Down-under innovators share knowledge for global good

London, 20 Feb 2016

Auditory Verbal UK is a national charity which teaches deaf babies and children to listen and speak as part of helping them achieve their full potential. Chief Executive Anita Grover won Macquarie’s 2014 David Clarke Social Innovation Fellowship in the UK and used her Fellowship grant to travel to Australia and New Zealand in 2015 to meet world leading organisations at the forefront of delivering innovative listening and spoken language programs, which Anita is leveraging to scale up Auditory Verbal UK.

“One of the long-term benefits of the Fellowship is the scope for collaboration in the field of research and development. It has given me not just the insight and experience, but the confidence and connections to take forward the strategic development of our small charity and transform the provision of services for deaf children in the UK,” says Grover.

For many parents, learning that their child will live in a world of silence comes as a deep shock. Parents talk about feelings of despair, heartache and anger. They feel lost and anxious and their hopes and expectations for their child’s future may be dashed.

In Australia, deafness is one of the most common disabilities at birth, affecting about one in 1000 babies born each year (350 children). About 92 per cent of children with permanent hearing loss are born to hearing parents.

Without early intervention, hearing impaired children likely face a future of social and educational disadvantage.

However, more parents in this predicament are discovering that early auditory-verbal therapy, coupled with the right hearing devices, puts their child on a level playing field.

Auditory Verbal UK’s play-based program empowers parents of deaf children with the skills needed to help their child develop their speech in a natural way as well as the listening skills critical to literacy learning.

Seeing the confident, talking children with every opportunity before them, who emerge from the centre and knowing that there are so many others out there who can benefit from this therapy – there is no greater motivation than that. – Anita Grover

Recent evidence in Australia and New Zealand has shown that with this therapy, deaf children are starting school with listening and language skills on par with their peers.

Much about social innovation is about raising expectations – lifting the bar for disadvantaged people and creating opportunities that might not otherwise exist.

Anita Grover, the Chief Executive of Auditory Verbal UK (AVUK), a small organisation of just 15 people, is the first UK recipient of Macquarie’s David Clarke Social Innovation Fellowship and is visiting Australia in late 2015 to learn more from established organisations teaching this therapy.

Without this early intervention, deaf children can typically acquire language at half the rate of hearing children. That disadvantage can carry on through their education and social life, affecting employment opportunities and their wellbeing.

Grover says the organisation wants all deaf children in the UK to have the opportunity to enter school with language levels at least equal to that of hearing children.

"The bar is set so low for families with deaf children. Their hopes and dreams are shattered, they worry about what the future holds for their child. The program has really given them an equal start in life – they know anything is possible. We see some of these children, profoundly deaf and doing all the things that hearing children do like chatting on the phone or singing in their school choirs," says Grover.

It costs about $10,000 a year for three years for AVUK to provide therapy for a child. There is a very short window where all the neural pathways for language are laid down – 85 per cent in the first three years and that’s a critical time for getting the right support for children.  

Grover is profoundly deaf after losing her hearing progressively from childhood and had successful cochlear implant surgery in 2006.

"When I was first ‘switched on’ after surgery for a cochlear implant, I could not tell the difference between someone speaking, a jumbo jet or anything – so the process of learning is to make sense of the sound. The difference for a child is that they learn at the time that they are learning to make sense of the world around them, they have the tools that enable them – with the implant and AVT – to make sense of it like hearing children would," says Grover.

Before joining AVUK, Grover was a senior civil servant, having led communications on the government’s disability, employers, pensions and poverty agendas, and worked with a succession of cabinet ministers, business leaders and third-sector organisations.

Grover has been using this work history to leverage support in the health and education sector in her quest to see every deaf child in the UK have the opportunity to benefit from auditory-verbal therapy

While auditory-verbal therapy is part of mainstream provision in Australia, New Zealand and America, it is relatively new in the UK. It takes three years to train to be an auditory verbal therapist after qualifying as a speech and language therapist, audiologist or teacher of the deaf and there are currently only 17 therapists in the UK – some 300 are needed. AVUK is the only charity in the UK offering professional training that has been accredited by the Alexander Graham Bell Academy for Listening and Spoken Language in Washington DC.

Grover’s Australian trip in 2015 will involve visiting Hear and Say in Queensland and The Shepherd Centre in Sydney and learning how to potentially scale up AVUK’s programs.

The Shepherd Centre says that 90 per cent of children with hearing loss who graduate from its program attend school with listening and language skills on par with those of their hearing peers.

"Australia is leading the way in that centres in Australia have been working to enable all deaf children to learn to listen and talk through auditory verbal therapy programs for many years," says Grover.

"The Australian experience is so important for us and I’m so excited about being able to learn more from these great organisations when I visit through the fellowship."

AVUK also hopes to collaborate with Australian and New Zealand professionals on a literacy study with deaf children on an auditory-verbal program to further improve understanding of what is working and the potential impact.

"It is really about us continuing to challenge ourselves and others, to learn and share our experiences so that we can ensure that every deaf child in the UK is able to access a program of AVT if their parents want them to listen and talk and reach their full potential in the hearing world," Grover says.

A recent study evaluating nearly 700 children in Australia and New Zealand showed that deaf children who receive early intervention services not only develop successful listening and spoken language skills, but their language, vocabulary and speech are better in some cases than their typical hearing peers.

The study, Sound Outcomes: First Voice speech and language data, found 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 performance in the normal range or better.

The findings were drawn from one of the largest collections of data on deaf children in the world, collected by six early intervention agencies.

In 2013, AVUK launched a pilot parent support group which has since proved to be invaluable and lived on outside the organisation in the form of play dates and a closed Facebook group.

It has also been in the process of developing an online classroom for professionals wishing to train in auditory-verbal therapy and has harnessed the support of hearing aid manufacturer Phonak to establish its unique initiative, Listen and Talk as One, at its London centre. The program brings together the skills of paediatric audiology and listening and spoken language specialists under one roof, united by a desire to achieve the very best outcomes for hearing impaired babies and children.

Jim Hungerford, CEO of The Shepherd Centre, says the notion that deafness equates signing is old-fashioned.

"The reality is most deaf children are taught to listen and speak, attend mainstream schools and integrate into the hearing world," says Hungerford.

One of The Shepherd Centre’s graduates, six-year-old Charles Stenstrom, is part of the choir at St Andrew’s Cathedral School and is the proud recipient of an academic achievement award. Charles had hearing aids fitted at only 10 weeks old and then cochlear implants after he lost all hearing 12 months later. Grover says AVUK is experiencing similar success stories.

"Seeing the confident, talking children with every opportunity before them, who emerge from the centre and knowing that there are so many others out there who can benefit from this therapy – there is no greater motivation than that," says Grover.

"I feel we are breaking down barriers." 

Image caption: Anita Grover, Auditory Verbal UK CEO. Photographer: Graham Flack.

This article is an excerpt from the Macquarie Group Foundation's book, Innovation big and small: How great ideas are strengthening our community, which was produced in 2015 in celebration of the Foundation's 30th anniversary.

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