportion of the total funding.
Conclusion – Most New Zealand children with hearing issues receive therapy significantly below international best practice and not optimised to their needs
We are convinced that the current arrangement for providing therapy and support for children with Cochlear Implants (and most other children with hearing loss for that matter) is poorly configured to meet the needs of the majority of these children. With the exception of those in the Auckland metropolitan area who access services solely through The Hearing House, all other children are reliant to some degree on ‘professionals’ who are neither experienced in nor qualified to deliver AVT based therapy. This situation is comparable to where the Australian deaf education sector was around 20 years ago.
The effect of this is to:
- Lengthen the time it takes for Cochlear Implant children (and most other children with hearing loss) to catch their normal hearing peers – in many cases pushing it passed the goal of being caught up by the start of school
- Waste considerable amounts of resource
- Increase the amount of effort parents have to expend in ‘organising’ and communicating with the professionals – which could be used to work with their child
- Put at risk the ability of some children to catch up their normal hearing peers