4March2015

We acknowledge 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 that faces Indigenous leaders and families to overcome the unacceptably high levels of ear health issues among first Australians.

Sale of Australian Hearing The Government seems set to proceed with a sale, keeping its decision under wraps until the federal budget is announced in May.

Disability groups granted temporary reprieve The federal government has made a partial backflip on its cuts to disability groups including Deafness Forum, granting a temporary funding reprieve.

Australia leads the world A new study reveals that deaf children who receive early intervention services can go on to develop vocabulary and speech skills better than their typical hearing peers.

Brain waves show listening challenges in older adults The elderly often complain about hearing difficulties, especially when several people are talking at once. Researchers have discovered that the reason for this does not just concern the ear but also changes in the attention processes in the brain of older people.

Disability groups granted temporary reprieve

By Julia May, Sydney Morning Herald The federal government has made a partial backflip on its cuts to disability groups, granting a temporary reprieve to eight bodies whose funding was due to run out. The Department of Social Services had announced it would cut funding to the disability sector by 40 per cent and support an alliance of just five representative bodies. It left eight bodies representing 200,000 people with disabilities under threat and sparked allegations that the government was in breach of the United Nations convention on the rights of disabled people. But on Thursday the eight organisations (including Deafness Forum of Australia) were told they had secured "transition funding" until the end of June. Assistant Social Services Minister Mitch Fifield said he decided to extend the groups' funding and to "provide an additional payment to each of them to assist with a smooth transition".

From the chairman of Deafness Forum

The Assistant Social Services Ministers announcement of a short term extension to our funding is welcomed. Minister Mitch Fifield went further by putting on the public record that he will find a new way to ensure the continuance of organisations such as Deafness Forum. The Government has shown it is prepared to temper the ambition of its economic agenda with empathy for disadvantaged and vulnerable members of the Australian community.

What does this extension of funding mean in practical terms? For Deafness Forum it provides a realistic timeframe in which to reprioritise and reorganise; to find ways to get more impact with less funding; to be a resilient and self-sufficient organisation; and to build meaningful links with the peak disability organisations that did receive government funding. We will use this time wisely. In the last two months I was fortunate to meet many member organisations and individuals to listen to their opinions about the future role of Deafness Forum of Australia. It was clear that what is needed is a game-changing strategy on behalf of the 4 million people who experience hearing difficulties. Yes, we have heard you, and we will take the lead on a new approach to reform. We will focus on a campaign to make Hearing, the 10th National Health Priority in Australia, alongside cardiovascular health, diabetes, obesity and other priority conditions and diseases. It is in the top 5 of the nations biggest health issues, but it is widely misunderstood, frequently overlooked, neglected and forgotten. So, weve begun the national conversation and its not about a single fix. We believe we can create a public campaign that considers all aspects of our large and diverse constituency. Each of us may have our own ideas on what the priorities are and what can be achieved from the Make It Number 10 campaign. I invite you, your family, friends, colleagues and organisations to come on board. This is not a short term, self-serving strategy to save Deafness Forum after its government funding expires. It is about a landmark change to the way hearing issues are perceived and addressed in Australia. If together we can put this on the nations political agenda, Deafness Forum will have earned the right to represent you. Lets be ambitious, take a new approach, persevere and play the long game to win. Best wishes David Brady Canberra

Hearing loss suffered by more than half of 'high needs' Indigenous NT children More than 50% of Indigenous children with high needs in the Northern Territory have hearing loss, a report has found. The report by the Australian Institute of Health and Welfare (AIHW), found hearing loss in 55% of 1,764 children who received services in 2013-14. Middle-ear infections were also common among the children and young people who received services, the report found. Of those who received an audiology or ear, nose and throat (ENT) service in 2013-14, 67% were diagnosed with at least one type of middle-ear condition, an increase from 61% in 2012-13, it said. From The Guardian, http://www.theguardian.com/australia-news/2015/feb/26/hearing-loss-suffered-by-more-than-half-of-high-needs-indigenous-nt-children

