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We recently conducted research about Early Intervention for hearing loss. A BIG thank you to those of you who took part. We as well as Hi Hopes, who commissioned the research, are appreciative of your effort and feedback. Your opinions are extremely important and your views are highly valued.

Hi Hopes wanted us to share some of the results with you:
  • A total of 192 responses were received from GPs, ENTs, Paediatricians and Audiologists (including Audiologists, Speech-hearing Therapists, Speech Correctionists and Acousticians)
  • 46% of respondents had more than 50 babies/children under the age of 3 in their practice
  • 35% had done a hearing screening on between 1 and 10 babies/children under the age of 3 in the past year: usually Otoscopy and/or Noisemakers
  • Most respondents (97%) said that early referral of suspected hearing loss in babies and children was either important or extremely important: ENTs and Audiologists have the most referrals
  • Only 16 respondents knew about Hi Hopes
  • Respondents were given some information about Hi Hopes: the most attractive aspect about the Hi Hopes Programme was perceived to be its family-centred approach. Other positive factors were that it is home based and that there is no cost until the child turns 3
  • There was strong agreement with multi-disciplinary support and decision-making for the parents of babies/children with a hearing loss, as well as for parent’s and families’ need for information and new skills
  • Over 90% of respondents wanted more information about Hi Hopes: contact details as well as patient information pamphlets/brochures
Yours sincerely
The e-View Market Research Team

Click here to view Hi Hopes brochures

By Debbie Salter

Getting older is a fact of life. It is estimated that more than 34 million adults are aged 65 years or older, and with improved disease control and healthcare this number is steadily growing. Most elderly people plan new recreational and social activities for their retirement age. They aim to keep fit and mentally alert, continue to form and enjoy strong interpersonal relationships, and to avoid disease and disability.

Beth Jones*

is an active and vibrant 67 year-old grandmother of ten.

This is her story: “My husband and I have always looked forward to our retirement. We have looked after our health all these years. Three years ago I noticed that sometimes I struggled to hear our youngest granddaughters. This gradually became worse until I couldn’t hear the television unless it was quite loud, and I battled to hear at family gatherings and in restaurants. It was so frustrating to realise that at a stage in my life where I had the time and need to communicate with those around me, I was being shut-out of social situations.”

Hearing Loss and Aging

The gift of longevity brings with it some difficulties. Hearing loss is the third most prevalent chronic disease in elderly adults over the age of 65 years (arthritis and hypertension are at the top of the list). Hearing loss is more common than heart disease or visual problems in the elderly. One in three elderly adults is estimated to experience some degree of hearing impairment. This number increases in the plus-85 year age group.

Hearing loss in the elderly is known as “presby-cusis”. This word is composed of two Greek words that translate literally into “hearing of the elders”. Presbycusis is the most common form of hearing loss. It is usually caused by damage to the tiny hair cells in the organ of hearing known as the cochlea. This delicate and complex organ is responsible for sending sound signals to the brain in the form of nerve impulses. When these impulses reach the auditory centres of the brain, complex sounds such as speech and music are perceived and understood. Any damage to the hair cells results in decreased hearing ability and distorted transmission of sound to the auditory centres. Noisy environments make it even more difficult to hear with damaged haircells. Hair cells can be damaged by exposure to loud noise over time, poor blood-supply to the cochlea, certain medications and general deterioration in the structures within the cochlea. Prebycusis may be also be accompanied by a noise in the ears known as “tinnitus” and problems with balance.

The Effects of Hearing Loss in the Elderly

A large study by the National Council on Aging in the United States of America has shown that hearing loss in the elderly can contribute to feelings of sadness, depression, anxiety and insecurity. Jack Berry* is 87 years old and has been hearing impaired since his mid-70s: “I noticed that I was withdrawing from my friends and family. The social isolation and the fact that I felt shut off from all sounds in my environment made me feel anxious and depressed. I gave up trying to listen for the doorbell or the telephone. I used to rely on my dog to let me know if there was someone on my property. I became paranoid about not hearing intruders.”

