FOIOFFICIAL24/25-2169 DOCUMENT 22 Knowledge Article
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EC: Guide - Supporting children younger than 7 who are deaf or hard of hearing (including under the priority hearing stream)
Guidance in this document is not approved for use unless you view it in PACE.
This article provides guidance for an early childhood partner or planner delegate to:
• understand the role of the early childhood partner when a priority referral has been made
by Hearing Australia
• understand the priority hearing stream pathway and eligibility requirements
• understanding supports for children who are deaf or hard of hearing
Recent updates
October 2023
Current guidance
Before you start
You have read and understood:
•
Guide for understanding supports - Children who are deaf or hard of hearing
• Article: EC: PEC – NDIS Pathway Hearing Stream
• Article: EC: PEC – Capacity Building – Early childhood supports overview
• Article - Deafness and hearing impairment snapshot
• Hearing Australia’s Choices eBook (external)
• Our Guidelines – Early childhood approach
• Our Guidelines – Early connections
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For Internal Use Only What is the role of the early childhood partner under the hearing stream?
Early childhood partners will provide early connections for all children and families including supporting them to apply to the NDIS under the hearing stream if the child is likely to meet the NDIS eligibility requirements and hearing stream criteria. This could also include connections with mainstream and community services, helpful information for the child and family and/or connection to peer supports. Please refer to Our Guidelines – Early childhood approach and Our Guidelines – Early connections.
If a child with a hearing loss is unlikely to meet the NDIS eligibility requirements (for example, a temporary conductive hearing loss) and there are concerns about the child’s development then the early childhood partner can provide early connections to determine the right supports and services for the child and family, this may include early supports if they are younger than 6 with developmental concerns.
NDIS eligibility for children younger than 7 with a hearing loss
Early intervention requirements for the NDIS are typically used for children younger than 7 with a hearing loss.
The NDIA will be satisfied a person meets the early intervention requirements for hearing loss if they:
• are aged between 0 and 25
• have evidence from a specialist audiological assessment
• have auditory neuropathy or a hearing loss at least 25 decibels in either ear at 2 or more
adjacent frequencies, and
• the hearing loss is likely to be permanent.
A child is eligible for the priority hearing stream pathway if they meet NDIS eligibility requirements, are younger than 7 and have a new diagnosis of a confirmed, permanent hearing loss.
What is the hearing stream?
The hearing stream is a priority pathway established to allow children to move quickly from diagnosis to early intervention.
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For Internal Use Only If a hearing loss is suspected in an infant or a child of any age, they will be referred to a paediatric audiologist for a full diagnostic assessment. If a permanent hearing loss is confirmed, the paediatric audiologist, with consent from the family will arrange a priority referral to Hearing Australia (External).
The Hearing Australia audiologist will complete Form - NDIS Pathway Hearing Stream - evidence of hearing loss (EOD) and email as a priority to the National Contact Centre (NCC). This will often occur at the child’s first appointment with Hearing Australia but may happen later if requested by the family or carer. The EOD form is unique to the hearing stream and is completed exclusively by Hearing Australia audiologists.
Once received, NCC will create a priority enquiry case which will be routed to the early childhood partner.
The early childhood partner will prioritise contact with the family or carer, provide early connections and determine if the child is likely to meet the hearing stream criteria.
For children that are likely to meet the hearing stream criteria, the early childhood partner will prioritise this work by:
• completing the information gathering steps in PACE
• gathering a holistic picture of the child’s developmental support needs in addition to their
hearing loss
• submitting a priority access request case (refer to article: Request priority eligibility
decision.)
When submitting a priority access request case for a child who is likely to be eligible for the hearing stream, you will enter a prioritisation reason and prioritisation description in the case.
• Prioritisation reason: 0-6 years with hearing impairment.
• Prioritisation description: Hearing Australia or EC Partner Priority.
If a child younger than 7 is diagnosed with hearing loss an eligibility decision will be made within 2 business days once a completed access request case is received.
The initial plan will be approved within 14 calendar days of the child being eligible for the Scheme.
A child is not eligible for the priority hearing stream pathway if they have an existing diagnosis of a confirmed hearing loss. The early childhood partner can support the family or carer to apply to the NDIS, through the early childhood approach. A priority access referral and planning decision is not required.
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For Internal Use Only Capacity building supports
For children with a newly diagnosed hearing loss, use information provided in the EOD from Hearing Australia to complete the PEC case (refer to article: EC: PEC – NDIS Pathway Hearing Stream)
For a plan reassessment, or for children not eligible for hearing stream, refer to article EC: PEC – Capacity Building – Early childhood supports overview.