In honour of Presidents Day in the U.S During his second term, former President Bill Clinton was fitted with a pair of digital hearing aids after years of experiencing difficulty hearing high-pitched sounds. According to media reports, his doctors linked his progressive hearing loss to a history of saxophone playing, noisy campaign rallies, and outdoor hunting. In 1983, after many years of difficulty hearing, former President Ronald Reagan was fitted with a custom-made hearing aid in his right ear. Media outlets reported that Mr. Reagans doctors attributed the beginning of his hearing loss to his acting days in Hollywood, when a .38-caliber pistol was fired near his right ear. At close range, a firearm shot can reach 150 decibels. As shown by former U.S Presidents, long or repeated exposure to sounds at or above 85 decibels can cause noise-induced hearing loss. It can also be caused by a one-time exposure to an intense impulse sound.

A Noisy Planet, http://www.noisyplanet.nidcd.nih.gov/Pages/Default.aspx

Australia leads the world in teaching deaf children to hear and speak By Lisa Mayoh, The Daily Telegraph A new study reveals that deaf children who receive early intervention services can go on to develop vocabulary and speech skills better than their typical hearing peers. Based on data from 696 Australian and New Zealand children, the study found that 83 per cent of deaf preschool children had better or average vocabulary skills compared with typical hearing children. Almost 78 per cent had better or average language skills and 73 per cent had speech in the normal range or better. The mean age at diagnosis was six months of age, with 13.2 per cent having a severe hearing impairment. The Shepherd Centre said the figures showed Australia and New Zealand were leading the world in their ability to teach deaf children to listen and speak. Shepherd Centre CEO Jim Hungerford described the findings as a remarkable outcome for deaf children and their families. We live in an era when most people still equate deafness with just signing. However, the reality is most deaf children are taught to listen and speak, attend mainstream schools and integrate into the hearing world he said. Charles Stenstrom, 6, was fitted with hearing aids at just 10 weeks of age and a year later had lost hearing completely so had cochlear implants. He is now a thriving Year 1 pupil at St Andrews Catholic School, was awarded an academic achievement award and sings in the choir. Comments on our Facebook page Jacqueline: Stop control deaf people to speak and hear it is up to them... let them choose to sign language. Shannon: This is insulting in the assumption that the deaf can just be taught to hear. While I fully support the right for families to choose, my daughters first language is English and we

are choosing bilingualism, there are certain physiological facts that cannot be overcome. I am shocked and offended that Deafness Forum would post an article with such a flagrantly ignorant headline. Toni: Hearing is not listening. Deaf children can be taught to listen. I agree - the headline is wrong. But equally concerning is the concept of "just" signing. Rachael: Hearing and speaking does not always equate understanding. When one understands a concept whether it be conveyed via speaking or signing, that is success and this is the success we should be measuring. Liz: Gosh I SO wish this was available to me when I was growing up - I had NO support whatsoever, and I STILL fumble pronouncing some words. I'm SO grateful for my cochlear implant now because I am hearing so many sounds I never knew existed when I was young. Jodes: As an oral deaf kid I learnt to communicate with speechies and sign (family) and I'm grateful to have both languages Auslan and English as strong as each other. My preference is to sign but my language is both when I need it to be.. Glad I was given the learning to love and live in both worlds.

International Deafness Symbol The correct use of the Symbol encourages and helps organisations to identify and promote places that provide hearing augmentation. The Symbol is a registered trademark in Australia, held by Deafness Forum of Australia. By 1 July 2015, current users will reapply for continued use of the Symbol. For renewed and new applications by not for profit organisations there shall be no fee for each two years of license. For organisations such as businesses, and for governments, institutions and agencies, a fee shall apply for each two years of license for each place. License fees now apply to new applications by these types of organisations. License fees will help develop a public database to inform people about places that have hearing augmentation available; and to promote the importance of hearing augmentation and other necessary services to people who experience hearing difficulties. http://www.deafnessforum.org.au/index.php/find-out-about/37-access-resources/resources/170-hearing-loops1

