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8 August 2018

At last! A Roadmap for hearing health in


Australia
A newly-established Hearing Health Sector Committee brings
together key stakeholders in the hearing sector to develop a
Roadmap that sets out future reform directions and priorities for
hearing health in Australia.

When wealth meets disability


"I threw money and rage at the system to get the outcome I
wanted – to get what we knew we needed. But what if you can't
do that?" It's one of many troubling questions that drove the
formation of the National Disability Insurance Scheme.

Cochlear expands in Brisbane


Cochlear has invested more than $15 million in capital, plant,
equipment and labour to manufacture the latest electronic
components used in their implants. The expansion will enable
Cochlear to re-direct more than $20 million of work from
overseas to Queensland.

Hearing problems common among


preschool teachers
Hearing protection devices are normally the main intervention
but the design of the premises and room acoustics also have to
be considered.

Why people get dizzy from certain sounds


A hole in that bony enclosure can cause the inner ear
semicircular canals to become sensitive to acoustic sounds like a
sustained tone from a musical instrument such as a trumpet,
violin or piano, even a higher-pitched conversation.

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.
Roadmap for hearing health in Australia
The Minister for Aged Care and for Indigenous Health Ken Wyatt has established a national
Hearing Health Sector Committee to create a Roadmap for Hearing Health in Australia.

This follows a long-running Break The Sound Barrier campaign headed by Deafness Forum of
Australia chair David Brady to make hearing health & wellbeing a National Health Priority. The
campaign led to the federal parliament commissioning a national inquiry into hearing health. The
inquiry report was published in September 2017: the Government has yet to respond.

More recently, state, territory and federal health ministers met last week as the Council of
Australian Governments (COAG) Health Council. The official statement issued after the COAG
meeting included reference to a:

National approach to hearing health


Minsters recognised that 3.6 million Australians currently experience hearing loss and that
the prevalence of hearing loss is expected to more than double by 2060. Ministers discussed
the economic, social and health impacts of hearing loss, particularly for the 90 per cent of 3

Aboriginal and Torres Strait Islander children in some remote communities who experience
otitis media infections at any time. Ministers agreed to further consider a national approach
to hearing health, following the Commonwealth’s response to the House of Representatives
Inquiry Report ‘Still Waiting to be Heard’ expected later this year.

The newly-established Hearing Health Sector Committee met for the first time on 25 July 2018
and brings together key stakeholders in the hearing sector to develop a Roadmap that sets out
future reform directions and priorities for hearing health in Australia.

The Committee will be chaired by an Independent Chair, and comprise representatives from:
peak/advocacy bodies representing consumers; peak bodies representing hearing health
practitioners; peak bodies representing hearing health care providers; peak body representing
hearing device manufacturers; representatives from medical colleges/societies; representatives
with expertise in Indigenous ear and hearing health; and a representative from the Department of
Health.

The Committee is chaired by Professor Cindy Shannon. Other members are: Steve Williamson
representing Deafness Forum Australia; Ann Porter, Aussie Deaf Kids; Donna Edman, Hearing
Care Industry Association; a representative of National Hearing Care ; Stephen Logan, Hearing
Business Alliance; Samantha Harkus, Australian Hearing; Catherine McMahon, Hearing CRC; Tony
Coles, Audiology Australia; Kelvin Kong, Australian Society for Otolaryngology Head and Neck
Surgery; Kyle Miers, Deaf Australia; Harvey Coates, Paediatric ENT Services; James Battersby,
Hearing Aid Manufacturers and Distributors Association of Australia; Fiona Buffinton,
Commonwealth Department of Health.
Hearing-related problems common among preschool teachers
Seven out of ten female preschool teachers suffer from sound-induced auditory fatigue, one out of
two has difficulty understanding speech and four out of ten become hypersensitive to sound.

This is a considerably higher share than among women in general and also higher than in
occupational groups exposed to noise, according to research in Sweden.

“We have an occupational group with much higher risk for these symptoms, and if nothing is done
about it, it's really alarming. We have to lower sound levels, have a calmer preschool," says Sofie
Fredriksson, an audiologist with a doctorate from the Occupational and Environmental Medicine
Department at Sahlgrenska Academy.

Of the preschool teachers surveyed 71 percent


experienced sound-induced auditory fatigue,
making them unable to listen to the radio, for
example, after a day at work. Almost half, 46
percent, had trouble understanding speech.
Thirty-nine percent said that at least once a week
they experienced discomfort or physical pain in
their ears from everyday sounds that are not
necessarily loud at all.

