SENIOR audiologist and manager of the Speech & Hearing Centre at Sunway Medical Centre, Saravanan Selanduray, takes time to answer a list of questions from Thots n Tots, giving us insight into his job and the importance of audiology testing for children.
Where did you study? How long have you been an audiologist?
I have a Bachelor of Audiology degree from Universiti Kebangsaan Malaysia. I have been a qualified audiologist since October 2003.
Where have you practised?
My practice has been exclusively in Malaysia. In 2010, I did short-term attachments in many prominent audiology clinics and centres in Adelaide, Australia, under the Australian Endeavour Executive Award programme. It was an enriching experience and I gained a lot of valuable exposure to audiology practices.
Why did you decide to be an audiologist? What or who influenced this decision?
I have always been interested in patient treatment and care. After my STPM (Sijil Tinggi Persekolahan Malaysia), I applied to do medicine but received an offer to do audiology. The field of audiology was then very new in Malaysia, not many people had heard of audiologists. After some research, I decided to give it a try. I found that I absolutely loved audiology. It involves patient treatment and care but also includes rehabilitation. You are also involved with patients and their families for longer periods. It lets you see how a patient’s life changes due to your efforts. It is one of the best life choices I have made.
Many parents do not understand how an audiologist works together with an ENT (ear, nose and throat) specialist. Can you explain it in simple terms?
The hearing and balance system is quite complicated. The audiologist runs diagnostic tests to identify the affected area of hearing or balance, and the severity of the problem. This helps the ENT surgeon uncover the root cause and treat this with either medication or surgery. If no suitable treatments are available, the audiologist then does non-medical management using devices or rehabilitation techniques to restore as much function as possible. We work together to ensure that the patient’s hearing or balance problem is resolved in the best way.
What are some perks or interesting aspects of being an audiologist?
There is never a boring day in the clinic. I am always learning, as the field is relatively new and constantly expanding. I see many different patients, from newborns to the elderly. It is just as rewarding to see a child with hearing loss respond to her parents without needing to look at them, as it is to see the smiles of my elderly patients when they can hear their grandchildren speaking to them.
What is your policy or belief when it comes to children’s auditory health and wellbeing?
All children deserve to hear as best as they can. Hearing loss is invisible but causes speech delays and learning difficulties when left untreated. It affects a child for his entire life, as he will struggle to master basic language, compared to his hearing peers who will learn language effortlessly. It will also affect the child’s academic performance and social behaviour. No hearing loss should be left untreated, especially in a child.
What is your opinion about hearing aids for children (especially since many children do not always like to wear them)?
Children often don’t realise what is best for them. Many children don’t like to eat vegetables, going to school or taking medicine. As parents, we usually find ways to overcome this. So, why is it different with hearing aids? A hearing aid helps to restore hearing functionality that is as close to normal as possible. It minimises the impact of hearing loss and helps improve a child’s life. As parents, we have a duty to ensure our child uses a hearing aid if they need it. There is always a way.
After children overcome the initial resistance of having a foreign object in their ear and can hear better, most children cannot be separated from their hearing aids.
What are the most common hearing-related issues that you see?
It is conductive hearing loss due to middle ear fluids. Most children will have it at least once or twice in their lifetime. The issue will mostly resolve by itself. However, in some children, this happens frequently and can cause hearing loss as well as auditory processing issues.
What are the most common and preventable causes of hearing loss in children?
The most common cause that is preventable is wax blockage. Parents have to stop using cotton buds or ear picks to clean their child’s ear. The ear has a self-cleaning mechanism and wax helps to protect the ear canal’s delicate skin lining. It is sterile and helps the ear canal become water resistant. When you clean with buds, you may push the wax deeper, causing it to block your child’s hearing. You can also puncture the child’s eardrum.
The accumulation of middle ear fluids is another cause. Although middle ear fluids cannot be prevented, the main cause of the fluids which is due to a blocked Eustachian tube can be minimised.
If your child has long recurring episodes of blocked nose due to flu, anatomical issues or other reasons, consult your paediatrician or an ENT specialist. Early treatment can prevent middle ear fluids from building up.
Noise-induced sensorineural hearing loss is also preventable. We used to see noise-induced hearing loss only in musicians or adults working in very noisy environments. However, children and teenagers today are exposed to extremely loud noise from personal music devices, handphones or even toys. If you can hear the music from your child’s earphones when he has it on, it is probably too loud. The rule is not too loud and not too long.
Do you have any kids?
I have two girls, aged three and eight, as well as a newborn baby boy.
Has being a parent helped you in your job? How?
Yes, conversely my job has also helped me be a better parent. As I handle many newborns and children at work, I am comfortable swaddling and feeding my baby, and playing with my children. As a parent, I can empathise with parents of my patients and their challenges. I also apply parenting tricks I know on my patients to get them to do what I need and share these tricks with their parents.
What do you enjoy doing when you are not working?
I really love reading fiction. It allows me to experience fantastic magical adventures. However, due to the demands of work and parenting, I have less time to read nowadays.
If you could invent something that is hearing-related for the child (and money or resources were no issue), what would it be? And, why?
I would invent completely implantable hearing aids for children. Although current hearing aids are super small and advanced, many parents are still not comfortable with the stigma of hearing loss. They delay getting a hearing aid for their child or do not get one at all. An implantable hearing aid would give the child the freedom to do everything a hearing child can do, without having to worry about dropping or damaging the aids.
What is your best advice to parents for better auditory health and wellbeing?
Parents have to ensure that their child goes through a newborn hearing screening and another hearing test just before they start primary school. Always look out for signs and symptoms of hearing loss. When in doubt, bring your child to see a qualified audiologist. In many cases, hearing loss was sadly only detected when the child was much older as parents kept putting off a hearing test or were misled by others on the need for a hearing test.
Our current education system does not emphasise hearing tests like it emphasises vision tests, medical checks and dental checks. So, as parents we must take up this responsibility of hearing loss detection, while urging the relevant ministries to implement hearing screening and related programmes.