The Governments proposed sale of Australian Hearing was raised at a recent Senate Estimates hearing in Canberra. Based on the responses to questions it seems that changes are highly likely and will be announced in the Budget in May. Transcript Senator Cormann: In the budget last year we announced that there would be scoping studies into future ownership options with the potential sale of four Commonwealth assets: Defence Housing Australia, the ASIC registry services, the Royal Australian Mint and Australian Hearing. That is a matter of public record. Those scoping studies have been pursued under the leadership of the Department of Finance and they are in various stages of completion. As the government indicated in the budget last year, we will consider any recommendations and any findings as part of the 2015-16 budget process. But let me say up-front that we will consider any such advice with a completely open mind; we do not have any predetermined views. Our focus will be on what delivers the best possible outcomes for relevant stakeholders and for the community at the best possible price. Senator SMITH: Has the government yet given any public guarantees with regard to what future support Hearing Services might receive in the event that it is sold? Senator Cormann: The support for Hearing Services is not connected to the ownership of Australian Hearing, which is a matter for the Health portfolio, actually. I might just ask Secretary Halton, given her current and past responsibilities, to give you some more information on this. Ms Halton: As the minister says, I think it is important to make the distinction here between the actual entity itself and the guarantee in relation to the services that are provided. There are a number of things that are important and, as you know, as a former health secretary, being able to ensure that people actually get access to needed services is incredibly important. But one of the things that we also know is that the market is actually changing quite significantly. So being able to say to people, 'The community service obligation is very important and people getting access to needed services is very important'but obviously the scoping study is looking at how that market currently works and where

Hearing Services sits in that context. In fact, as you know, there are a number of major changes going on in this space at the moment, most particularly with the NDIS. Senator SMITH: Agreed, yes. Ms Halton: So the reality is that we are not in a steady state environment. It is more than timelyit is actually necessarythat we have a look at these arrangements because I think that it would be generally agreed that a commitment to make sure that people have access to appropriate and needed services is a fundamental part of all of the other things that are going on around us at the moment. Senator Cormann: There is a very important point that is directly relevant to your question, and that is, what is driving the service levels and the guarantees around the community service obligations as far as the customer group and Australian Hearing are concerned. It is really driven by the Office of Hearing Services in the Department of Health. It is the Office of Hearing Services in the Department of Health which exercises direct control over the cost of service delivery through control of service pricing and funding levels. The important point here is that nothing that the government may or may not do in relation to the future ownership of Australian Hearing Services really in any way impacts on the eligibility for important support, which is really driven by determinations that are made in the Health portfolio. Just to put this into context, with Australian Hearing, 70 per cent of their revenue actually comes from providing services to pensioners, to Defence personnel and to veterans. They provide that service as part of a completely contested market. There are about 240-odd providers in the marketplace, compared with Australian Hearing, in relation to that particular business. The terms and conditions, if you like, around eligibility and around how much is paid and whatever are really driven through a voucher program which facilitates access for that part of the population to those services. The community service obligation really is about providing hearing services to children and young Australians and various other vulnerable groupsIndigenous people and the likeand that is where it really goes to the heart of the community service obligation, which is managed by the Office of Hearing Services in the Health portfolio. Nothing that the government may or may not do in relation to Australian Hearing will have any bearing on any of these eligibility criteria. That is a very important point. Senator SMITH: The eligibility criteriaif I have heard you correctly, Ministeris part of the relationship between the Department of Health and Australian Hearing. Is that what you are saying? Ms Halton: The reality is that the CSO is actually covered by legislation and it is part of the Department of Health's responsibility to make sure that those obligations are realised. The fact is that it is currently delivered by Hearing Services, although, in fact, there is some change anticipated in that and, as you know, with the advent of the NDIS, it was always the

