Breaking the silence
Sitting confidently in front of the crowd, nine-year-old Lee Chee-yan delivers an eloquent narrative about a kind-hearted soldier who gives an old lady a coin in exchange for a fake one she had been tricked into taking. His life is later saved by the fake coin when it deflects a bullet. The Primary Three student is a special guest at a storytelling competition for schoolchildren, and at first glance appears to be no different from the others. However, Chee-yan is severely hearing impaired and wears a hearing aid.
Her mother, Lai Wing-han, is justly proud of Chee-yan's performance, which would once have been unimaginable to her. 'When she was about seven months old, she failed the hearing test for the third time during check-ups, and I thought: 'If she can't hear, she can't talk.' At that time there wasn't much attention being paid to hearing-impaired kids, so I didn't have any knowledge about it and I panicked.'
Deaf or hearing-impaired children are generally taught to express themselves using sign language. Many have difficulty speaking or enunciating properly because they've never heard the sounds. But with proper training in their early years, they can be encouraged to learn normal speech and communicate freely.
'Hearing-impaired children - even the totally deaf - can speak as long as their speech organs, such as the tongue and vocal cords, are normal, although the accuracy may vary,' says Archer Yeung Kin-kwan, social service manager of Hong Kong Association of the Deaf.
Bessie Pang Lau Seung-man, executive director and audiologist of Suen Mei Speech and Hearing Centre, agrees. 'People with hearing impairment can speak. It's just that they have a problem hearing properly; some can't even hear the sound of lightning or drums. But they can still speak like anyone else, especially if they start training early. The youngest child at our centre is three months old.'
On advice from a nurse, Lai enrolled Chee-yan at Pang's centre. It provides what Pang describes as an individualised educational programme - one-on-one training with a module tailor-made for each student - involving hearing training, linguistic development, pronunciation exercises and development of intelligence.
'I was all teary when I approached Pang. I was so lost. But then Pang fetched one of her students who answered her questions fluently. I was relieved to find that hearing-impaired children could actually speak,' Lai says.
Pang says the centre's goal is to enable hearing-impaired children to enrol in regular schools by teaching them how to understand what others are saying and to communicate well with others. 'Their linguistic level should be similar to all the others' because if there's a great discrepancy they cannot learn in a regular primary or secondary school,' she says.
But it is no easy task training hearing-impaired children to speak clearly. They hear sounds differently, depending on the degree of hearing impairment - whether they have lost high-frequency or low-frequency hearing.
'For instance, if they've lost more high-frequency hearing, they cannot hear sounds like 's' and 'ch' and can only hear some vowels or lower pitched consonants,' Pang says. 'So we have to teach them to use other senses, for example sight and touch, to make them realise how each sound is pronounced.'
At the Association of the Deaf, Yeung says: 'We use pictures, movements and sign language to teach them how to pronounce different sounds. For instance, the speech therapist will teach them how to shape their lips or show them videos teaching them how to move and place their tongues. 'We also use tools like whistles and balloons to help train their muscles to achieve accuracy for words pronounced by that group of muscles.'
It took Chee-yan a tough three months to learn how to correctly pronounce her first word - 'ay', Cantonese for 'hi'. She was 18 months old.
'It was after practising 100 to 200 times that I heard her say it. I was so looking forward to hearing her say it, and when she did, I was really happy,' Lai says.
'It's all about building from a base. We start off with vowels, then a word, then vocabulary and phrases. It's a cumulative process.'
Pang admits that it takes a lot of time and effort before children can speak properly. Parents' support during training, which lasts from two to five years, is crucial.
'Normal kids may need to repeat their first word five or six times to learn it. But hearing-impaired kids may have to repeat it 100 times. But why should they give up? I've seen many examples. You have nothing if you give up, but you stand a chance if you persevere,' Pang says.
'Constant repetition and the use of different contexts are essential. That's why we also train the parents to teach their children, so that they can practise all the time.'
Raymond Kong's son was diagnosed with profound hearing loss when he was two, and Kong gave up his job to take him to Pang's centre for training every day. After three years' training, his son was able to speak well and attended regular primary and secondary schools. He is now 23 years old and is studying at a university in Canada.
'It's all about starting the training during the golden period. Chee-yan may have taken three months to speak her first word, but as my son started the training when he was two, he only managed to speak his first word - 'ball' - after five months,' Kong says. 'The earlier they start the training, the better. But then the technology wasn't as good at that time.'
Compared with 10 years ago, Yeung says, today's advanced technology makes a huge difference. 'Implanting an artificial cochlea can help some hearing-impaired children to compensate for their hearing loss,' he says. 'A majority of children, given successful surgery to implant an artificial cochlea, will gain partial hearing. So there are relatively fewer children who are completely deaf now, as opposed to the unalterable situation in the past.'
The association estimates that about 400 preschool children in the city have hearing problems, 250 of whom suffer moderate to serious impairment, while 2,000 primary school pupils and a similar number in secondary schools are hearing impaired, about a quarter of whom have more serious conditions.
It believes hearing and speech training is important not only because it's crucial for better communication and relationships, but also because it helps the development of logical thinking.
'If children can't speak well, they lack communication skills, which affects their interpersonal relationships with peers and family. They may keep to themselves and feel isolated. It will also affect their self-recognition and self-esteem,' Yeung says.
'Learning is about interaction with one's surroundings, and communication and social skills are mediums for that interaction. If there are communication problems when they are young, it will obstruct their interaction with their surroundings, and eventually learning of logic and causality, because they rely only on visuals.'
But focusing solely on training speech and hearing may not be the best idea, either, Yeung says, because sign language helps children to more easily understand what is being taught.
So audiologists, speech therapists and social workers are working together to help hearing-impaired children become bilingual - learning sign and spoken language.
'Many of the kids are very smart,' Pang says. 'It'd be a pity if they can't realise their full potential just because they can't hear well.'
Help for hearing impaired children
The Hong Kong Society for the Deaf
15 Hennessy Road, Wan Chai, tel: 25278969
Service: two special childcare centres - the Bradbury Special Child Care Centre in Kowloon City and the Sheung Tak Child Care Centre in Tseung Kwan O - provide preschool training for children from two to six. Intensive auditory and speech training prepares them for transition to higher education.
Suen Mei Speech & Hearing Centre
G/F, Lai Chi Kok Bay Garden, 272 Lai King Hill Road, Mei Foo, tel: 27437377
Service: speech and hearing education for children (and their parents) to help them enter regular schools.
Hong Kong Association of the Deaf
G/F, Chi Mei House, Choi Hung Estate, Choi Hung, tel: 23272497
Service: training for children and parents through sign language, towards signing and vocal speech.
Ha Kwai Chung Special Education Services Centre
4/F, 77 Lai Cho Road, Kwai Chung tel: 23076251
Service: identifies children with special educational needs at an early stage. Speech therapy, referral and placement services and educational psychology.
Special Education Services General Office
Kowloon Tong Education Services Centre, Room W240, 2/F, 19 Suffolk Road, Kowloon Tong, tel: 3698 3957.