General election 2017: Uninspected audiology services

Beccy Forrow Policy and Campaigns Officer

Beccy Forrow, Policy and Campaigns Adviser

Would you send your child to a school that hadn’t been inspected by Ofsted? Would you ride in a car that didn’t conform to industry safety standards? Would you eat in a restaurant that refused to take part in food hygiene inspections? All questions I’d answer no to.

But this is what is being allowed to happen with children’s audiology services in England. Only 15% of services have been inspected and achieved a high enough standard to become ‘accredited’. This leaves the majority of services uninspected – with deaf children, young people and their families having no idea whether they are attending a great service or one that is poor quality and unsafe.

Considering that an NHS report in 2014 found that one third of audiology services were failing to meet critical NHS quality standards, with no incentive to improve, it’s unlikely that many will now be providing a better service. This matters because hearing is critical to a child’s development of language and learning. Early diagnosis and support reduces the risk of delays in language, educational, social and emotional development. But this support needs to be consistently of good quality.

Earlier this year we created an audiology map so that parents could check if their local service had reached a high enough standard to be accredited. However, of 134 services, 40 have so far refused to take part in the inspection scheme at all. Many others have registered for the scheme but not moved closer to an inspection visit over the course of the last few years.

We’re calling on the next Government to make it compulsory for all children’s audiology services in England to take part in the inspections so that parents can be confident that they are fit for purpose. As the inspections cost money and can be time consuming to prepare for, it’s vital that the Government levels the playing field by making the inspections mandatory for all services. Audiology services for deaf children won’t get better on their own.

If any general election candidates come to your door, be sure to ask them about the quality of children’s audiology services. We’ve got some other questions you might like to ask them on our election web page.

Getting it right from the start

ndcs_right_start

Today, we’re launching a new campaign in England, called Right from the Start.

NDCS - Ian Noon, Head of Policy and Research

Ian Noon, Head of Policy and Research

The campaign is celebrating 10 years of newborn hearing screening and how this simple and painless test has literally transformed the lives of thousands of deaf babies.

But whilst screening has made a big difference, there is still much that needs to be done. Once diagnosed as deaf, children and their families need high quality support to ensure they can develop the language and communication skills that are the foundations for success in later life.

Unfortunately, it’s clear that this support is not being provided consistently across the country. We know there’s a massive attainment gap in the early years foundation stage, where children are assessed among a range of early learning goals. We also regularly hear from parents that vital support, such as audiologists, Teachers of the Deaf, support with communication and so on is not being provided when it can have the most impact.

We’re calling on the Government, local authorities and health bodies to work together and make a commitment to ensure high quality support is in place as soon as a child is diagnosed as deaf. Our campaign report explains how the benefits of hearing screening at birth are being lost and what action is needed to ensure deaf children get the right support, right from the start.

Join us in getting it right from the start. We’re asking our campaigners to email our report to their MP and to ask them to take action.

There’s lot of other ways you can support the campaign. Find out more at www.ndcs.org.uk/rightfromthestart.

Have your say on audiology services in Leeds!

Arthur Thomas Campaigns Officer

Arthur Thomas Policy & Campaigns Officer

NDCS are supporting a review of Leeds Audiology Services. If you live in the Leeds then make sure your voice is heard by taking part in a short survey below.

By completing the survey you can help Leeds Audiology Service understand how best to meet the needs of deaf children across Leeds.

Please follow the link below to contribute to the review and have your say:

Complete-the-survey-button-red

We will keep you updated about the progress of the review.

If you have any questions or would like any more information, please contact Carla Rose-Hardman at: Carla.Rose-Hardman@ndcs.org.uk

Liam’s Story: Volunteering with the NDCS Youth Advisory Board

Youth Advisory Board (YAB) volunteer

Liam, Youth Advisory Board (YAB) volunteer

It’s been over a year now since I first joined NDCS’ Youth Advisory Board (YAB) as a volunteer. The role of the YAB is to work closely with the NDCS and help them with their campaigns and projects. After finding out through NDCS’ online website for young people, The Buzz, I decided to apply…

The reason I chose to join the YAB was because I have always liked to voice my opinion on issues that matter to me. My deafness is one of the main things I am passionate about, and being able to share my thoughts and opinions with other like-minded, deaf young people from across the UK seemed like a great opportunity to get involved in.