former government's intentionand, as we know, there is bipartisan support for the NDISto actually include that CSO funding for the groups that will transition in in the NDIS. The minister talks about the part of the market that is contestable, although I should observe that Hearing Services, probably for a series of reasons, have not grown that part of their market anywhere near as significantly as the private providers. At the same time, the NDIS will also be significantly changing the approach to the delivery of services to people who are eligible, people with disability and a potentially significant groupand Mr Thomann can probably go to some of this detailwho are currently in receipt of CSO obligations. That funding is earmarked into the NDIS. So, by definition, this world is going to change fairly significantly. Those decisions have already been taken, but Mr Thomann can probably Senator SMITH: No. There was a lot in what the minister and you have shared with us. Senator Cormann: This is a very important aspect though. What the secretary has just talked about is really very important for everyone to understand. When we talk about these issues, I appreciate that there are a lot of stakeholders across the community who take a very close interest in this because of their care for loved ones and their perception of what may or may not happen to the services for their children and so on in the future, depending on what decision the government might make. So we have got to separate out the benefits and services that people are entitled to from the provision of those services. When you look at the way Australian Hearing operate right now, 70 per cent of their revenue is generated in a completely contestable market already, where they are competing with 240 other private providers; the other 30 per cent so far has not been part of a contestable market. But what the secretary has just indicated to you was a very important consideration as we grapple with the decision about the best way forwardthat is, as a result of the NDIS, which is being pursued in a bipartisan way, the other 30 per cent is also going to a contestable market where Australian Hearing will have to compete with all of these other providers. What we have to think about is, in that context, what is the best way for Australian Hearing to position itself in that market in the strongest possible way in order to be able to meet those opportunities? Senator SMITH: I do not want to lose my train of questioning, so my question was: what, if any, public guarantees have the government given regarding support for Hearing Services in the event that Australian Hearing Services is sold? Ms Halton: in legislation, and let us be very clear, what we are talking about here is access and quality; they are important considerations. There are a number of people at this table who have worked in the health portfolio. This is something which we understand is extremely important to consumers. It is also amenable to people running a scare campaign, so we need to be very clear that we are on about protecting access and quality for people. There are commercial issues about the running of Australian Hearing at the moment which, if they are allowed to run as they currently are, will present a serious

problem in terms of delivering that access and quality, NDIS being one part of it. So they are all issues that we are currently considering, but access and quality and the guarantee are very important to be understood. The important point here is that nothing that the government may or may not do in relation to the future ownership of Australian Hearing Services really in any way impacts on the eligibility for important support, which is really driven by determinations that are made in the Health portfolio. Just to put this into context, with Australian Hearing, 70 per cent of their revenue actually comes from providing services to pensioners, to Defence personnel and to veterans. They provide that service as part of a completely contested market. There are about 240-odd providers in the marketplace, compared with Australian Hearing, in relation to that particular business. The terms and conditions, if you like, around eligibility and around how much is paid and whatever are really driven through a voucher program which facilitates access for that part of the population to those services. The community service obligation really is about providing hearing services to children and young Australians and various other vulnerable groupsIndigenous people and the likeand that is where it really goes to the heart of the community service obligation, which is managed by the Office of Hearing Services in the Health portfolio. Nothing that the government may or may not do in relation to Australian Hearing will have any bearing on any of these eligibility criteria. That is a very important point. Senator SMITH: The eligibility criteriaif I have heard you correctly, Ministeris part of the relationship between the Department of Health and Australian Hearing. Is that what you are saying? Ms Halton: The reality is that the CSO is actually covered by legislation and it is part of the Department of Health's responsibility to make sure that those obligations are realised. The fact is that it is currently delivered by Hearing Services, although, in fact, there is some change anticipated in that and, as you know, with the advent of the NDIS, it was always the former government's intentionand, as we know, there is bipartisan support for the NDISto actually include that CSO funding for the groups that will transition in in the NDIS. The minister talks about the part of the market that is contestable, although I should observe that Hearing Services, probably for a series of reasons, have not grown that part of their market anywhere near as significantly as the private providers. At the same time, the NDIS will also be significantly changing the approach to the delivery of services to people who are eligible, people with disability and a potentially significant groupand Mr Thomann can probably go to some of this detailwho are currently in receipt of CSO obligations. That funding is earmarked into the NDIS. So, by definition, this world is going to change fairly significantly. Those decisions have already been taken, but Mr Thomann can probably Senator SMITH: No. There was a lot in what the minister and you have shared with us.

