Next month in Brussels, meanwhile, the Flemish deaf community will celebrate the recognition of Flemish Sign Language by the Flemish government five years ago with a major three-day event in parliament.
This got us thinking that sign language might just be as hot a topic as spoken language. What we discovered took us all the way back to the beginning - what first happens when a deaf baby is born in Flanders.
In 1998 Flemish agency Kind & Gezin (Child & Family) introduced a neonatal hearing screening programme - the first region in Europe to implement such a scheme. Previously, hearing problems in many children went undetected until they went to school for the first time. Every newborn in Flanders now gets a visit from a care worker from Kind & Gezin, who conducts an automated hearing test. Virtually all countries in western Europe and most states in the US have now followed Flanders' lead.
If the screening shows hearing problems, the parents are referred to a specialised audiological assessment centre or university clinic, where additional testing is completed within four weeks. These centres work closely with the five early intervention teams in Flanders (one per province), which inform parents about hearing problems and the communication and therapy options.
Early screening is vital because it gives health workers the chance to implement early onset of intervention. In this area too, Flanders is a pioneer, particularly in the area of cochlear implants.
Helping to hear
A cochlear implant is a small, complex electronic device that helps provide sound to a person who is deaf or severely hard of hearing. An external portion sits behind the ear, and a second portion is surgically placed under the skin. A cochlear implant has:
> a microphone, which picks up sound from the environment
> a speech processor, which selects and arranges sounds picked up by the microphone
> a transmitter and receiver/ stimulator, which receive signals from the speech processor and converts them into electric impulses
> an electrode array, which is a group of electrodes that collects the impulses from the stimulator and sends them to different regions of the auditory nerve
An implant does not restore normal hearing. Instead, it gives a deaf person a useful representation of sounds in the environment and helps him or her to understand speech.
"About 200,000 people worldwide are wearing cochlear implants," says Leo De Raeve, Director of the Independent Information Centre on Cochlea Implants (ONICI) in Zonhoven, just north of Hasselt. "In the last three years in Flanders, 95% of all children born deaf received a cochlear implant - nearly three-quarters of them before they were 18 months old."
The average age of implantation is 14 months, but implants have been successfully installed in babies as young as six months. Of course, such early intervention would not have been possible without the universal hearing screening programme.
The results are impressive. Around 60% of all deaf babies given a cochlear implant can be sent to a normal, hearing school by the time they are six years old. The reason is that the implant stimulates the auditory nerves as early as possible - when the brain is the most receptive.
"It's a successful combination of early screening within weeks of birth, cochlear implantation in the next six months if possible, and the provision of excellent support of the parents," adds De Raeve. "This involves helping parents to use the implant properly and advising them how to communicate most effectively with their child."
When the child enters mainstream education six years later, his or her language ability is either average or only slightly below average. Without implantation, many of these children would not be able to communicate with hearing children or teachers.
Since February 2010, medical insurance companies in Flanders also reimburse the second implant (that is, in the child's other ear) - previously, only the first implant was covered. Most countries, in fact, reimburse just one implant, but after Flanders began covering the second, Sweden, the UK, Austria, Switzerland and some areas of Germany are now introducing legislation that allows the second implant to be reimbursed.
It's highly advantageous for parents, as the total cost of a cochlear implantation is about €22,500. After reimbursement, the cost to parents winds up at only about €500, part of which covers the child's stay in hospital.
Going to school
Despite being in mainstream education, children with cochlear implants still need support, as they can face issues, especially when they are the only deaf or hard-of- hearing child in their class.
"We give them comprehensive counselling to help them look after their device and to learn how to react when a classmate laughs at them or tries to remove their microphone," says De Raeve. "It's also important that hard-of- hearing children meet similar children and even adults who wear these devices so they realise they are not the only child with a hearing problem."
The field of deaf education has been riddled with controversy for hundreds of years, so it's no surprise to find that cochlear implantation has its critics. On one side of the fence are those - particularly the hearing parents of a deaf child - who support cochlear implants because they believe that they allow children to function successfully in society. On the other side is a sizeable portion of the deaf community who believe that deafness is a cultural identity, not a disability.
"With deaf children of deaf parents, we say that their first language is sign language, and we emphasise the need for the child to learn that important language - even after receiving an implant," explains De Raeve. "But in situations where the parents are hearing and don't know sign language, the cochlear implant is a huge advantage both to the child and the parents."
