Hearing Loss in Your Child: Communication and Assistive Listening Devices

Hearing Loss in Your Child: Communication and Assistive Listening Devices

Communication Decision

One of the most difficult decisions that you might have to make for your child would be the method of communication that he/she would use. The choices vary from the Aural-oral which relies totally on normal spoken language to Sign language that is a language that uses visual hand signs only. Other communication methods that are in between these two choices would include Total Communication and Cued Speech.

No single approach would work with all children. Thus, a thorough discussion with your audiologist and speech language pathologist would help you decide the primary communication method your child would use.

Visits to centers where these particular methods are taught before deciding would also help. A good audiologist would never presume to suggest the best option for your child. Instead, he would provide you with all the information you require to decide the best option for your child and your family.


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Communication method chosen would also bear an important impact on your child’s school placement when he is older. A child with hearing impairment with good amplification and acquisition of speech and language can be considered to be placed in normal schools. Others might be placed in integrated schools while those who use signing as their primary communication mode have the choice of attending special school for hearing impaired children.


Assistive Listening Devices (ALD)


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As your child’s needs changes, hearing aids alone might be insufficient for all situations. Devices that are designed for specific needs of a hearing impaired person are often termed as assistive listening devices.

The most popular ALD would be the FM system. This system which usually couples to your child’s hearing aids is important in situations that are noisy and there is a significant distance between the speaker and the hearing impaired person. Examples would be classrooms, meetings and lecture halls.

Although a hearing aid amplifies speech and modern digital hearing aids are capable to reduce some background noise, the challenges of a noisy classroom is more difficult. Imagine a teacher that is standing at the front of the classroom at a distance that is more than the optimum amplification region for the hearing aids.



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In addition, background noise that is highly speech noise. When the speech signal from the teacher reaches your child’s hearing aids, the loudness is greatly reduced; it is then further degraded by competing background noise. It would be very hard and tiring for your child to continuously pay attention to understand the teacher.

An FM system which consists of a microphone worn by the teacher and a receiver worn by the hearing impaired child ensures that the speech signal is transmitted directly to the child’s hearing aid, thus ensuring no degradation of signal due to noise. FM systems are routinely recommended to school going children to aid their studies.

Other ALD devices would include vibrator alarms that wake up the child in time for school as he would not hear the normal alarms because he does not wear his hearing aids to sleep. More examples would be blinking lights for fire alarms, teletext phones and many others.



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Hearing loss is a condition that could be managed by you. The important thing to remember is that your child is just as normal as the next child with the only problem being he does not hear sounds as clearly. In every other aspect he has the same potential to be whatever he wants. It is up to parents and professionals to ensure that the impairment does not become a handicap.

As parents, you face the heavy burden of being your child’s teacher, mentor, friend, therapist, advocate and support system. However, you have the assistance from a whole range of professionals, ever improving technologies for amplification and other communication needs as well as the growing knowledge on hearing impairment and ways of managing it.

Download Teleme’s mobile app and consult an Ear, Nose and Throat Surgeon or an Audiologist



Dr. Shailendra Sivalingam

Dr. Shailendra Sivalingam

Ear, Nose & Throat Surgeon

Mr. Saravanan Selanduray

Mr. Saravanan Selanduray


Hearing and Speech Development in Children

Hearing and Speech Development in Children

The first 3-4 years of life is when the child acquires speech and language skills.  These skills develop best when the child is exposed to world rich in sounds (hearing skills), sights and exposure to the speech and language of their parent and care givers.

What is the difference between voice, speech and language?

1) Voice

This is the sound made from vibration of the vocal folds when air is pushed from the lungs through the larynx (refer to Figure 1).


Figure 1: How voice is produced in human

How voice is produced in human

2) Speech

Speech is created by talking to express language and requires coordinated muscle actions of the vocal folds, tongue, lips and jaw.  Speech is controlled by the Broca’s and Wernicke’s area on left side of the brain (refer to Figure 2).


Figure 2: The Broca’s (area to express speech) and Wernicke’s (area to understand speech) areas at the left side of the brain control speech by sending signals to the motor cortex (which control the mouth and lips) to articulate the words out loud


3) Language

Language is how people express themselves through speech.

Communication Disorder Red Flags

baby's response to touch and sound

Image source: Stock Unlimited

 Communication is a process of exchanging verbal or non-verbal information between individuals. It involves the receptive (ability to understand) language, expressive (production of words to convey messages) language, speech (sound of a spoken language) and pragmatic language (rules in a spoken language).