Help is at Hand

Hearing loss in the elderly is most commonly treated by a hearing healthcare professional using a combination of assistive listening devices and counselling. Hearing aids are the most common and generally the most effective form of assistive listening device. Other devices include television and telephone amplifiers, and different forms of frequency modulated amplifying systems.

Hearing aid use has been shown to restore the feelings of security and safety that have been compromised by a hearing loss. The aim of fitting a hearing aid is to restore functional independence and to promote the quality of life for the elderly individual experiencing a hearing problem. Effective communication is the ultimate goal of fitting a hearing aid.

Who Benefits From Hearing Aids?

Any level of hearing loss can be assisted with hearing aids. However, motivation is the key in the success of a hearing aid fitting, along with the desire to become involved in social activities. Realistic expectations of the benefits of hearing aid use are also very important. Hearing aids attempt to mimic the way the damaged hair cells work, but cannot replace them. Complete restoration of normal hearing is not possible at this stage.

What Type of Hearing Aid?

Hearing aids are available in a number of different styles and technologies. All offer relief from hearing difficulties. A comprehensive hearing test by a qualified audiologist or hearing aid acoustician will identify the correct style and type of hearing aids for an individual’s hearing loss and specific needs.

Beth Jones on her hearing aids:
“It took me two years to pluck up the courage to face my hearing problem. I kept telling myself it wasn’t that bad and that I could cope. At first I wasn’t sure if I would get used to the hearing aids. Within two weeks and regular visits to my audiologist I was hearing comfortably in most situations. I never realised just how much I had been missing. Now I cannot be without them for a minute. I tell my friends not to wait too long to check their hearing. Hearing again with my hearing aids has eased the burden of loneliness and isolation that I experienced for two years.”

Debbie Salter is an audiologist and the managing director of a hearing aid company.
*(Names have been changed)

If you would like more information about presbycusis, hearing aids and assistive listening devices please contact the following organisations:

South African Speech, Language & Hearing Association (SASLHA)
Tel : + 27- 12- 653 2114
Email :

Society of Hearing Aid Acousticians (SHAA): 011-907-9445

Q & A regarding ICD 10 Codes

  • What are ICD 10 Codes?

    ICD 10 stands for the tenth revision of the International Statistical Class of Diseases and related Health Problems. The ICD 10 is a diagnostic coding system which is used in addition to the procedural codes currently in use.
  • What are ICD 10 codes for?

    The ICD 10 system is an International standard used to collect data for health statistics. 
    It is used as an attempt to create a link between diagnosis, treatment and product while reducing administrative costs.
  • What is the difference between diagnostic and procedural codes?

    Diagnostic codes are used to identify what went wrong where as procedure codes are used to describe what is to be done about it. Both code types must be reflected on accounts submitted to medical aids.
  • What do ICD 10 codes look like?

    ICD 10 codes have up to 6 characters, e.g. A00.00. It is important to use as many digits as possible to be as accurate as possible. The more specific the diagnosis, the easier it is to find the correct code. If a limited number of digits are used, the claim may be rejected as the diagnosis will be too general.

Click here to read the South African ICD-10 Coding Standards.

Click here to search the World Health Organization website for ICD-10 code definitions.