Sign language(s)
However, when it comes to sign language, nothing is clear and simple. If you are under the impression that there is one global sign language that allows deaf people everywhere to communicate with each other, nothing could be farther from the truth.
There are as many sign languages in the world as there are spoken languages. Unlike spoken English, sign languages used in English- speaking countries aren't similar to each other. Someone using British Sign Language, for example, would not be able to communicate with someone using American Sign Language (which is much closer to French Sign Language). An attempt was made to create an International Sign Language, but this has never been well received. Therefore, there is no universal sign language.
Even in a region as small as Flanders, there are two main sign languages (Flemish Sign Language and French-Belgian Sign Language) as well as a multitude of dialectical variants. So the chance that a deaf person in Hasselt can understand what a deaf person in Knokke-Heist is signing is, unfortunately, very small.
This dichotomy is also linked with the absence in Flanders of a special academically oriented college or university for the deaf, at which sign language could be further developed. In fact, there is no such institution in the whole of Europe. The only university specifically designed for deaf and hard-of-hearing students in the world is Gallaudet University in Washington, DC.
The advantage of such a specialised institution is that all deaf students from the US (and elsewhere) can come together to study at a high academic level. It's therefore a wonderful learning opportunity and a place to build on your sign language. This is one of the reasons why American Sign Language is at such an advanced level in all academic subjects, from civil engineering to art history, and computer science to modern languages.
"This contrasts with the situation in Flanders, where most of our deaf students are studying a vocation - learningtobeabaker,butcher,carpenter etc," says De Raeve. "However, there are notable exceptions."
Flanders does have special schools for the deaf - one per province. KIDS, the Koninklijk Instituut voor Doven en Spraakgestoorden (Royal School for the Deaf and Speech Impaired) in Hasselt, for instance, provides education, rehabilitation and counselling services for around 1,000 deaf and hard-of- hearing children aged three to 18. This assistance is offered in residential, semi-residential and outpatient form, delivered by a staff of more than 400. (On our cover is Xander, who goes to KIDS.)
Born deaf
Despite vaccinations against rubella and meningitis, deafness is not on the decline. "At KIDS Hasselt we are supporting about 20% more deaf and hard-of-hearing children than 15 years ago," says De Raeve, who works part time at the school as a psychologist. "This is partly because of universal hearing assessment leading to more hearing problems being detected, but there is another possible reason for the increasing prevalence of deafness. Hearing loss in a child may be linked to a virus that the mother got while she was pregnant."
That is the cytomegalovirus (CMV). It's a common virus that normally causes a harmless infection. However, if a woman gets CMV while she's pregnant, there is a 33% chance that it passes on to the baby.
Research is still inconclusive but is beginning to link hearing loss with CMV. Studies indicate that about 9% of all children who have some degree of hearing loss had CMV at birth. The degree of hearing loss varies from partial impairment in one ear to total deafness. As yet, researchers don't know why being exposed to CMV in utero might cause hearing problems in babies but think that the virus damages the cochlea.
"Infection with CMV is very common, but it rarely causes symptoms - often only a runny nose or a slight fever - so most infected people are not aware of their infection," adds De Raeve. "It therefore largely goes undetected. But knowing how exactly CMV causes hearing loss is important if a treatment is going to be developed."
In research into CMV, looking for the cause of deafness in general and possible solutions involving gene therapy and hearing cell regeneration, Flanders is in the front line of European research, with the Catholic University of Leuven and Antwerp University taking a leading role.
Born deaf to a Flemish hearing family in the late 1960s, Helga Stevens spent the first half of her childhood in KIDS Hasselt before moving to a mainstream school - Heilig-Grafinstituut in Sint-Truiden. She then spent a year in the US as an exchange student and visited Gallaudet University, the world's only university designed for deaf and hard-of-hearing students.
There Stevens met a deaf attorney who inspired her to pursue her dream of becoming a lawyer. Returning to Belgium, she enrolled in law school at the Catholic University of Leuven. In 1994, Stevens passed the bar examination in Brussels and became a certified lawyer. Two years later, Stevens became a project coordinator for the European Union of the Deaf (EUD) and later its president. In July 2007, the Flemish Parliament appointed Helga Stevens to the Senate as a Community Senator. She is the only deaf person who has entered the parliament chambers and also served as Senator. Consequently, Stevens has raised significantly the profile of the deaf community in Flanders, and all discussions in parliament are now signed.
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