Senator Cormann: This is a very important aspect though. What the secretary has just talked about is really very important for everyone to understand. When we talk about these issues, I appreciate that there are a lot of stakeholders across the community who take a very close interest in this because of their care for loved ones and their perception of what may or may not happen to the services for their children and so on in the future, depending on what decision the government might make. So we have got to separate out the benefits and services that people are entitled to from the provision of those services. When you look at the way Australian Hearing operate right now, 70 per cent of their revenue is generated in a completely contestable market already, where they are competing with 240 other private providers; the other 30 per cent so far has not been part of a contestable market. But what the secretary has just indicated to you was a very important consideration as we grapple with the decision about the best way forwardthat is, as a result of the NDIS, which is being pursued in a bipartisan way, the other 30 per cent is also going to a contestable market where Australian Hearing will have to compete with all of these other providers. What we have to think about is, in that context, what is the best way for Australian Hearing to position itself in that market in the strongest possible way in order to be able to meet those opportunities? Senator SMITH: I do not want to lose my train of questioning, so my question was: what, if any, public guarantees have the government given regarding support for Hearing Services in the event that Australian Hearing Services is sold? Ms Halton: in legislation, and let us be very clear, what we are talking about here is access and quality; they are important considerations. There are a number of people at this table who have worked in the health portfolio. This is something which we understand is extremely important to consumers. It is also amenable to people running a scare campaign, so we need to be very clear that we are on about protecting access and quality for people. There are commercial issues about the running of Australian Hearing at the moment which, if they are allowed to run as they currently are, will present a serious problem in terms of delivering that access and quality, NDIS being one part of it. So they are all issues that we are currently considering, but access and quality and the guarantee are very important to be understood.

Deafness Forums view Australian Hearing is highly regarded internationally as the provider of high quality hearing services, particularly to Deaf and hearing impaired children. The National Acoustic Laboratories (a part of Australian Hearing) is regarded as a world leader in hearing research. Any proposed changes to existing arrangements should ensure that Australia maintains its reputation as a world leader in hearing services delivery and research.

Clients receiving services under the Australian Government Hearing Services Voucher Program are predominantly pensioners and veterans with non-complex hearing rehabilitation needs. If the Voucher Program was the only issue to consider in relation to the sale of Australian Hearing then the investigation and decision on the sale would be straightforward. However this is not the case. The main point of difference between Australian Hearing and other hearing services providers is its delivery of services to special needs groups under the Australian Government Hearing Services Community Service Obligations Program (CSO Program), and the world renowned research undertaken at the National Acoustic Laboratories (NAL). In 1997 when the Voucher Program was established, it was determined that the needs of certain client groups could not be adequately met by the Voucher scheme. These client groups were classified as Community Service Obligations, and Australian Hearing was appointed as the sole provider of services under a fixed funding arrangement. The NAL research facility was also identified as a Community Service Obligation (CSO). There have been several investigations in the last 17 years to see if the service could be delivered by other providers, but no changes have been made. Clinicians working with the CSO client groups need to have a high level of specialised knowledge and expertise. There are no formal qualifications in paediatric audiology, or working with clients with complex hearing rehabilitation needs. Audiologists working with CSO client groups attain their skills through in house training and mentoring programs at Australian Hearing. So before the CSO Program arrangements could change, there would need to be formal training programs established for professionals to gain the skills they need to deliver CSO client services. If CSO clients are not able to access services from an appropriately skilled clinician, it is likely to have a detrimental effect on their rehabilitation program outcomes. Also, there is a critical number of clients that need to be seen by an individual clinician in order to maintain skill levels. The CSO client groups are very small. There are around 20,000 Deaf and hearing impaired children and about the same number of adults with complex hearing rehabilitation needs across Australia that qualify for services under the Program. If that number is broken up across more than one Provider it will be difficult for clinicians to maintain their skill level. There are other crucial considerations. We have done the analysis for the government investigation in our submission at http://www.deafnessforum.org.au/index.php/issues/112-uncategorised/245-submissions We request the government reciprocates by making the report on its investigation publicly available.