Simptome van moontlike gehoorverlies by kinders vanaf 0 tot 2 jaar:

  • Geboorte - 3 mnde: My baba skrik nie vir skielike harde klanke nie;
  • 3-6 mnde: My baba reageer nie op my stem nie;
  • My baba geniet dit nie om met 'n ratel te speel nie (of enige ander speelgoed wat geluide maak).
  • 6-12 mnde: My baba reageer nie op sy/haar naam nie;
  • 12-18 mnde: My baba kan nie eenvoudige klanke of woorde naboots nie;
  • My baba kan nie wys na bekende voorwerpe indien ek vir hom/haar daarna vra nie.
  • 2 jaar: My kind het nog nie begin praat nie;
  • My kind het opgehou babbel en stil begin raak
Indien u JA op enige van bogenoemde stellings geantwoord het, moet u asseblief onverwyld u baba/kind se gehoor laat evalueer. MOET ASSEBLIEF NIE WAG NIE. Konsulteer `n OUDIOLOOG. Vroeë identifikasie van `n gehoorprobleem is baie belangrik vir die ontwikkeling van jou kind se spraak- en taalvaardighede.

Simptome van `n moontlike gehoorverlies by kinders:

  • Het jou kind 'n probleem met aandagspan en konsentrasie in die klaskamer?
  • Sukkel u kind om te hoor wanneer iemand agter hom/haar praat?
  • Dink u dat u kind wel kan hoor, maar hoor net wanneer hy/sy wil hoor?
  • Praat u kind ontoepaslik hard?
  • Kla u kind dikwels dat die televisie se volume te sag gestel is?
  • Het u kind dikwels middeloorinfeksie?
Indien u JA op enige van die bogenoemde vrae geantwoord het, word 'n gehoorevaluasie aanbeveel: KONSULTEER 'N OUDIOLOOG.

Simptome van gehoorverlies by volwassenes:

  • Dink u dikwels dat ander mense mompel of te sag praat?
  • Is u gehoor in die een oor swakker is as in die ander oor?
  • Ervaar u dat u beter hoor wanneer u, u bril op het en wanneer die spreker se gesig goed kan sien?
  • Sê vriende en familie vir u dat hulle hulself dikwels moet herhaal alvorens u hoor?
  • Sukkel u om te hoor wanneer u in 'n groepsituasie is, of wanneer agtergrondslawaai teenwoordig is?
  • Kla mense dat u die volume van u televisie te hard stel?
  • Sê u dikwels : "Ek het jou gehoor, maar ek kon nie verstaan/onderskei wat jy sê nie"?
  • Vermy u sekere aktiwiteite omdat dit te moeilik is om te hoor?
  • Het u oorpyn? Klink dit soms asof u ore suis of hoor u soms `n geluid soos sonbesies in u kop of ore?
  • Het u vir baie jare in 'n geraasomgewing gewerk sonder dat u gereeld gehoorbeskerming gebruik het?
  • Jag u graag of doen u houtwerk, sonder dat u gehoorbeskerming gebruik?
Indien u op enige van bogenoemde vrae JA geantwoord het, behoort u 'n gehoorevaluasie te laat doen:

Wat is 'n oudioloog?

'n OUDIOLOOG is die professionele persoon wat opgelei is om gehoorverliese by babas(vanaf 3 dae oud!), kinders en volwassenes te identifiseer. Sy/hy bepaal verder die aard, graad en omvang van die gehoorverlies en beveel dan die toepaslike behandelingsopsie aan.

Diagnose van die gehoorverlies:

Oudioloë gebruik klankdigte kamers en het verskillende tipes gesofistikeerde gerekenariseerde toerusting waarmee 'n wye verskeidenheid diagnostiese gehoortoetse uitgevoer kan word. So byvoorbeeld kan 'n gehoorverlies die gevolg wees van 'n probleem in die buite- oor, die Buis van Eustachuis (verbindingsbuis tussen oor en keel), die middeloor (waar die oordrom en gehoorbeentjies geleë is), die binne-oor (koglea/slakkehuis en die balansorgaan), die gehoorsenuwee of breingedeelte van die oor. Na afloop van die konsultasie en die uitvoering van'n volledige gehoorevalusie sal 'n OUDIOLOOG u terug verwys na u Algemene Praktisyn of na 'n Oor-, Neus-en Keelarts indien u gehoorprobleem verdere mediese evaluasies of behandeling vereis. Die OUDIOLOOG is daarom 'n sleutelfiguur in u "gehoorsorgspan".