Baby respond to voice and playing with doll

Image source: Pixabay


Every child may not develop these communication skills at the same time or rate as compared to another child. Every child is unique in his/her development. However, when a child does not acquire certain skills at a certain developmental age, this could be a red flag of a communication disorder.


Here are some of the communication disorder red flags to look out for:

If you notice any of these signs, please do not wait to seek help. It is highly recommended that you get your child evaluated by a qualified Speech-Language Therapist or a related professional (ie. Developmental Paediatrician, Clinical Psychologist).



American Speech-Language-Hearing AssociationThe Hanen Centre, Jeanne S. Chall, Stages of Reading Development , N.Y.: McGraw-Hill Book Company, 1983.

Download Teleme’s mobile app and consult an Ear, Nose and Throat Surgeon or an Audiologist



Dr. Shailendra Sivalingam

Dr. Shailendra Sivalingam

Ear, Nose & Throat Surgeon


Mr. Saravanan Selanduray

Mr. Saravanan Selanduray



Pregnancy and Your Vision

Pregnancy and Your Vision

Pregnancy is a time of joy when the mother will be carrying and nourishing her child for the next 9 months. The duration of pregnancy is divided into 3 phases called trimester (1st, 2nd and 3rd trimester) each of which consists of 3 months.

Throughout pregnancy, there are changes in the hormone levels in the body which are essential to support the growth and development of the baby. These hormones also cause change in the mother’s metabolism, blood circulation, body size and a whole host of other symptoms such as tiredness, body swelling, mood changes and appetite changes which we are familiar with.

Pregnancy also affects the vision but only in a very minor way and may not even be apparent to most mothers.

Changes in refraction

The curvature of the cornea may change during pregnancy and as such may affect the vision as there may be either an increase (or rarely decrease) in the refractive error such as short or long sightedness. This is due to fluid retention at the lens and cornea causing a change in refraction.

Fortunately, this is temporary and the refractive error should return to the previous level within 1 month after the birth of the child.
As such, there is no need to change prescription of your glasses during pregnancy as the effect is only temporary.


Dry Eyes


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The eyes can get more tired during pregnancy for 2 reasons. Firstly, the mother’s sleep may be disturbed as she finds it difficult to get into a comfortable sleeping position as her abdomen gets larger as the baby grows. Secondly, the cornea tends to get drier and contact lens wearing may be more uncomfortable and the eyes feel gritty.

This is easily solved by using eye lubricants on a regular basis (between 2-6 times per day) during pregnancy. If you wear contact lenses, you could apply preservative-free lubricants while wearing them or simply wear them for shorter periods.

The amount of dryness is related to the number of hours wearing the contact lenses. If this is too much trouble, just wear glasses during the pregnancy.


Diabetic Retinopathy

Diabetes becomes more difficult to control during pregnancy. As such, the eye is at risk of developing diabetic retinopathy and retina haemorrhages during pregnancy. It is very important that pregnant diabetic visit to the ophthalmologist (eye doctor) more frequently during pregnancy.

A general rule is a visit at the beginning of each trimester and monthly during the last trimester until 1 month after the birth of the child.


Hypertensive Retinopathy

In rare occasion, pregnancy can cause the blood pressure to rise very high in a condition called eclampsia. This is dangerous to the baby’s development and the mother’s health. In the event of uncontrollable high blood pressure, the mother is at risk of developing neurological (brain) strokes, kidney and heart failure as well as hypertensive retinopathy (haemorrhages in the retina) or strokes in the eye called vein occlusion which can cause blindness.


Image source:  Below the Belly Button


  • Vision changes can occur during pregnancy but fortunately these changes are temporary and in most cases, the vision returns to normal within 1 month after birth.
  • If you wear glasses or contact lenses, do not change the prescription until after you have had the baby.
  • Dry eye symptoms are common and can be easily treated with lubricant eye drops. Use preservative-free eye drops if you are wearing contact lenses.
  • Mothers who are on treatment for diabetes or hypertension should have their eyes checked during pregnancy as they may develop sight-threatening complications.

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Dr. Lee Mun Wai

Dr. Lee Mun Wai


 Dr. Adrian Tey

Dr. Adrian Tey


Dr. Premadeva

Dr. Premadeva


Healthcare Checklist Before You Travel Abroad

Healthcare Checklist Before You Travel Abroad

Prepare Before You Travel Abroad

1) See Your Doctor

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Planning before you travel abroad allows you to enjoy your trip with ease of mind and helps you stay healthy throughout the trip.

It is important to see your doctor and discuss about your travel plans before you leave.  Ask about any vaccinations or medications required for the destination, understand the health risks you could face in the places you’re traveling to and take preventive measures against illness and injury.