Evidence shows that communication outcomes are significantly improved when the hearing loss is identified early, and intervention commences soon after. The earlier there is language (spoken and/or signed) in a child’s environment, the sooner their communication, language and literacy can develop.
The impact of mild and unilateral hearing loss varies amongst individuals, as does the benefit of early intervention including amplification. Given there are no clear recommendations of best management approaches, it is recommended that the outcomes of hearing related functional assessments (documented in provider reports) are also taken into consideration when determining whether hearing is identified as a high or medium to low area of need.
For further guidance on early intervention supports, refer to Guide for understanding supports - Children who are deaf or hard of hearing.
Core budget supports
Consumable – Low cost assistive technology
The early childhood partner will identify the low-cost assistive technology needs from conversations with the family and evidence provided.
Hearing devices for children are provided by Hearing Australia, funded under the Hearing Services Program (HSP). Hearing Australia is responsible for managing this program, including the provision of hearing devices and speech processors. To learn more about the technology that is provided at no cost to children go to Hearing Australia’s website (external).
Families can enter into a maintenance agreement, receiving batteries and maintenance for their child’s hearing device. This includes repairs and spare parts for their hearing device and/or speech processor. Under the maintenance agreement the participant’s family makes a small co-payment towards the annual maintenance fee. (Refer to article: EC: PEC – NDIS Pathway Hearing Stream) to include funding for this support.
Speech processors (including their replacement parts), remote microphones or wireless communication devices are funded under the HSP and are generally not funded under the
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For Internal Use Only NDIS. Eligible Australians under 26 years of age can obtain speech processors to replace those that are lost or damaged beyond repair. Upgraded technology can be provided to young people who meet certain clinical criteria. For further information go to Hearing Australia’s Funding Options (external).
Communication approaches
The choice of communication approach is the family’s decision. There is widespread recognition that no single option is ideal for all children with hearing loss at all stages of their development. Some families may feel under pressure when making choices about communication. It is important that families understand that they do not have to make a choice for life. They may wish to change their approach as they learn more about their child’s needs and preferences. The right choice is the one that works best for the child and their family and will adequately support a child’s language development and minimise the risk of language deprivation.
To learn more about communication approaches go to Hearing Australia’s Choices eBook (external). This resource can be shared with families if they do not already have it. You can also refer families to Guide for understanding supports - Children who are deaf or hard of hearing.
Based on the information that you have gathered with the family; you may include information in the PEC based on the families preferred communication approach (refer to article: EC: PEC – NDIS Pathway Hearing Stream).
Auslan related supports
Auslan related supports should be considered on an individual basis and funded where the support meets the NDIS funding criteria. When determining reasonable and necessary supports, the NDIA will need to ensure the capacity of families is increased, so they can support their child’s language development.
A participant’s age and level of hearing loss are also factors to consider when determining the level of support an individual may need in their everyday life. Other factors to consider include:
• the child’s family and social networks
• the child’s access to early intervention supports
• access to mainstream service, for example, education
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For Internal Use Only • provider reports which include the child’s progress towards goals, outcomes achieved
and provider recommendation
• other disabilities, geographic location and cultural backgrounds also influence the type
and severity of barriers which a child who is deaf may experience.
The level of support that a participant might require will vary depending on the child’s language development, literacy skills and the family’s preferred method of communication.
Auslan language development supports
This support type is best delivered in children’s natural, everyday settings, such as home and childcare. Auslan language development supports aim to build the capacity of the child, family, and other important people in the child’s life to ensure that they can meaningfully and effectively communicate.
Auslan language development support may include, but is not limited to teaching Auslan, provision of strategies to support communication and interaction between the child and informal supports, education around Deaf culture, recommendations and the development of resources.
Learning Auslan is not a short-term activity, it requires long-term support to ensure the child and their family fully immerse in learning Auslan to maximise language acquisition. Families should be encouraged to use quality Auslan trainers who are fluent and extensively experienced with teaching Auslan to children and families. It is important that families have opportunities to practice Auslan skills with other fluent Auslan users.
Auslan training is typically delivered at settings in the child’s community, like their local sports club or church. They may include but is not limited to Deaf Awareness Training (DAT), provision of targeted strategies to promote inclusion and communication and education of specific Auslan signs. The availability and appropriateness of mainstream options for general Auslan training through, for example, the education system or the community should be explored alongside NDIS funded supports.
Auslan interpreting
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For Internal Use Only This is an important consideration to ensure Deaf children can access services. It is recommended that funding for interpreting services be included where it is considered appropriate and meets the NDIS funding criteria. It is important to give children access to incidental learnings and positively increasing their social and community participation, supporting their social and emotional development.
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