Indien die gehoorprobleem nie medies of sjirurgies herstelbaar is nie sal die OUDIOLOOG bepaal of daar 'n behoefte aan gehoorrehablitasie is. Die OUDIOLOOG sal ook vasstel of 'n persoon wel 'n kandidaat vir gehoorversterking of ander gehoorhulpmiddels is. Die OUDIOLOOG evalueer, selekteer, pas en verskaf gehoorapparate. Dit sluit ook gehoorapparaat-rehabilitasieterapie en opvolgdiens in.

Indien u dus 'n OUDIOLOOG besoek vir 'n gehoorapparaat evaluasie behoort hy/sy vir u 'n keuse tussen verskillende gehoorapparate te kan bied. Sodoende word dus verseker dat u gepas word met die mees geskikte gehoorapparaattegnologie vir u spesifieke tipe gehoorprobleem, lewensstyl en begroting. Individuele- en gesinsberading oor hoe om met 'n gehoorverlies saam te leef en inligtingsprogramme om gehoorverliese te voorkom, vorm 'n integrale deel van OUDIOLOë se diens.

Selfs 'n baie geringe gehoorafname kan u daaglikse lewenskwaliteit negatief beïnvloed. Gehoorverliese is dikwels behandelbaar en daar is geen rede waarom enige persoon al die belangrike en wonderlike lewensklanke moet mis nie. Daarom, moenie wag nie, raadpleeg die OUDIOLOOG in u area- sy/hy sal u graag adviseer en help.

OUDIOLOë het gegradueerdes van verskillende universiteite en is geregistreer by die Raad vir Gesondheidsberoepe van Suid-Afrika (voorheen Mediese en Tandheelkundige Raad). OUDIOLOë is werksaam in privaat praktyke, hospitale, mediese sentrums, skole en universiteite. Die Suid-Afrikaanse Vereniging vir Spraak-Taal- en Gehoor (SASLHA - South African Speech- Language-Hearing Association) is die professionele assosiasie vir Spraak-Taalpatoloë en Oudioloë in Suid-Afrika. Indien u enige verdere navrae het, kontak SASLHA hoofkantoor by (011) 475 3555. Stuur e-pos by:

Die SPRAAK-TAALTERAPEUT of PATOLOOG is die professionele persoon wat oor omvattende opleiding en vaardighede beskik in die evaluering en behandeling van kommunikasie afwykings by alle ouderdomsgroepe.

Het u nodig om `n spraak-taalpatoloog te konsulteer?

  • Was daar komplikasies tydens geboorte, bv. premature geboorte?
  • Het u kind `n gesplete lip- en of verhemelte?
  • Is u kind gediagnoseer met bv.Down Sindroom of Serebrale Verlamming?
  • Is dit vir u kind moeilik om te kou, suig of sluk?
  • Is u kind twee jaar en ouer en kwyl hy/sy nog steeds?
  • Is u kind se spraak- of taalontwikkeling stadig vir sy/haar ouderdom?
  • Spreek u kind al die spraakklanke korrek uit?
  • Is u kind se spraak verstaanbaar vir vreemdelinge?
  • Vind u kind dit moeilik om sy / haar gedagtes en idees uit te druk of om die toepaslike woord te vind om te gebruik?
  • Ondervind u kind probleme met geskrewe-taalaktiwiteite - lees en spelling?
  • Het u kind leerprobleme en vind hy/sy dit moeilik om aan klasaktiwiteite deel te neem?
  • Vind u kind dit moeilik om te konsentreer en het hy/sy swak luistervaardighede?
  • Is u kind se stem hees of gaan sy/haar stem vir kort rukkies weg?
  • Hakkel u of u kind?
  • Het u `n beroerte-aanval gehad of was u in `n ongeluk betrokke wat u sluk, spraak- of taalvaardighede beïnvloed het?
  • Het u `n hoofbesering gehad?