"Preschool teachers have a much higher risk than those who work in environments with a similar
noise rating. The symptoms can be triggered by the boisterous environment, and it's also difficult
to use hearing protection," says Sofie Fredriksson.

Hearing loss and tinnitus were the second most common symtoms affecting preschool teachers,
but in this case the differences with women in general were not as pronounced.

The solution to the preschool teachers' problems are complex, Sofie Fredriksson emphasises. It is
not just about how large the groups of children are, but also about opportunities for good periods
spent outdoors and much more.

"Hearing protection devices are normally the main intervention if the sound level cannot be
reduced in another way, and it may be necessary if you have a child who subjects your ears to
crying for a whole day during their introductory period at preschool.”

“But the design of the premises and room acoustics also have to be considered. In a large room
with solid walls, it becomes noisy no matter how educational and strategic you are in your work,"
she says.

https://www.sciencedaily.com/releases/2018/06/180625122345.htm
Cochlear expands manufacturing base in Brisbane
Bionic ear implant maker, Cochlear is expanding its manufacturing base in Brisbane as it looks to
bring more manufacturing home from overseas.

Cochlear is currently in the final phase of redeveloping its Newstead site in Brisbane, where the
company has 200 employees.

Cochlear has invested more than $15 million in capital, plant, equipment and labour to enable the
Newstead facility to manufacture the latest electronic components used in their implants.

This is in addition to products and components used in the external parts of the cochlear implant
system like sound processors.

Queensland Minister for State Development and Manufacturing Cameron Dick said the expansion
will enable Cochlear to re-direct more than $20 million of work from overseas to Queensland.

“Cochlear has transformed the lives more than 475,000 people across 100 countries and now they
will continue their great work with Queensland-built technology,” Dick said.

“More than 27,000 Queenslanders have severe to profound hearing loss, more than 2100 have a
Cochlear implant, and we hope to see many more Queenslanders benefitting from this incredible
innovation now happening right here in our state.”

Dick said Cochlear is the perfect example of Australian-headquartered, globally-competitive


exporters choosing Queensland to base their manufacturing operations.

“This is an important step for the development of advanced manufacturing capabilities in our
state, with our growing manufacturing sector already employing 170,000 Queenslanders and
consistently contributing nearly $20 billion a year to Queensland’s economy,” he said.

“We want manufacturing businesses in Queensland to set their sights on delivering not only for
domestic markets, but also for global markets, and Cochlear is one company grasping that vision
with both hands through their Newstead operations.”

In 2017-18, the facility manufactured 1.2 million parts and 550,000 finished products for global
export.

Over 475,000 people of all ages across more than 100 countries now hear because of Cochlear.

Manufacturers’ Monthly, http://www.manmonthly.com.au/news/cochlear-expands-manufacturing-base-brisbane/


My (Hearing) Wake-Up Call
Heather Rivera, Ph.D

Many people have experienced a “wake-up call”— a defining moment when something in their life
has to change. For some, it’s a dramatic event and for others, a seemingly mundane event, but
for most people, the moment is life changing. My wake-up call was no exception.

For years I struggled with hearing loss. As time went on my world


got smaller and smaller. Easy conversations with friends and
family became a thing of the past. At work, as a Registered
Nurse, because I was having difficulty hearing, I moved myself
into positions that not only took me away from direct patient care
but was very much “behind the scenes.” I relied on my husband
to step in and translate for me when we ran errands. I even relied
on my husband to order for me at restaurants. I was losing my
independence.

Hearing aids were no longer providing me enough sound to enjoy life fully. I was resistant at first
when my audiologist suggested that I get evaluated for a cochlear implant. I wasn’t one to jump
into having a surgical procedure. As time went on though, it became increasingly difficult to hear.
One of my favorite joys, music, was slipping away from me too.

One year “Phantom of the Opera” came back to Los Angeles. I very much wanted to see it
because I thought it may be my last time to hear it before my hearing declined even more. I
purchased a ticket in the fourth row, center, so I would have the best chance of hearing the
production. As soon at the musical began my heart sank. I couldn’t make out one line of dialogue
or any of the lyrics. Tears dribbled down my cheeks as I watched a performance I couldn’t hear.
After the show, I walked down the street to my car in a daze. There was no denying it anymore.
I could not pretend that all was okay. I was going deaf. This was my wake-up call.

