By Suzanna Pillay

IS the ability to hear more important than the ability to see?

The topic is open to debate, but professor and senior consultant otorhinolaryngologist Datuk Dr Lokman Saim believes that it is.

"Those who are totally deaf need help. Visual impairment in the blind is easy to see and identify, but the majority of the totally deaf suffer silently.

"The partially deaf who are fitted with hearing aids can still communicate but a totally deaf person who makes no effort at improving himself will remain deaf and mute," said Dr Lokman, who is Universiti Kebangsaan Malaysia Medical centre's dean and director.

"In developing and progressing in intellectual capacity, you would need to be able to communicate with others. Hearing is associated with speech. People can express their ideas because they are able to speak, which is why although a blind man lacks sight, he can still express himself and his ideas, and be understood.

"On the other hand, a deaf person can only communicate through sign language, which has limitations because it is only understood by a small majority. If you can't hear and talk, you may be left behind in today's world with its emphasis on IT.

"Sign language is not as flexible as Braille. Aside from possessing a limited vocabulary, it depends on the use of your hands to communicate.

"In Malaysia, the culture is so established that people who are deaf are automatically directed to sign language centres and schools for the disabled. But a change in paradigm is needed.

"Those who are born totally deaf should have their hearing improved with aids such as cochlear implants so they can eventually attend normal schools."

A child wearing a cochlear implant. -NST photo

There has been a gradual paradigm shift globally which started in the 1990s with advances in hearing aid technology, especially in cochlear implants.

Although smaller, they are more sophisticated and powerful than older aids in magnifying sound.

"They can amplify speech and dampen background noise, which was one of the major problems with earlier hearing aids. When cochlear implants were first introduced in the United States, there was resistance from the deaf community who viewed it as an attack on their culture, but once it was shown to significantly improve hearing in children, the whole paradigm changed.

"It was the same in Australia. Cochlear implants have been so effective there that today 70 per cent of the world use Australian-made cochlear implants."

Early detection of deafness is vital, said Dr Lokman, because cochlear implants are unsuitable for those who are older than four years.

Ideally, newborns should have their hearing tested with the Universal newborn hearing screening programme. Such tests are already being done in some hospitals in Malaysia.

"There is a high risk of hearing loss in premature babies and babies with jaundice and infections during pregnancy such as mumps and German measles."

It is possible to fit an infant as young as six months with a cochlear implant and although he would not be able to speak yet, he could be trained to develop hearing and listening skills, he adds.

When he becomes a toddler, he would then have intensive auditory verbal therapy to help him acquire language skills and speech development by the age of six, so that he can attend a normal school.

"At present in Malaysia, we identify deaf children fairly late at three years and the implants are only done when they are four. They then have more of a challenge in developing speech."

New Straits Times/Asia News Network

This story was first published in NST on Oct 13, 2008.