Spraak- en taalprobleme neem baie vorme aan. Kommunikasie afwykings kan die oorsaak wees van ontwikkelingsagterstand, kan verwerf word voor, tydens of na geboorte. Kommunikasie afwykings kan oorgeërf word of veroorsaak word deur ongelukke of siektes. Evaluering van kommunikasie afwykings word uitgevoer deur middel van onderhoude, waarneming van die pasiënt en deur die gebruik van gestandaardiseerde toetse. `n Behandelingsplan word dan saamgestel om die individuele behoeftes van die pasiënt aan te spreek.


  • adviseer individue en hul familie om spraak- en taalafwykings die hoof te bied;
  • adviseer en ondersteun ouers van jong kinders met kommunikasie probleme en bied bystand aan die ouers ten einde die kind se kommunikasie tot die beste van sy / haar vermoë te ontwikkel;
  • bied terapie aan kinders met vertraagde spraak- en taalontwikkeling;
  • bied terapie aan babas, kinders en volwassenes met suig, kou en sluk probleme;
  • bied terapie aan kinders en tieners met taal-leerprobleme om hul luister en taalvaardighede te ontwikkel en sodoende akademiese prestasie te verbeter;
  • bied terapie aan kinders en volwassenes om spraakklankproduksie te verbeter;
  • bied terapie aan persone wat hakkel om vlotheid van spraak te verbeter;
  • bied terapie aan persone met neurologiese afwykings soos Parkinsonisme & Alzheimer se Siekte;
  • bied terapie aan persone wat, as gevolg van `n beroerte-aanval of hoofbesering, spraak- en taalprobleme ondervind;
  • bied terapie aan persone met stemprobleme, insluitende die wie se larinks verwyder moes word as gevolg van kanker;
  • adviseur onderwysers om leerlinge met kommunikasie probleme te ondersteun en om tweedetaal-sprekers te help.
Die SPRAAK-TAALPATOLOOG is `n belangrike lid van `n professionele span. So `n span kan bestaan uit `n Mediese Praktisyn, Oor-Neus-en Keelarts, Neuroloog, Pediater, Verpleegkundige, Fisioterapeut, Arbeidsterapeut, Opvoedkundige Sielkundige en Onderwyser. Die ouers en / of pasiënt vorm ook `n integrale deel van die span.

Spraak-,taal- en gehoorprobleme kan akademiese prestasie, sosiale aanpassing en beroepsgroei beperk. Gelukkig kan persone met spraak-,taal- en gehoorprobleme meestal gehelp word. Selfs as die probleem nie geëlimineer kan word nie, kan vaardighede aangeleer word om dit te hanteer. Almal sal nie hul kapasiteit om te praat en te verstaan ten volle herwin nie, maar 'n spraak-taalpatoloog kan hulle help om meer onafhanklik te funksioneer.

Spraak-taalpatoloë is die professionele persone wat alle tipes spraak-, taal- en verwante probleme hanteer. Hulle beskik oor ten minste 'n vier jaar Baccalareus graad en is geregistreer by die Raad vir Gesondheidsberoepe van Suid-Afrika. Hulle werk in skole, privaat praktyke, hospitale, klinieke, universiteite en ander gesondheids- en opvoedingsinstansies.

Die Suid-Afrikaanse Vereniging vir Spraak- Taal- en Gehoor (SASLHA - South African Speech-Language-Hearing Association) is die professionele assosiasie vir Spraak- Taalpatoloë en Oudioloë in Suid-Afrika. Indien u enige verdere navrae het, kontak SASLHA Hoofkantoor by (011) 475 3555. Stuur e-pos by:

Signs of a hearing loss in young children:

  • Birth to 3 months: My baby does not startle to sudden loud sounds.
  • 3 to 6 months: My baby does not respond to my voice.
  • My baby does not enjoy rattles or other noise making toys.
  • 6 to 12 months: My baby does not respond to his or her name.
  • 12 to 18 months: My baby can not imitate simple words or sounds.
  • My baby can not point to familiar objects when asked.
  • 2 years: My baby hasn't started talking yet.
  • My child became silent and stopped babbling.
If your answer is YES to any of these statements, have your child's hearing tested. DO NOT WAIT. Consult an AUDIOLOGIST. Early detection of a hearing problem is very important to your child's normal speech and language development.