It’s also important to keep your doctor informed about your health condition and information about your travel such as:

i) Existing medical condition

ii) Pregnancy

iii) Vaccination history (see below)

iv) Traveling with kids

v) Traveling period

vi) Traveling activities if it involves high risk such as mountain climbing or diving

2) Equip Yourself with Proper Vaccination

image credit: Big Stock




See your doctor before travelling to ensure that you and your family are equipped with the recommended vaccination schedule.  WHO recommends that all travelers be up-to-date on their routine vaccinations listed below:




i) Measles, Mumps, Rubella (MMR)
ii) Influenza
iii) Tetanus, Diphtheria, Pertussis (TDaP)
iv) Hepatitis B
v) Polio
vi) Pneumococcal disease




Vaccination for the following diseases may also be recommended if the disease is common in the country you’re traveling to:




i) Hepatitis A


The hepatitis A virus is found in the faeces of people with infection. It’s usually spread by close personal contact with an infected person or by eating or drinking contaminated food or water handled by the infected person.




ii) Malaria


You’re at risk of getting malaria when you’re travelling to tropical or subtropical areas of Africa, Asia, the Pacific, Central and South America.  Malaria disease is transmitted by mosquito after getting bitten by an infected mosquito. Symptoms of malaria can be detected as early as 6 days to a couple of months later. Symptoms include fever, chills, headache, muscle ache, diarrhoea and malaise.


iii) Yellow Fever


Yellow fever is a viral infection transmitted by mosquitoes. Yellow fever occurs in parts of west and central Africa and South America. Although this illness rarely occurs in travelers, it’s important to equip yourself with the vaccination where the disease is present.




Infection can lead to two distinct phases of disease. The first phase of disease normally has symptoms such as fever, muscle pain, headache, nausea and vomiting.  Patients normally recover after a few days. Some patients will enter into a more serious phase where the fever returns, jaundice occurs and blood appears in vomit. This phase may be fatal to the patient if untreated properly.




iv) Typhoid


Typhoid fever are mainly spread to people who has travelled to places with poor hygiene such as parts of Africa, Asia, South and Central America and the Middle East.  It’s caused by the bacteria Salmonella Typhi and Salmonella Paratyphi which can be found in the blood, faeces and urine of the infected person. You can be infected by ingesting the bacteria through your mouth such as drinking contaminated water or eating contaminated food prepared by the infected person.




Symptoms include lethargic, headache, fever, stomach pain, constipation or severe diarrhoea, rose coloured spots on the body and weight loss.




v) Meningococcal Disease


Meningococcal disease is a result of bacterial infection of the blood and/or the membranes that line the spinal cord and brain.  Meningococcal disease spread by respiratory secretions such as coughing, sneezing or kissing. Disease is most likely spread through close contacts, such as living in the same household with the infected person, sexual contact with the infection person, partygoers contained in the nightclub for the whole night or children attending the same day care of the infected person for the day.




Symptoms in babies include fever, rapid breathing, vomiting or difficulty in feeding, irritability, lethargic and unusual crying.  Symptoms in adults include fever, headache, vomiting, diarrhoea, stiff neck, muscle or joint pains or feeling drowsy and confused.




vi) Rabies


Rabies is a disease spread through the bite or scratch by an infected animal such as dogs, monkeys, cats and bats. Rabies can be found in most parts of the world including Africa, the Americas, continental Europe and South-East Asia.




vii) Japanese Encephalitis (JE)


JE is commonly found in rural or farming areas where pigs are present such as China, parts of South-East Asia and the Pacific. JE is transmitted through infectious mosquito bites. The mosquitoes suck blood from sick birds or pigs pick up the pathogen and pass it on to their next victim.




Symptoms of severe JE include headache, high fever, confusion, disorientated, vomiting, seizure and mental status changes.




This is a guide of vaccines recommended for travel in the following continents.  Please consult your doctor for your vaccination requirements.






Eastern Europe

Mexico &
S. America

Pacific Islands






















Japanese Encephalitis







Yellow fever







Meningococcal disease














Note: Y – Required vaccination



3) Prescription Medications

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Ensure that you have packed your medication such as anti-malarial or anti-diarrhoeal tablets (prescribed by your doctor depending on the countries you’re going). Most importantly, make sure you have brought sufficient medication for your existing medical problems.  It is very difficult to obtain replacement overseas due to either strict regulations or access to pharmacies.

You’ll need to label your medicine properly and carry the prescription letter along for your travel in case you get stopped at the customs check point or if you need to get refill prescription.

