"When you hear this kind of bird call, press the big red button," blurts a pair of headphones plugged into an iPad. Clayton is playing a game. He's attentive, smart, competitive, and keen to impress a teacher who he knows thinks he's dull. After completing a few challenges, he's now watching several birds flying across the screen -- but pressing nothing. Within a few days, Clayton sees an audiologist recommended by his short session with a videogame, and he gets treatment for an issue that would have severely set him back over the next few years. This is the vision of Sound Scouts.
cmee4 Productions is three people — Carolyn Mee as the producer, with developer Cuauh Moreno, and collaborating with Dr Harvey Dillon, Director of the National Acoustic Laboratories. They've been trying to weave together the tech, business, and scientific solutions for an app that catches hearing problems in young children before it seriously hinders their progress, and the result is Sound Scouts.
From left to right: Carolyn Mee, Cuauh Moreno, Dr Harvey Dillon
Coming in at five years, the project is now older than the minimum recommended age of their target audience — but it's soon expected to have a high impact for a low cost when it comes to improving the lives of Australian children. Not bad for before your sixth birthday.
We spoke to producer Carolyn Mee about the project, which is close to being released in a form she'll want to make noise about.
"The figures, year on year, show a peak in hearing aid fittings in kids between the ages of 5 and 8," said Carolyn Mee. "But kids don't get tested at that age. We test them at birth, but mainly for one type of hearing loss."
After that point, aside from some vigilant private schools and other programs, kids aren't tested again — and it only gets picked up when they start to do badly at school.
"They're vulnerable," says Mee. "Their speech is impacted. They're often put in the lowest reading group, the children assume they're dumb, and the impact on their self esteem is significant. You have to claw back that self esteem at the same time as catching up on reading."
According to the Senate's inquiry into hearing impairment in Australia, one in six nationwide suffer from some form of hearing loss, with that number forecasted to be one in four by 2050. And while a large portion of that is due to our aging population, one whole third of it is preventable.
That's why the inquiry is full of recommendations like this:
The committee recommends that the Commonwealth provide funding to expand services for hearing impaired children in rural and remote areas through e-technology based program such as that developed by the Royal Institute for Deaf and Blind Children.
Time to up our game
Sound Scouts is just the solution the Senate has asked for. An easily accessible program, in game form, to identify these problems as kids are entering their early school days.
Most similar software solutions at the moment are "tone detectors" which purely test for hearing loss, but not auditory processing disorder. Someone with that condition could be sent back out thinking their hearing is fine.
"They're missing half of what's happening on the playground, what's going on in the classroom, and they're being told they're okay." Aside from the obvious effect of falling behind in school, this can also cause kids to internalise the belief that they're just not that smart — and sometimes, those effects last until later in life.
Mee remembers having firewood delivered to her house by a bright and talkative young man, who admitted to dropping out of school. He said he just couldn't hear in the classroom. He described classic symptoms of auditory processing disorder, without having been told what Mee does for a living. "I told him to wait there while I got my game."
As you've probably guessed, the app identified a hearing problem — Central Auditory Processing Disorder (CAPD), which affects how the brain processes audio information. Funnily enough, the treatment for CAPD is a game which retrains the brain over 12 weeks to be able to separate sounds in a noisy environment.
"It will stay with me forever, how excited he was to discover that there was a reason."
That gives you an idea of how sneaky hearing disorders can be, with some going through life simply unaware, or worse, believing there's a problem with their intelligence.
In the case of otitis media - which can cause fluid to build up behind the eardrum until hearing is impacted - it can be hard to even know there's a problem because there's not always pain. But as Mee found out in the earlier stages of her career, sometimes the most dangerous conditions are when the sufferer isn't suffering.
Sound Scouting The Outback
I asked Carolyn Mee if her children were her inspiration for this project, but there aren't any hearing problems to be found there. "They're probably the most tested kids in Sydney," she jokes.
Her real inspiration was a man named Kelvin Kong, Australia's first Indigenous surgeon. Having heard about him in the capacity of a video producer, Mee visited Kong's when he was volunteering at a Broome-based clinic where he operated on the ears of adults and children.
"I spent five days with him in his clinic and saw all these gorgeous young kids coming in from all over. They have significant hearing loss, and suddenly they go from being very bright little kids to to becoming disengaged if their loss isn't treated.
"I was meeting 50 year old women whose eardrums had been burst or destroyed when they were kids, and they were having them repaired."