As well as that, I’m a huge fan of networking and meeting new people. I’ve been to three YAB meetings since March 2014 and I’ve met some great deaf role models, made new contacts and friends for life in my fellow YAB members.

Lastly, I always wanted to learn British Sign Language. Where I live, there isn’t much opportunity to learn, but one year on, I’m proud to say that I am learning more BSL every day. Over one year on from joining the YAB, all of us have achieved some great things.

In terms of campaigns, one YAB member, Zanna, recently took legal action against the Government for not consulting deaf young people about the proposed changes to the Disabled Students’ Allowance, and forced them to delay their plans to cut back support for disabled students (read more about this story here)! Other members of the YAB went to numerous party conferences to meet MPs and ask key questions concerning deaf young people. In particular, the Board contacted the Department for Education to tell them our thoughts on teaching assistants (TAs). We have also contacted the NHS and health commissioners about local audiology services. Overall, the YAB’s campaigning work has been quite impressive!

But that’s not all. We’ve helped the NDCS with designing leaflets about the Local Offer, vision statements, as well as sharing our thoughts on resources that the NDCS creates.

As it’s Volunteers’ Week, now is the perfect time to recommend getting involved in voluntary opportunities like the Youth Advisory Board. Opportunities like these are so important because there’s endless benefits to both you and the organisation you are helping. By seizing opportunities like these, you have the chance to make personal achievements (make new friends, develop new skills and so on), as well as make a key difference to an organisation through giving up your time, sharing your thoughts and helping them with their work.

For deaf young people, I cannot recommend the Youth Advisory Board enough, and for everyone, I thoroughly recommend exploring every voluntary opportunity there is available to you – the possibilities and benefits are endless!

The NHS makes me feel like a drain on resources

Danielle Davies, Deaf Social Work Student

Danielle Davies, Deaf Social Work Student

I am 20 years old, a University student studying for my degree in Social Work. I am severely hard of hearing and have worn two hearing aids since birth. I am not blind to the harsh cuts the NHS has faced over the past few years and I understand we have been in a financial crisis under the previous coalition government. However, I have never in the past 20 years seen these cuts affect the service that I receive from the NHS, especially in audiology, the department I receive my hearing aid support from.

Not until now. I want to tell you about my experience a couple of weeks ago.

A few weeks ago, I made an appointment at my local audiology department at the hospital in my local town. This appointment was to have new moulds fitted for my ‘in the ear’ hearing aids. I went into the consultation room and I explained that I needed some new hearing aid moulds due to the current mould rubbing me severely. The moulds had also become discoloured and not very presentable. No hearing aid user likes to wear yellow looking moulds that look mouldy and unpleasant. It is natural that the moulds discolour and I usually stick it out long enough in till they are that bad they need changing.

The audiologist looked at the fit of the aids in my ear and the hearing aid itself. He stated that there was no need for new ones to be made as they fitted well and I had already had new moulds made a year ago. I explained that 6 months to a year seemed usual to come in for new hearing aid moulds. The audiologist stated that now I am in adult services replacements are every 2 years and not as regularly as they would have been in children’s services.

I did not know how else to respond to this but to sit in silence. I had never been told that was now eligible for new moulds every 2 years and not yearly. I was still confused as I had explained to the audiologist that the moulds had discoloured and rubbed me, regardless of how long ago I had new ones. The audiologist stated that on this one occasion he would fit new moulds.

After that the audiologist asked ‘do you know how much hearing aids moulds cost?’ to which I replied I didn’t know. The audiologist stated ‘they cost between £15 to £20 for the moulds and this is very expensive, the money comes out of adult services budgets’. What was going through my head was ‘are you trying to make me feel bad for coming to my appointment and asking for new moulds because my current ones have left me in discomfort’? I was made to feel like a drain on NHS resources and that I was using money unnecessarily, however this was not the case.