Signs of hearing loss in older children:

  • Does your child have a problem paying attention in school?
  • Does your child have a problem understanding if you speak from behind?
  • Do you think your child can hear but only when he or she wants to?
  • Do you think your child speaks too loudly?
  • Does your child complain that the volume of the television is turned too low?
  • Does your child have frequent ear infections?

If the answer to any of these questions is YES, a hearing test is indicated. Consult an AUDIOLOGIST.

Signs of hearing loss in adults:

  • Do you think other people mumble or speak too softly?
  • Is your hearing worse in one ear?
  • Do you hear better when wearing your glasses or looking directly at the speaker's face?
  • Do friends and family tell you that they have to repeat themselves?
  • Do you have difficulty hearing when you are in a group of people?
  • Do people complain that you turn up the T.V. too loudly?
  • Have you ever said? "I hear you but I just didn't understand what you said "?
  • Do you avoid certain activities because it is too difficult to hear?
  • Do you have pain or ringing in the ears?
  • Have you worked in a noisy environment for many years without wearing ear protection such as plugs or muffs? Did you do woodwork or took part in hunting?

If the answer to any of these questions is YES, you should have your hearing tested. Consult an AUDIOLOGIST

What is an audiologist?

An AUDIOLOGIST is the professional trained to identify, evaluate and manage impaired hearing in babies, children and adults.

AUDIOLOGISTS conduct a wide variety of diagnostic tests, to determine the exact nature and degree of an individual's hearing problem. These tests are typically conducted in sound proofed rooms with sophisticated calibrated, computerised equipment.

AUDIOLOGISTS determine the need for hearing rehabilitation and also determine whether or not a hearing aid will be of benefit and, if so, selects and fits the appropriate aid. When the hearing problem needs medical or surgical intervention, AUDIOLOGISTS refer to Medical Practitioners or Ear- Nose- and Throat Specialists and are therefore key members in your "hearing care team". Individual and family counselling, about living with hearing loss and conservation programmes to prevent hearing loss, form an integral part of AUDIOLOGISTS' services.

AUDIOLOGISTS hold degrees from universities and are registered with the Health Professions Council of South Africa.

Even a very slight hearing loss can have an impact on your daily life. Hearing loss is often treatable, and there is no reason for anyone to miss all the important sounds of life. So don't wait - consult your local AUDIOLOGIST, who will advise and assist you.

Audiologists can be found in private practices, hospitals and medical centres, schools and universities.

Contact the South African Speech, Language and Hearing Association (SASLHA) at (011) 475 3555 for a list of practicing AUDIOLOGISTS in your area or visit our web site at: or e-mail us at

The SPEECH AND LANGUAGE THERAPIST / PATHOLOGIST is a professional who has extensive training and skills in evaluating and managing the communication disorders of all age groups.

Do you need to consult a speech-language pathologist?

  • Were complications present at birth, such as premature birth or a cleft lip and or -palate?
  • Does your child have difficulty chewing, sucking or swallowing?
  • Is your child still drooling after two and a half years of age?
  • Is your child's speech or language development slow for his/her age?
  • Does your child pronounce all his/her speech sounds correctly?
  • Is your child's speech intelligible to strangers?
  • Does your child have difficulty expressing him/herself and finding the words he/she wants to use?
  • Does your child have difficulty with written language - reading and spelling?
  • Does your child have difficulty with learning and classroom activities?
  • Does your child have difficulty with concentrating and listening effectively?
  • Is your or your child's voice hoarse, or has it disappeared for short periods?
  • Do you or your child stutter?
  • Have you had a stroke or an accident which affected your swallowing, speech or language?
  • Have you had a head injury?