Otitis media is very prevalent in Indigenous and Pacific Islander communities. Children who suffer recurrent episodes are at risk of developing conductive and senorineural hearing loss.
"Sometimes the hearing loss is so endemic," says Mee, "that schools set up amplification systems where the teacher would speak into a microphone."
For those in rural Australia with less access to funds and treatment, the cost and accessibility of hearing tests becomes a life-changing issue. And while seeing an audiologist could run somewhere between $100-150, playing Sound Scouts will be closer to $15 — discounted to $9 for large groups such as schools.
With 285-300k kids coming into the relevant age range every year, that means testing with the app could cost $3 million annually, as opposed to $30 million. A small price to pay when the Senate's inquiry estimated that in 2005 the Australian economy lost $11.75 billion - or 1.4% of our GDP - due to hearing loss in the workforce.
So what's the plan?
Sound Scouts isn't aiming to replace audiologists or any kind of specialist, but its upcoming build will be able to identify hearing problems, and even discern between types like sensorineural & conductive loss and CAPD before referring the user to the proper kind of specialist and treatment. In the future, the app will leverage large sets of data to analyse how a user's performance stacks up with local norms — hearing patterns are different from place to place, making what's "normal" an important part of the science.
Around 50% of Australian homes have a tablet, but the accessibility of the app doesn't stop there. A secondary market for Sound Scouts is programs that can reach a large number of children. Schools are a perfect fit, as well as other youth programs and businesses. Some pharmacies are pushing into delivering health care screening solutions, and Mee points out that the larger ones even have their own rooms where you can get checked for various things.
But while an early version of Sound Scouts is out in the wild at the moment, the team is waiting a little longer before making its big PR push. There's the new build to work on, plus possible grant funding coming in, and on Friday it'll find out if it's the winner of the Samsung & Optus Regional App Challenge Pitchfest. Not that Sound Scouts isn't already decorated. It won the SimTect 2014 Serious Games Challenge, the Tech23 Digital Disruptor award, and was also selected for the Springboard Enterprises Accelerator Program.
I get the sense that Mee is a bit of a perfectionist with her tech, and doesn't want to shout from the rooftops until it's perfect. It's a curse many creatives suffer from, but there's a good reason for it here: She's putting the science first.
"Among many categories we technically fall under, one of them is 'tech startup'," she says, "and that community is all about bringing it out straight away. And of course, in the gaming world, your first week is what defines your success. I've had to set new standards, and establish new ways of doing things. What I've built is not the same as a casual game. It's a game, but it's a clinical application, and I can't say it'll test a kid's hearing unless I know it'll do that well."
Scouting the globe
Sound Scouts is well set up for Australia. Children's hearing aids are subsidised here, and there's a clearly identified problem with no universal testing solution. According to Mee, 3-5% of the country may have some level of CAPD, and a survey of parents has shown that the biggest barrier to getting kids tested is finding the hours around their work schedule, making a 15-minute app ideal.
But it's a solution that governments, businesses, schools, and parents all over the world will be interested in, and that kind of global scaling holds challenges for Sound Scouts' three person team.
Given part of Sound Scouts' business model is reaching out to programs that might use the app en masse, that means a hefty effort on the marketing and sales side. It's something that Australian hearing organisations are already excited about, but that groundwork has to be done anew overseas, and non-English speaking countries might not fully appreciate Mee's brilliant puns.
"Asia has been earmarked as the next big growth area for hearing problems over the next 5-6 years — if they can work out how to screen all the kids", she tells me.
Localisation isn't just a matter of getting the menus right, either. Language actually plays a key factor in how the brain interprets sound, and thus how Sound Scouts identifies brain-based hearing disorders — making it not just a UI or tech issue, but a scientific one.
While Sound Scouts is close to releasing a build with arguably its main dot point, it still has a long way to go in terms of changing the world. In the meantime, Carolyn Mee is regularly reminded of the potential success of the program.
"At a school dinner, one of the mums was talking about problems with her daughter. To me, they sounded like telltale signs. So we had the light bulb moment and got her to try the game. Sure enough, she failed the test, and was referred to an audiologist who confirmed a hearing problem."
The daughter then had surgery to insert grommets. Afterwards, she said, "Mummy, Daddy's voice is so loud!"
"The next time I see her," says Mee, "she's covering her ears because everything is so loud now. She'd had everything muted for her for the last two years!"
Our thanks to Carolyn Mee for taking the time to speak with us. You can find out more about Sound Scouts on its website.