Following the moulds being made, the audiologist explained that I would be telephoned to come in and have an appointment to have them fitted. However, as I have fitted my own hearing aids for the past few years I asked if the moulds could be posted instead. The audiologist stated that we do not post them as ‘that costs money and it isn’t cheap for postage’. I pointed out that for years now I have had them sent in the post, but agreed I could come in and have them fitted if they weren’t going to post them. The audiologist stated we only post them to our university students, as I was a student living away, the audiologist agreed to post them on this occasion.

Again I felt like I had to justify myself to the audiologist.

It was also clear that my records weren’t read and my hearing loss understood, because when the moulds were being made and left to harden in my ear, the audiologist started to talk to me. For people who don’t know, to make new moulds the hearing aids have to be taken out for a few minutes. You wait patiently until the solution is hardened and ready to be taken out of the ear and you put your hearing aids back in.

As a professional in audiology I would expect the audiologist to have read my records and check my level of hearing before he tried to communicate with me verbally when I did not have my hearing aids in. I had no idea what was said but nodded and pretended I could hear him – I felt devalued.

I was born with a hearing loss due to sensorineural nerve damage but I have never experienced this feeling in the 20 years I have been using the services. I was not advocated and was alone on this visit. The reason I wanted to write my story was because I want people to understand that you should never feel like you are a burden, scrounger or drain on the NHS.

I will be qualified as a social worker in 12 months and will be paying taxes in which will help fund care that I need. I feel that no one who is hard of hearing or deaf should be spoken to about budgets, cuts and costs on their appointments. I walked away from that appointment wanting to use private services. I want to be proud of using NHS services – I have received extraordinary support for many years from some great audiologists and in writing this I do not want to undermine their amazing work and efforts.

Finally, I completely understand why postage services are being cut and why moulds need to be changed every 2 years and not more regularly. However, it is important that every deaf and hard of hearing patient has these changes explained. I walked out of that appointment feeling undeserving of new hearing aid moulds, I felt that I was using NHS budgets unnecessarily and I did not feel proud to be deaf.

It wasn’t in till I got home and explained this to my mother and older sister, who were appalled at my experience, that it made me want to make other people feel empowered. I want all audiologists to be approachable and provide advice in a manner of professionalism, to understand their patients hearing and to never let them walk out feeling devalued.

Please take a message from this…be proud of who you are and your disability, tell your story, because just writing this made me feel amazing to have spoken out.

5 things to watch out from the new Government

NDCS - Ian Noon, Head of Policy and Research

Ian Noon, Head of Policy and Research

So we have a majority Conservative government! Now the dust has settled on last week’s election results, we’ve looked into our crystal balls and picked out five things to watch out for from our new Government.

1) Education spending. In their manifesto, the Conservatives said they will protect funding for schools on a per pupil basis. This means that, if the number of pupils go up, schools shouldn’t lose out. But it also means that schools might get less money in real terms if inflation goes up. It also means that funding for early years education and post-16 is not protected. So what impact will this have on spending for specialist education services for deaf children? We know from the NDCS Stolen Futures campaign that local authorities have still been cutting services, despite the protection already in place over the past five years. Will that change?

2) Will Ofsted inspections make a difference? We know that Ofsted are planning to inspect local provision for children with special educational needs and that a consultation on how they will do that is due out later this year. What’s not yet certain is the extent to which Ofsted will take a proper, more focused look on how deaf children are doing as part of this. Will Ofsted, for example, inspect specialist education services for deaf children? Indications are that Ofsted are not keen to go into this level of detail. We may need to campaign to make sure they do. We may also need to campaign to make sure that inspections are carried out by inspectors with proper expertise in deafness.

3) Is Disability Living Allowance (DLA) for deaf children under threat? The Conservatives have indicated in the past they would like to look at reforms to DLA for disabled children, having already changed DLA for adults to a new benefit called Personal Independence Payments (PIP). The Conservatives have already pledged to reduce the welfare budget by £12bn, without specifying how they will do that.

4) Audiology services. How can we make sure that audiology services are delivering a good service? Our Listen Up! campaign has found that too many aren’t. Over the past 5 years, it was the government’s policy that audiology services should be accredited under a programme called IQIPs. Yet, to our knowledge, very few have to date. What will happen to those audiology services that don’t get accredited or don’t seek accreditation anytime soon? Will the new Government insist they be closed down or will they just allow poor audiology services to coast along? Will they improve transparency over which audiology services are seeking accreditation?