When I arrived home, I got serious and took a good look at cochlear implants for a hearing
solution. After months of research and contemplation I decided on Cochlear Americas. I had my
first implant surgery and was activated with the Cochlear Nucleus 6 early in 2016. At activation, I
understood speech immediately.

My husband and I went out to dinner to celebrate that night. For the first time in a very long time
I ordered for myself and understood the server. For weeks, I laughed and cried at all the sounds
I was getting back.

Later in the year I had my second implant surgery done. Thankfully, I had remarkable results
again. Being bilateral made a huge difference in my life. I no longer had to lean in with my
implanted side to hear people and I could discern the direction of sound much easier.
My implants gave me back my independence. Because of them, I was able to go back to patient
care nursing and communicate well with the patients. I loved the look of surprise on my patient’s
face when I listened to their lung and heart sounds with my special stethoscope that streamed
sound directly into my processors. The patients thought it was magical.

I’m also a writer and now I can speak publicly about the writing process again. Music is coming
back to me too. I play my CD of “Phantom of the Opera” and sing along with my favorite show
tunes.

I’m glad that I paid attention to my wake-up call.

From Hearing Health & Technology Matters,


http://hearinghealthmatters.org/betterhearingconsumer/2018/my-hearing-wake-up-call/

Why some people get dizzy when hearing certain sounds


For some people, certain sounds like a trumpet blowing a particular tone can make them dizzy.

It has been estimated that 1 in 100 people around the world have a congenital inner ear condition
known as semicircular canal dehiscence, a thinning of the bone enclosing the inner ear that can
lead to vertigo in response to certain sounds, changes in atmospheric pressure or coughing. It is
a condition in which a person can feel the same imbalance effects of being drunk just by hearing
certain tones, even from the sound of someone's voice or a musical instrument.

Researchers from the University of Utah, Johns


Hopkins School of Medicine and the University
of Mississippi have discovered how that
happens and have published their findings in
the recent issue of Scientific Reports. The
lead author is Utah biomedical engineering
doctoral student Marta Iversen, and the senior
author is Utah biomedical engineering
professor Richard Rabbitt.

Normally, the inner-ear balance and hearing organs are encased in solid bone. But in 1929,
Italian biologist Pietro Tullio discovered that a hole in that bony enclosure can cause the inner ear
semicircular canals to become sensitive to acoustic sounds like a sustained tone from a musical
instrument such as a trumpet, violin or piano, even a higher-pitched conversation. This condition
causes the eyes to rotate through an automatic reflex that normally would stabilise the image in
the eye during head movements. But if the signal from the ear is wrong, the eyes movements are
also wrong, causing the patient to feel dizzy.
"It's very much like the feeling when they've had too much to drink. They get dizzy, and they feel
nauseous, and they can't see well and lose their balance," says Rabbitt. "What our paper is about
is the biophysics of how that happens. How does sound excite the inner ear balance organs
causing them to send the wrong head-motion signals to the brain”?

By monitoring the neurons and inner ear fluid motion in toadfish, which have similar inner ear
balance organs as humans, it was discovered that this dizzying effect occurs when the sound
generates pathological fluid mechanical waves in the semicircular canals of the ear. Normally,
inner ear fluid moves when you rotate your head, and your eyes automatically counterrotate to
stabilise the image on the retina.

But when there is a pathological hole in the bone certain acoustic tones cause the inner ear fluid
to pump, and as a result, the ear sends an incorrect signal to the brain that you're rotating your
head when you're not.

"Your eyes will counterrotate the wrong way, and it will look like the world is spinning," Rabbitt
says.

Fortunately, surgery to repair the dehiscence can help patients, Rabbitt says, but researchers now
understand the connection of how a small hole in bone can create a lifetime of debilitating
dizziness for many.

"What wasn't known was the 'Why?' What exactly causes the symptoms patients have?" he says.
"This finally connects the symptoms and the dehiscence in a precise biophysical way."

From Science Daily, https://www.sciencedaily.com/releases/2018/07/180710113445.htm

National Disability Agreement under review


The National Disability Agreement is being reviewed by the Australian Government.
The National Disability Agreement is an agreement between the Australian and state and territory
governments for the provision of disability services for people with disability. It features clear
roles and responsibilities for each level of government.

