Wednesday, July 9, 2008

A brief to parents-2

A disturbed parent would try everything to cure deafness-e.g. allopathy, homeopathy,unani,ayurved,acupressure,acupuncture,holy water,expensive petition to Gods, and so on.Sadly none of these are of use.
It must be understood that congenital deafness is not a disease which can be cured by medicines or surgery.It is a condition which is for life.Therapy can only "address"its consequence - "mutism".
The 1st professional the parents seek is the pediatrician ,who will direct to an ENT specialist.It is his duty to alleviate their anxiety and suggest a plan of action.He can assure the parents that the baby will definitely talk provided the parents are able to cooperate & work with the a team of professionals on a long programme.He should stress that even if baby is deaf ,it does not mean he will be dumb.He should assess the loss.Is
1.He should conduct tests to find out if the child is deaf.Tests like B.E.R.A. and O.A.E. are awailable.O.A.E. can be done on tiny infants.
2.Is the loss conductive or neural-sensory.IMPEDANCE test will tell you that.
3.Does the deafness exist from birth or for some reason happened after birth.If it is acquired, then then at what age.
4.Most important-the FREE FIELD AUDIOMETRY and PURETONE AUDIOMETRY [PTA] will tell us how much hearing he has in both ears.STONE DEAFNESS is misleading.95-98% of deaf children have some residual hearing and that can be tremendous advantage.
No matter what the child's age is, once the loss is ascertained, the child should be fitted with 2 appropriate hearing aids.{proper binaural fitting}Sometimes if the loss is more than 90 d.b. it is said that hearing aids will be of no use.THIS IS WRONG. With advanced technology and insights in language learning and improved teaching methods even profoundly deaf children are able to acquire speech and language.
The speech therapists role is most important after that.Right from building up the confidence of parents to establishing a rapport with the mother and child ,getting the child to wear the aids consistently,to developing awareness and meaning of sounds in general and paying particular attention to voices and sounds of speech, the therapist has to work through the mother.To make the child enjoy listening of conversation, the mother has to be guided step by step and actually shown how and when to put on the aids, what to say when and how ,she must say it.Her voice should convey FEELING.{in sanskrit the feeling means 'bhav'}.She has to be explained that her speech should be excellent.The therapist has to treat the mother's speech.She has to be told again and again the following-
1.To speak grammatically correct sentences.Single words do not contain a thought.
2.Verbs are very important without which the sentence is incomplete.The verbs must take the correct form ,conjugated accordingly and nouns must be properly declined according to grammatical case, number, gender.The various word endings are important for meaning.eg...'s,..es,etc.Normal speakers do follow the rules automatically.
A quick recap..
-Deafness is not a sickness, it is a condition.
-Progressive deafness is about 5% in deaf population.
-Mutism in deaf people does not have an organic cause, it is a result of soundless environment.
-Hearing aids help even profoundly deaf people.
-cochlear implant does not restore normal hearing.It is only a vastly superior hearing aid.
-Speech therapy is vital ,more important than the surgery itself.

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