5) How will the Government halve the disability employment gap? This was one of their manifesto pledges. NDCS believes that many deaf young people will need support from Access to Work to make a successful transition into employment. However, we know that the Government are looking at ways to manage the Access to Work budget, with a new cap to be introduced later this year. Will this make it harder for the Government to support disabled people into employment?

Is there anything else we should be watching out for? Leave a comment below to let us know what you think.

The NDCS policy and campaigns team will be working to get answers to these questions. You can help us campaign for a world without barriers for every deaf child by joining our cool club, the NDCS campaigns network today.

The impact of mild and moderate deafness in the classroom

Vicki Kirwin, Audiology Specialist, NDCS

Vicki Kirwin, Audiology Specialist, NDCS

New research carried out by The Ear Foundation, with funding from the National Deaf Children’s Society (NDCS), is being published today. The research highlights issues that children with mild to moderate deafness encounter, gathered from the views of their parents and Teachers of the Deaf.

I previously blogged about mild deafness when NDCS ran a pilot weekend for families with children with mild deafness, who reported similar feelings to the new report findings. Common themes included lack of understanding of the impact of mild to moderate deafness on family and education and a belief that the terms “mild” and “moderate” are not helpful in describing the potential impact for a lot of children.

This blog provides a reminder of the impact of mild and moderate deafness and explores why this impact is so often overlooked.

Impact of mild deafness

  • A child can usually hear everything that is said to them in a quiet room, but not if there is lots of noise present or they are far away from the speaker.
  • A child would not be able to follow a whispered conversation.
  • Some children with mild deafness use hearing aids.
  • A child with glue ear will usually have mild deafness.
  • A child with mild deafness will miss 25% to 50% of the teacher’s voice in a classroom.
  • The teacher’s voice is typically heard at about 70dB at the front and 40 dB at the back of the class. A child with mild deafness (21-40 dB) will typically not hear anything of the teacher’s voice at the back of the class.

Impact of moderate deafness

  • Most children with moderate deafness use hearing aids.
  • Without their hearing aids, they could hear most of what someone says to them in a quiet room as long as they speak clearly, but could not follow a conversation in a large group, if there is lots of background noise or they are far away from the speaker.
  • A child with moderate loss will miss over 50% of the teacher’s voice in a classroom.

Why is the impact of mild and moderate deafness so often overlooked?
Adults can find it very difficult to understand the impact of mild and moderate deafness on children. This is because any child they meet with a mild and moderate deafness is likely to have clear speech and be able to answer questions asked directly of them. But classrooms are typically noisy and background noise can have a significant impact on speech understanding for a child with mild and moderate deafness. This is because the adult brain is much better at filtering out background noise than a child’s.

Also, the adult brain is very good at filling in the gaps of missed information – speech sounds or parts of words – that weren’t heard. Children with mild and moderate deafness are not able to do this – they lack the knowledge, vocabulary and context to be able to fill in the gaps. This means they miss out on a lot of the new vocabulary and concepts being taught every day at school.

Diagnosis
Newborn hearing screening does not usually identify mild hearing loss in very young babies because it is designed to pick up greater levels of deafness, and many children develop hearing loss during early childhood. It is important that parents and health professionals are vigilant about the child’s development and refer them to an audiologist at any stage if they are concerned about their hearing or speech development.

Parents’ views should be taken seriously. If they have concerns about a child’s hearing they should be referred for testing without delay.

Once a hearing loss is identified it’s vital a child is offered information, advice and possibly hearing aids or other intervention as soon as possible. It isn’t acceptable that they wait longer because their hearing loss is viewed as being more borderline or not as ‘significant’ as other children’s.

What can be done to help?
The research report calls for more support to parents and young people with mild and moderate deafness. It also calls for teachers to have greater awareness of the impact that mild and moderate deafness can have and for local authorities to ensure that services are sufficiently resourced to provide the necessary support.

NDCS’s website has more information about the resources available to families of children with mild or moderate deafness.