The Productivity Commission has prepared information to explain what information it is after.
Interested individuals and organisations can contribute their ideas to this review.

Visit the website to:


• View the issues paper
• Participate by making a submission
• Register your interest in the study
www.pc.gov.au/inquiries/current/disability-agreement#issues
Challenges: a sibling’s perspective
By Joe Mussomeli, a 10th-grade student who lives in Westport, Connecticut USA

Everyone has challenges in their life; they can be small or big, but they’re still challenges. My
brother, Alex, was born with severe hearing loss.

Alex’s diagnosis marked the start of very stressful period for our family. It took some time for my
mother to process his hearing loss, but both of my parents quickly recognised the importance of
helping Alex get access to sound as soon as possible. They equipped Alex with hearing aids
before three months old and our journey began.

I don’t remember too much of the details, as I was only two years old at the time, but I was told
that my parents spent many nights with Alex, practicing the sounds of letters, and making sure he
could distinguish and pronounce each of them correctly.

What I do remember is initially feeling left out as a little kid. At first, all of my parents’ time was
occupied by Alex. At 15 years old, this is understandable to me now, but as a little kid it wasn’t.
My parents picked up on my feelings and began to make sure I wasn’t left out. They did their
best to make sure I was involved and helping Alex. They taught me how to practice sounds with
Alex, how to change his hearing aid batteries, and most importantly, how to be there for him
when he needed me most.

Today, whenever I think of my brother Alex, I rarely think about his hearing loss. I almost always
think of him as just Alex — not Alex with hearing loss or anything like that. I’ve almost always
treated him the way any other older brother would treat their younger brother. We roughhouse,
tease each other, laugh together (mostly at each other), and most importantly, we care for each
other.

Alex has been in my life so much that by now I barely notice his cochlear implant on his right ear,
or his hearing aid on his left. To me, they’re just ears, just like Alex is just Alex.
But there are certain times when his hearing loss is very evident to me, like when he takes off his
hearing aid and implant and can’t hear my mom call him for dinner or answer a question I might
ask him.

These moments by now are part of our daily routine. They’re small and I don’t think about them
often, but when they happen, they remind me how lucky I am. How I’m able to hear our mom
call us for dinner without devices. How I can tell my dad I love him back when he says it, without
taking the time to put on a hearing aid or implant. Thinking about this doesn’t make me pity Alex,
it makes me admire him. I admire his strength and I admire how he doesn’t let hearing loss bring
him down.

Alex’s hearing loss started out as a struggle, but it wound up bringing my brother and me closer
together. I wouldn’t be as close with Alex as I am today if I never helped him overcome the
challenges he faced with hearing loss. Challenges are tough and hard to deal with at times, but
overcoming those challenges are even harder. If someone can overcome the challenges that life
throws at them, then they can do anything.

https://hearinghealthfoundation.org/blogs/challenges-a-siblings-perspective

Purchasing a hearing aid in Vic


Are you looking at purchasing your next hearing aid, but are unsure which brand to pick from?
Are you simply overwhelmed by the number of products available?

These questions will be clarified at a seminar, ‘Purchasing a Hearing Aid: How to Navigate
the Journey Smiling’, to be held at the Better Hearing House.

This event will help you better understand the hearing aid market and learn about new
technologies that may assist your hearing health.

Location: Better Hearing House, 5 High Street Prahran


Date: Friday 17 August
Time: 10.30 am- 12.00 noon
Cost: Members: no charge, Non-Members: $20
Booking essential: Anne Young on (03) 9510 1577

Schedule
10.30am Morning Tea on arrival with viewing exhibition
11.00am Presentation with Facilitator Jenny Smith
11.30am Panel Discussion and Question Time
12.00pm Close Session
What happens when the powerful deal with disability
Fiona Carruthers for The Financial review

Mark Carnegie and his daughter Matilda. Arsineh Houspian

Surrounded by the accoutrements of corporate success – plush sofas, expensive art, an office full
of busy staff – venture capitalist, banker, philanthropist and father of three girls Mark Carnegie
casts his mind back to when his youngest daughter Matilda, now 20, was diagnosed with profound
deafness and limb abnormalities at the age of 11 months.

"Life is never the same again," Carnegie recalls, gazing out his Sydney office window at a
poignantly pretty dusk sky. "It changes everything. Up until that point … how to describe it," he
tilts his head towards the ceiling and runs his hands over his face in remembered frustration.