These communication disorders can take many forms. Such disorders can be of developmental origin, or can be acquired before, during or after birth. Communication disorders can be hereditary or can be acquired due to illness or injury.

Assessment of the communication disorders is done by means of interviews, observation of the patient and the use of standardised tests. A management programme is then designed to meet the patient's individual needs.

Speech-language pathologists:

  • counsel individuals and families to deal with speech and language disorders;
  • counsel and support parents of young children with communication problems and assist parents to optimise communication development;
  • assist children with delayed speech and language development;
  • assist babies, children and adults who have difficulty in chewing, sucking and swallowing;
  • assist children and adolescents who have language learning difficulties to improve their listening and language skills which will lead to better academic performance;
  • assist children and adults with pronunciation difficulties;
  • assist persons who stutter to improve their fluency;
  • assist persons with neurological disorders such as Parkinson Disease, Alzheimer's Disease;
  • assist persons who have had strokes or head injuries resulting in speech and language difficulties;
  • assist persons with voice disorders including those who had their larynx removed due to cancer;
  • work in close collaboration with teachers to advise them to be better able to manage learners who have learning barriers and to assist them with second language learners in the classroom.

The SPEECH- LANGUAGE PATHOLOGISTS forms part of a professional team. Such a team can consist of the Medical Practitioner, Ear-Nose-and Throat Specialist, Neurologist, Paediatrician, Nurses, Physiotherapist, Occupational Therapist, Educational Psychologist and Teacher. The parent and / or the patient also form an integral part of this team.

Speech, language and hearing disorders can limit academic achievement, social adjustment, and career advancements. Fortunately, most people with speech, language and hearing problems can be helped. Even if the problem cannot be eliminated, people with speech, language and hearing problems can be taught strategies to help them cope and help them communicate more effectively.

SPEECH-LANGUAGE PATHOLOGISTS hold at least a four-year Bachelors Degree and are registered with the Health Professions Council of South Africa. They work in schools, private practices, hospitals, clinics and other health and education settings.

The South African Speech, Language and Hearing Association of South Africa (SASLHA) is the professional association for Speech-Language Pathologists and Audiologists in South Africa. If you need any further information, please contact SASLHA Head Office at (011) 475 3555. Visit our web site at: or e-mail us at
We have all played the game before. We are blind-folded and staggering around with a group of our friends, trying to grab hold of them, feeling their clothing and their faces to identify who they are. In such a situation our hearing comes to play a very important role. The giggle from over there alerts us to the place where one of our friends is hiding. The echoes within a room give us an idea where the walls are. How would we cope with this game if our ears were plugged up? All of a sudden the idea of playing the game is no longer fun.

Normally hearing people rely on their vision to “hear well”. People trying to engage in conversation in a noisy restaurant or club will rely on visual cues in order to understand completely what is being said to them. They will focus on facial expressions and lip-reading in order to fill in the gaps of the conversation that they have not heard.

Ten percent of the population worldwide has a hearing disability. This number is on the increase as medical science provides the means for the world’s population to live longer and healthier lives. Both hearing and visual acuity are those primary senses that are affected by the aging process. The importance of good vision for hearing impaired people cannot be over-emphasised. Equally as important is good hearing for the visually impaired.

There is a small portion of the population who suffer from both deafness and blindness of a high severity. In America there are approximately 10,000 people with deaf-blindness. The population of deaf-blind people is very varied. A few are born as deaf-blind. The majority acquire their deaf-blindness either through the aging process or brain damage. Some people who are already blind may become deaf due to meningitis. There are also a number of genetic conditions associated with deaf-blindness. Possibly the most well-known genetic condition in South Africa is Usher’s Syndrome. People who suffer from Usher’s syndrome experience hearing loss or deafness from birth, and progressively lose their vision due to retinitis pigmentosa.

