History of Audiology
Summarized and translated from Verstraete, 2016.
History of Education and Rehabilitation of Deaf Children in Belgium
The so-called ‘Institute for deaf girls' in Ghent, the first Belgian school for deaf girls from 10 to 18 years, was founded in 1820 by Canon Triest (1760-1836). He sent a novice to Paris to study and learn the method of Abbé de l'Epee (sign language).
In 1867, David Hirsch (Rotterdam, the Netherlands) taught the novices the German Method, based on articulation and lip-reading.
In 1868, the Mixed Method was introduced, which combined sign language and speech.
Later, the institute became convinced that the oral method had the most benefits in educating deaf children (1881).
In the early years of the 20th century, oral education majorly improved by the introduction of the Belgian method (Alexandre Herlin). This method was inspired by the educational principles of Ovide Decroly and was the ground for the elaboration of the ‘Reflective Native Language Method’ by priest-psychologist Antoon van Uden. The Belgian method is a global method, in which words, sentences and conversations are the baseline. The long and tedious, analytical and alphabetical exercises were abolished.
With the installation of the 'radio' (an amplifier and a connection microphone combined with various helmets) in 1936, a new era had begun; it meant the introduction of an aural component in oral education.
As quoted above, from 1947 to 1966, the ‘Reflective Native Language Method’ of Antoon van Uden was used. The method is based on the everyday language and tries to combine it with learning language rules.
Mid ‘50’s, a kindergarten for deaf boys and girls and an institute for higher economic education for the deaf was founded.
In 1965 the 'Laboratory for Voice, Speech and Language Research ' was founded, but in 1968, it transformed into a rehabilitation center.
Meanwhile, the verbotonal method by linguist Petar Guberina (Zagreb, Yugoslavia) made its introduction in Flanders. This method starts from the optimal hearing spectrum and the reinforcement of the residual hearing of the child. Perception encourages speech, hearing is the basic condition for speech. The verbotonal method includes four disciplines: individual therapy with hearing training and speech and language development, corporal rhythm, musical rhythm and group therapy with audiovisual and structuroglobal components.
In the late ‘60’s, kindergartens and elementary schools for deaf children were established, (sometimes) combined with (semi) boarding schools; in the early ‘70’s day nurseries with a mix of deaf and hearing babies were opened.
Different rapid successive evolutions can be determined in the following years:
- Good audiometry lead to better diagnostics, which resulted in the differentiation between ‘hearing impaired’ and ‘deaf’.
- Class amplification systems were introduced in 1966, FM systems in 1974.
- In 1979, the Ministry of Education introduced the first integration project for deaf children in the regular educational system.
- A universal early hearing screening of babies or toddlers between 9 and 13 months was installed in 1980. Initially, the distraction-test (based on the orientation reflex on familiar sounds), also known as Ewing's test, was used. Since 1998 ‘Child and Family uses the highly reliable AABR-test, in the first 4 to 5 weeks after birth. A successful structured follow-up system is in place.
These developments, the early screening and rehabilitation, the use of the wireless FM equipment and the integration projects, stimulated school integration of deaf and hearing-impaired children. In different rehabilitation centers (geographically spread) aural rehabilitation was offered, completed with an offer of parental and environmental guidance and counseling.
History of Sound Amplification and Hearing Aids in Belgium
In the 19th century, mechanical hearing aids such as the horn were ‘sold’ on the Belgian market. At the beginning of the 20th Century carbon microphones were introduced. In the post-war year 1947, the transistor was invented, a revolutionary step in hearing aid technology. Mid-1960, body-worn hearing aids made an entry. A milestone in the evolution of the use of hearing aids was the use of FM.
From that moment on, remarkable and steady improvements in the sound reinforcement and hearing aid technology were visible: developments in the miniaturization, digital techniques (from 1988), evolution in fitting possibilities, in signal processing, the CROS-fittings, open fits, developments of the aesthetics of hearing aids and other aids, cochlear (1988) and other implants, Bluetooth, evolution of hearing aids to hearing solutions, etc. The adaptation of hearing aids and other assistive listening devices is much more than just a technical adjustment. This is seen as a part of a comprehensive approach, in relation to the individual and environment-oriented aspects of the person with a hearing loss.
History of Medical Audiology in Belgium
Medical Audiology (hearing and balance) knew the same rapid and continuous evolution as the hearing aid technology, in subjective and semi-objective techniques, as well as in objective audiometry.
History of the Education / Profession of the Audiologist in Belgium
Throughout the years, the role of the audiologist changed and expanded. Nowadays, the audiologist is the health care professional who works in prevention of and screening for noise induced hearing loss (NIHL), clinical/diagnostic audiology, hearing aid and cochlear implant fitting, rehabilitation and tinnitus management.
Hearing Loss Incidence and Prevalence
Unfortunately, there are no clear general figures on the incidence and prevalence of hearing loss in Belgium. There are only general estimations of hearing loss in Belgium.
Based on the most recent numbers within the EuroTrak studies (EuroTrak Belgium, 2017), the prevalence of self-reported hearing loss in Belgium is 9.6% or 1.10 million citizens. Table 2 shows an increase in the prevalence numbers from 2.3% in the youngest age group (< 15 years) up to 33.7% in the oldest age group (>74 years).
Congenital hearing loss
Kind en Gezin (Child and Family) is a governmental agency that works actively in the 'Public Health, Welfare and Family’ policy area. This Flemish agency focuses on preventive treatment and guidance of young children, until school-age, geared to good outcomes in the future. This agency is, among other, responsible for the newborn hearing screening. Table 3 shows that in 2017, unilateral or bilateral congenital hearing loss was determined in 1.88 of 1,000 newborns.
The Joint Report of The European Associations AEA, EFHOH and EHIMA (Laureyns et al., 2020) shows that the uptake of hearing aids by the Belgian people with self-reported hearing problems in 2017 was 30.7%, which was a little less than the European average of 33%. In 2019, the uptake in Belgium increased to 32.6%. These numbers are based on the refund of hearing aids in Belgium by the National Institute of Sickness and Disability Insurance.
The growth potential in selling hearing aids remains relatively high, considering that the Belgian population grows older and the demand for a hearing aid increases with age (Hoorapparaten, 2018).