"When you're someone who has been relatively successful in life, you just go along thinking you
can control your environment. Then you find out, actually … no."

He describes the treadmill of years that his former wife, Tanya, spent in waiting rooms with baby
Matilda; the endless appointments at hospitals and medical centres to consult specialist
audiologists, physiotherapists, orthopaedic surgeons, neurologists, cardiologists, speech
therapists, rehabilitation services and more. Life became an ongoing exercise in trouble-shooting
with glimpses of normality squeezed in between.

"Tilda's hospital file quickly got to two inches thick, then three inches thick …" his thumb and
forefinger indicate the expanding width. The couple sought 15 specialists' opinions for just one of
Matilda's issues; the gigantism that caused her right foot to grow to seven times the size of the
left one.

Exasperated with the often-limited treatment options on offer, in 2001 the Carnegies established
the multimillion-dollar Matilda Rose Centre in Sydney's Waverley – a one-stop shop with rehab,
therapist and education experts treating children's impairments early. It was the sort of centre
they had wanted for their daughter. "I threw money and rage at the system to get the outcome I
wanted – to get what we knew we needed," sighs Carnegie. "But what if you can't do that?"

It's one of many troubling questions that drove the formation of the National Disability Insurance
Scheme – now halfway through its three-year rollout, and the country's biggest social reform since
Medicare in 1975.

The scheme ends the old-style welfare model whereby governments shelled out billions of dollars
to thousands of disparate departments, agencies and charities. In its place, over time, will
emerge a teeming marketplace of disability service providers. The funding now flows directly to
individuals so they can decide which services and treatments best fit their needs.

A social insurance scheme, as distinct from welfare, NDIS has estimated it will need $22 billion a
year to ensure everyone eligible – Australian citizens with a severe lifelong disability – will be
cared for. That money is already locked in, quarantined from the typical annual budget bunfights.
It is a near-tripling of the funding for disability services from before the NDIS, partly paid for by a
rise in the Medicare levy from 1.5 to 2 per cent that was introduced in 2014. In dollar terms, the
NDIS is bigger than aged care and the Pharmaceutical Benefits Scheme, and is almost as big as
the $25 billion spent on Medicare each year.

As of April this year, 162,000 people had been phased onto the scheme – the overwhelming
majority of them since July 2016. It's still hoped the bulk of the estimated 460,000 eventual
participants can be phased onto the NDIS by 2020.

But the urgency behind the scheme's rapid rollout has caused even its original architects to pause
for breath. "It's clear now that the original 2020 timetable probably won't be met," says Bruce
Bonyhady, hailed as the father of NDIS and now head of the new Melbourne Disability Institute.

As the scheme cranks from the Productivity Commission's report to life, refinements are needed to
avoid it buckling under its massive weight. Controversy has erupted over who's eligible and who's
not, especially children on the autism spectrum. Bonyhady is particularly worried about ensuring
there's adequate support for people deemed ineligible. "Otherwise, the pressure to allow more
people in intensifies and undermines the scheme's sustainability," he says. "You don't want to
create perverse incentives by having a cliff at the edge of it." The scheme has been widely
attacked for its hasty implementation. Critics see the NDIS as another big idea from Labor, in this
case rushed into being by Julia Gillard in the final days of her prime ministership.
Wealth meets disability
It's in the spirit of the many innovative solutions that have resulted when wealth and disability
collide. From the late 1960s Rupert Murdoch's sister Janet Calvert-Jones funded treatments and
education for deaf children after her son was born deaf due to rubella. In 1995 Bega Cheese boss
Barry Irvin, who has a son with autism, helped establish Giant Steps to bring more autism experts
to Australia. In 2006 Moss started the wheelchair-friendly Lime Taxi business to meet that gap in
the market.

Mark Carnegie and his daughters, Matilda, Isabella and Cosima. Arsineh Houspian

Carnegie is a passionate supporter of the principles of the NDIS. "Bruce was missile-locked on
how he did it and he was a magician to get bipartisan buy-in, he really was," he says. "Is NDIS
having teething problems? Yes. Is it perfect? No. Is it the right thing to do? Absolutely. If we
can make this work, NDIS is the closest thing to a miracle that the sector is going to get."

Full article at http://online.isentialink.com/afr.com/2018/07/23/5e47eddb-3a67-4f21-bbed-2233e20bd144.html

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