4) First Aid Kit

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It’s useful to pack a first aid kit for your travel to prepare yourself for any unforeseen injuries or illness which contains the following:

i) Plasters, bandages, gauze, antiseptic, cotton-tipped applicators

ii) Sunscreen and after sun lotion

iii) Oral rehydration solution packets

iv) Insect repellents


5) Travel Medical Insurance Coverage

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Medical insurance covers the cost of medical expenses in the event of illness or accident. It’s important to know what type of medical coverage based on the countries you’re going to and/or the activities you’ll be participating.


6) Contacts for Doctor Abroad

In case of emergency, it’s best to have contact your tour agent or hotel staff. Keep a copy of your medication and medical history with you at all times so that you show it to any doctor during a medical emergency.  You can use the Medical Journey feature on Teleme to keep your medication and medical history.


7) Pack Appropriate Clothing and Footwear

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Planning ahead and packing the right type of clothing and footwear will reduce the chance of falling ill depending on the weather and geographical location of the country (ie in certain countries with poor cleanliness, wearing a proper footwear will protect your feet against parasites which can break through your skin).



Healthy WA, Travel State Gov, WHO

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 Dr. Suraya

Dr. Suraya

Vaccination Practitioner (Adult)


Stress Management: Avoid, Alter, Adapt and Accept

Stress Management: Avoid, Alter, Adapt and Accept

Practice the 4 A’s of Stress Management

While stress is an automatic response from your nervous system, some stressors arise at expected situations such as meeting monthly work targets, driving during rush hours or taking a blood test. When facing such predictable situations which will cause stress, you can either change the situation or change your reaction. When determining what to do in any given scenario, it’s useful and helpful to think of the four A’s: avoid, alter, adapt or accept.

1) Avoid unnecessary stress

image credit: Pexels

It’s unhealthy to avoid a stressful situation that needs to be resolved, but there are a number of unnecessary stressors in life that you can eliminate.

  • Learn how to say “no”. Know your limits be it your work or personal life, taking on more than you can manage will cause stress.
  • Take control of your environment. If you’re stucked in a jam in the morning when you travel to work and that causes stress to you, try to leave home earlier to avoid jam.
  • Plan on your to-do list. List down your schedule, responsibilities, daily tasks and deadlines. If you’ve got too much on your plate, prioritize your tasks based on how urgent the task is.

2) Alter the situation

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Alter the situation if you can’t avoid a stressful situation. This often involves changing the way you communicate and carry out your daily life.

  • Express your feelings instead of keeping your emotions. If someone or something is bothering you, be assertive and communicate your concerns in an open and respectful way. If your colleagues are chatting and you can’t work, tell them off in a polite manner. If you don’t voice out how you feel, resentment will build and stress will increase.
  • Be willing to compromise. If you and your partner are constantly arguing, both you and your partner would have to compromise to change each other’s behaviour in order to find a happy middle ground.
  • Start a balanced schedule. All work and play is a recipe for burnout. Find a balance between work and personal time.

3) Adapt to the stressors

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Adapt to stressful situations and regain your sense of control by changing your expectations and attitude.

  • Reframe problems. Try to view stressful situations from a positive perspective. Rather than raging at traffic jam, switch on your favourite music and enjoy it.
  • Adjust your expectations and standards. Stop being a perfectionism and set too high expectations and standards. Set reasonable standards for yourself and others as long as it is good enough.
  • Practice gratitude. When you’re breaking down, take a moment to reflect on all the things you appreciate in life such as people you love and your own positive qualities.

4) Accept the things you can’t change

In certain stressful situations which you can’t avoid, the best way to cope with stress is to accept things the way it is. There are situations which you can’t avoid such as death of a loved one, serious illness or recession. Acceptance may be difficult, but in the long run, it’s easier than railing against a situation you can’t change.

  • Don’t try to control the uncontrollable. A lot of things in life is outside of our control especially the behaviour of people. Choose to change your reaction towards them instead of stressing out over them.
  • Positive view. When you’re faced with challenges in life, look at them as opportunities for personal growth. If you’ve done a mistake which has contributed to the stressful situation, reflect on it and learn from it.
  • Learn to forgive. No one is perfect and people make mistakes. Overcome your anger and resentment by forgiving and moving on.
  • Share your feelings. Talk to a trusted family member or friend about your stressful situation. You can also talk to a trusted therapist.

Download Teleme App and consult a psychologist today on stress management


 Dr. Khairi Rahman

Dr. Khairi Rahman



Ms. Usha Ponnudurai

Ms. Usha Ponnudurai



Mr. Paul K. Jambunathan

Mr. Paul K. Jambunathan