Better Hearing Australia WA Branch PO Box 347 Floreat WA 6014 2015 EMAIL: bhawa2015conference@gmail.com WEBSITE: www.betterhearingaustraliawa.org

Better Hearing Australia WA Branch Celebrating 70 Years supporting our West Australian Community 1945 2015

2015 Better Hearing Australia 67th

National Conference

Better Hearing for a Sound Future

CALL FOR ABSTRACTS

Abstract submissions for the 2015 Better Hearing Australia 67th National Conference in Fremantle, West Australia, are Open. If you have any queries in regard to the abstract submission process please contact bhawa2015conference@gmail.com

KEY DATES

Conference Dates 16 18 October 2015

Date for Presentations 17 October 2015

Abstracts submission open 01 March 2015

Abstract submission closes 01 May 2015

Notification of Abstract acceptance 15 May 2015

Conference Registration Opens 01 June 2015

Early Bird Registration Closes 01 August 2015

Registration Closes 01 October 2015

INFORMATION REQUIRED WITH ABSTRACTS

Your Abstract text should be no more than 1 page, include your name, position, Title of Abstract, Presentation type theme, contact details and confirmation you are available to be in Fremantle West Australia on Saturday 17 October 2015 to deliver your presentation. Your abstract should be emailed to bhawa2015conference@gmail.com

Brain waves show listening challenges in older adults The elderly often complain about hearing difficulties, especially when several people are talking at once. Researchers at the Max Planck Institute for Cognitive and Brain Sciences in Leipzig have discovered that the reason for this does not just concern the ear but also changes in the attention processes in the brain of older people. Our brain is constantly active. The tiny currents flowing in the brain can be measured using an electroencephalogram in the form of voltage fluctuations on the scalp. In particular, regular alpha waves shape the signal measured in this way. In hearing tasks, the strength of these alpha waves indicates the listening effort of the listener. Scientists recorded the alpha waves of 20 to 30 year old and 60 to 70 year old study participants during a hearing task. While the participants were solving a number task, the researchers manipulated the acoustic quality by removing certain frequencies from the speech signal. They varied the predictability of the task's solution. If a very low number is given first, there is a greater probability that the second number will be higher. With better predictability, older and younger participants became quicker at completing the task. However, the outcome was different when the acoustic quality was changed. The older test persons paradoxically benefitted to a greater extent from better quality and completed the task more quickly. The major significance of acoustic quality for older participants was also reflected in the alpha waves. With better speech quality, the amplitude of the alpha waves in the group of older participants was significantly lower than among the younger ones. Attention in old age apparently shifts to acoustic aspects of the speech signal. These research results open up new questions and development opportunities. "I am thinking here, for example, of the possibility of adapting hearing aids to the listener's brain activity individually and dynamically in order to improve speech comprehension in challenging situations," said researcher Malte Wstmann outlining the prospects for further scientific studies. More at http://www.sciencedaily.com/releases/2015/02/150204125943.htm

Deaflympians join todays sporting stars at Deaf Sport Australia awards It was a whos who of deaf and hard of hearing sports stars at the recent awards night held by Deaf Sports Australia. Deaflympians and volunteers from the 2005 Melbourne Deaflympic Games who were celebrating the 10 year reunion were joined by current deaf and hard of hearing sportspeople to congratulate six 2014 DSA award winners. The annual awards night celebrates the achievements of athletes and those who are enabling the deaf and hard of hearing to excel in sport.

This years award winners included golfer Jack Beasley, triathlete Melinda Vernon, Coach of the year Brad Schofield, Murrumbeena Junior Football Club won Organisation of the Year, Emma Cairnduff was awarded Volunteer of the Year and Stefan Armbruster received the Media award.

Rising young star awards were presented to Declan Campion and Jamie Howell in athletics and Alex Kirchner in swimming. Every year it is an honour to award not only the athletes who are excelling in their chosen sport, but also those who are supporting and enabling the deaf and hard of hearing to achieve in sport, said Garry West-Bail, General Manager, Deaf Sports Australia. It was wonderful to see those athletes who competed in the Melbourne Games 10 years ago, many of whom who have gone on to continue to support the deaf and hard of hearing community in some way.

Know someone who might like to receive One in Six? Send an email to info@deafnessforum.org.au Items in Deafness Forum communications may incorporate or summarise views, standards or recommendations of third parties or comprise material contributed by third parties. Such third party material is assembled in good faith, but does not necessarily reflect the considered views of Deafness Forum, or indicate commitment to a particular course of action. Deafness Forum makes no representation or warranty about the accuracy, reliability, currency or completeness of any third party information.