Deaf-blindness is a unique condition. It is not simply a blind person with a hearing loss or a deaf person with blindness. Deaf people are taught to communicate through vision. A blind person is taught independent living and life skills through hearing. The deaf-blind are unique in that they cannot use either sense to communicate, develop independent living skills, or monitor their environment.

The deaf-blind are reliant upon one-to-one intervention with a sighted-hearing person. This person becomes interpreter for the deaf-blind. This interpreter uses the remaining senses – touch, smell and taste – to give information to the deaf-blind person about the environment and to teach communication. The learning process for the deaf-blind is slower due to the challenge of bringing information to the individual via the remaining senses. Deaf-blindness masks intelligence due to communication difficulties. Most people are familiar with the story of deaf-blind Helen Keller and her companion, Annie Sullivan who served as Helen’s sighted-hearing interpreter for most of her life. Helen Keller became an educated and accomplished woman.

Colette and Kenneth Kelly have a 3 year-old boy who was born deaf-blind. Colette says: “The lack of communication is the biggest problem that exists with deaf-blindness. The biggest reward, however, is once communication (of whatever kind) has been established. Now the deaf-blind individual can start to learn and develop into a person who, in some cases, will be able to function independently. This unimaginable disability hides wonderful individuals in the dark quietness of deaf-blindness. The most challenging experience we have ever experienced was when Sean was diagnosed as deaf-blind. We had a baby and no means to communicate with him or to know if he was aware that his world existed. Imaging trying to explain to a congenitally deaf-blind child what an apple is? Where do you start?”

Hearing aid amplification for the person with hearing loss and blindness may be indicated in some instances. Amplification for the deaf-blind plays a role beyond enhancing speech perception and language development. Hearing improvement, specifically in the very low frequency range may serve to enhance orientation and mobility skills, and encourage the development of independent living skills by providing important environmental and spatial information.

Teaching the deaf-blind is achieved with one-on-one tuition and interpretation. There are schools in South Africa which specialise in the education of the deaf-blind, such as Pioneer School in Worcester, Western Cape. With continuous stimulation a deaf-blind child can learn to communicate with tactile sign language and body language. They learn to monitor events and people in their environment using the tactile sense as well as smell. Colette stresses the need for teaching independent living skills, doing “with” and not “for” the deaf-blind. “Sean has stirred a passion in me for the field of deaf-blindness and I will be forever grateful to him for that. He is such a delightful and happy little boy who has taught me more than any University ever could,” says Colette.

Colette Kelly and some other interested parties started the Association for the Sensory Disabled (ASD) to assist and serve those who are deaf, blind or deaf-blind and for those who are involved or interested in these disabilities. ASD is the first organisation to bridge all three disabilities (deafness, blindness and deaf-blindness). The main goal of ASD is to establish a one-on-one training centre to provide multiple-sensory disabled learners the opportunity to develop to their full potential. This is would be the first of its kind in South Africa. Secondly, ASD aims to assist those with sensory disabilities with the provision of assistive devices (such as hearing aids), as well as the provision of experiences and opportunities that such individuals would not otherwise have had. If you are interested in learning more about ASD please contact Colette Kelly: Cell (072)198-5360, Office: (023)342-7939, email:

If you would like more information about hearing aids and assistive listening devices please contact the following organisations:

South African Speech, Language & Hearing Association (SASLHA)
Tel 012-653-2114

South African Association of Audiologists (SAAA):
Tel 0861-101924
(Debbie Salter is an audiologist and the managing director of a hearing aid company.)
Click here: For a resource site for patients and support personnel dealing with Speech Aphasia and Apraxia issues
Click here: for dysphagia diets from the International Diet Standardisation Initiative (IDDSI)