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November 10, 2002

Let's hear it for the boys

From: Sydney Morning Herald, Australia
Nov. 10, 2002

The idea that hearing and listening issues may handicap educational progress for many boys is finally coming through loud and clear, writes Bettina Arndt.

Are boys not doing well in school because they cannot hear their lessons properly? This surprising proposition was one of the major news stories to emerge from the recently released report from the parliamentary inquiry into boys' education. Poor hearing and listening are critical issues, the committee said, recommending national action to address the problem.

It was enough to prompt letter writers into action, with an amused response to the Herald from Robyn Fitzroy of Birchgrove. "Thank heavens I now have an explanation for sons' inability to hear simple instructions like 'please unpack the dishwasher' or 'our curfew is not 3am': they have poor hearing," she sniggered, pointing out that despite this disability, there are occasions when her sons hear well - "'dinner's ready' seems to open up those little hearing channels like nothing else", she added.

The jokes were inevitable but the parliamentary committee and researchers whose work they reported are very serious indeed. Kerry Bartlett, chair of the committee, acknowledges they were surprised to discover hearing and listening difficulties may be playing such a role.

"The evidence is based on extensive research and is most convincing. It really is very important because if boys are not clearly differentiating sounds and processing the auditory messages they are getting, it makes it harder for them to learn," he says.

Bartlett is not talking about the type of hearing problem picked up by the usual screening tests, involving audiograms which require children to respond to different tones. More complex hearing issues are involved, including subtle changes in the mechanical functioning of the ear and difficulties in processing what the children hear. The researcher responsible for bringing the mechanical functioning issue to the committee's attention is Dr Eric LePage, a physiologist and senior research scientist at the Australian Acoustic Laboratories in Sydney. LePage was also responsible for bringing to Australia a revolutionary new technique for testing hearing performance, known as the Otoacoustic Emission Test (OAET).

The test measures sounds (otoacoustic emissions, OAEs ) produced by hair cells in the ear. The condition of these hair cells relates directly to hearing - the fewer the cells and hence fewer emissions, the greater the hearing loss. In effect the OAET indicates the reaction time of the ears, looking at how quickly they can respond to a stream of sounds such as speech. Unlike the traditional audiometry which involved a behavioural measure based on listening and responding, the new test gives an objective physical measure of the ears' performance and picks up differences in auditory capacity, long before traditional tests would show hearing loss. "It's like replacing the stethoscope with an ECG," LePage explains.

As people age, OAEs tend to drop - the older the person, the lower the OAE. So the scientists talk about "ear age" - using the OAET to assess ear function compared with the average for a particular age. And that's where the boys enter the story. LePage noticed some years ago that boys' ear age is far older than girls - in teenage boys, about 10 years older.

He believes the differences he has found in the hearing of boys and girls is sufficient to explain boys' poorer school performance. "In a normal classroom, 70 per cent of males would experience poorer ear functioning than the average girl. That's a highly significant difference that could account for many of the learning problems being experienced by boys."

In a hearing held by the boys' education committee, his colleague Dr Narelle Murray explained the connection: "The act of actually hearing syllables, separating them and then repeating them is vital to the process of learning to read. The ability to analyse sounds quickly, particularly speech, may be the most significant component of comprehension and apparent intellect," she says.

The scientists suggest less acute hearing leaves the boys floundering. "If you take a typical boy and a typical girl, we are suggesting that if the teacher is speaking normally, the girl and the boy will be able to hear the first sentence but the boy may still be figuring out what was said when the second sentence comes along, whereas the girl will have taken it all in, thought about the mental connections and be ready for the next sentence," Murray told the committee.

Boys and girls are born with similar functioning but by age four, differences start to emerge. At this age, LePage suggests, boys' poorer auditory capacity is due to differences in the neural pathways which control the hair cells producing the otoacoustic emissions, possibly due to a genetic variation. But with older boys, the poorer functioning is self-induced, resulting from damage due to noise. LePage's research clearly demonstrates accelerated ear ageing due to noise, particularly from Walkmans. "The really damaging aspect of it is that people wear them in noisy background situations like riding in a car or in trains or when they are jogging, and turn up the volume. That increases the likelihood of damage."

Walkman usage accounts for a change in ear age of the younger generations, with teenagers and young adults today showing rapid declines in ear emission scores. "You can have some boys with older ears than their parents," says LePage.

At the same time as he was studying hearing capacity, in Melbourne a major clinical research project was under way tracking difficulties many boys are having with auditory processing, the ability to effectively listen and "digest" accurately what they hear. This ability usually develops rapidly between years 3 to 7, but in some children, particularly boys, it lags behind, making it difficult for them to absorb teachers' instructions or lessons.

Almost a quarter of children, 70 per cent of them boys, show poor auditory processing which puts them at risk of under-achievement, according to research by Jan Pollard, audiologist, and Dr Kathy Rowe, senior consulting physician at Melbourne's Royal Children's Hospital (RCH), and her husband, Dr Ken Rowe, principal research fellow at the Australian Council for Educational Research (ACER). This research showed 20 per cent of six-year-old children cannot process verbal information beyond an eight-word sentence.

"Many teachers use long sentences and the children switch off very quickly because after the first couple of words they 'lose' the rest of the sentence," Kathy Rowe says, adding this poor processing was found to be associated with lower scores on range of literacy assessments and with behavioural problems including inattention.

The research produced solid evidence that, with appropriate teacher training, auditory processing problems need not handicap children's learning. The study - which involved 1600 Victorian primary school children - looked at the effectiveness of a one-hour training session to give teachers practical skills to help these children. Children whose teachers had received the training showed significant improvement in literacy scores and measures of attentiveness, compared with those with teachers who hadn't had the training.

"You could see it on their faces, the look of bewilderment. There were always children who seemed just lost in the classroom," Sandra Sallpietro says. Sallpietro, a teacher at Woodlands Primary School, in Langwarrin, Victoria. took part in the teacher training to find ways to keep these children connected. "I've had great success with it. When you teach in this way, it's like a light comes on. The children know what you are talking about."

And what were these skills? "The techniques are as old as the hills but are sadly no longer part of regular teacher training," says Ken Rowe. "They involve teachers firstly making sure they have the children's attention and are listening, slowing down and shortening their instructions with pauses in between, maintaining eye contact and then checking to see if the kids are still with them. When teachers followed these instructions, the difference in the children was quite remarkable."

So remarkable that the Victorian Education Department is offering this training in a video kit prepared in co-operation with the RCH and ACER which has met with a strong response from teachers. Indeed, interest is being shown by schools, government and private, all over Australia. The NSW Education Department is already using the techniques with specific groups of children and is considering making the training more widely available.

In linking the auditory processing problems being picked up by the Rowe/Pollard research and the auditory capacity issues identified by LePage and Murray, the parliamentary committee is prompting further research to provide greater understanding of these complex issues. The two groups of scientists are investigating possible collaborative research projects. Ken Rowe says: "Eric's work on auditory capacity provides exciting clues to the mechanics underlying the auditory processing problems we have been working on and we are keen to explore research to clarify the connections."

But in the meantime, both groups of scientists applaud the committee's recommendation of nationwide professional development programs to assist primary school teachers to become more aware of these issues, to teach them to do preliminary testing for auditory processing problems and give them strategies to address them. The message that hearing and listening issues may handicap educational progress for many boys has finally been heard.

Copyright © 2002. The Sydney Morning Herald.