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90 per cent of deaf children are born into hearing families.

One-year-old Knox Duhau was diagnosed with profound hearing loss at just eight days old. The diagnosis came as a shock to mum Shanie and dad Andy as there was no history of deafness in the family. It was later discovered that Knox was born with Congenital Cytomegalovirus (CCMV), an infection that can cause a range of health risks for unborn babies, which caused his hearing loss.

“It was a very difficult time for us, coming to terms with it all and not knowing what the future looked like,” explained Shanie.

After a number of consultations at The Royal Victorian Eye and Ear Hospital’s Cochlear Implant Clinic, Knox received bilateral cochlear implants in November 2021 via Ear Nose and Throat (ENT) surgeon Dr Claire Iseli.

Baby Knox held by mum Shanie smiling at the camera
Baby Knox with Mum Shanie

Knox has now recovered from surgery and has been working hard on adapting to wearing his implants. Shanie, started an Instagram page, @_hearknox, to document Knox’s journey, connecting with a community of families going through a similar experience and quickly realised the importance of Auslan to best support Knox’s communication.

Dr Iseli explains:

I regularly encourage families to consider a bilingual approach to their hearing-impaired children, so they can have the best of both worlds.”

Currently, Knox comes into the Eye and Ear Cochlear Implant Clinic regularly for a check-up on his implants and for a therapy session with his speech pathologist, Cassandra Ramanathan.

“Our role in the cochlear implant journey for young patients like Knox is firstly, that we are often the first people the family are in contact with, we explain what a cochlear implant is, the benefits, assessment process and communication goals for the family – including the use of Auslan. We also act as a case manager in their journey up until the child is around 5-years-old. Which provides them with wonderful continuity of care,” said Cassandra.

“During our sessions we work predominantly on listening and language using child-led therapy, giving Shanie and Andy strategies to use at home,” said Cassandra.

Cassandra also has a Diploma in Auslan and uses it to support her practice as a speech pathologist.

“Cassandra and Dr Iseli were amazing and were very supportive of our decision to be a bilingual family, we’re really lucky to have them both at the Eye and Ear,” said Shanie.

The family have just completed their level 2 Auslan lessons and are now starting level 3 classes which will focus on more conversational Auslan.

“As we learn more about the outcomes of young cochlear implant patients, our practice evolves. Auslan is a rich and important language for our patients and by combining Auslan with the teaching of oral language in the early years, our patients receive a complete spectrum of communication. While it is critical for them to hear the oral words in the first few years of life if they hope to use oral language later in life, there is no negative impact for the child in also using the sign equivalent and it has the potential to connect them more strongly with our wonderful deaf community,” said Dr Iseli.

Cochlear Implant mapping appointment with Knox, Shanie, Cassandra and Jaime
Baby Knox, Mum Shanie, Speech Pathologist Cassandra and Audiologist Jaime in cochlear implant mapping appointment

Knox, his older brothers Nate (5) and Aston (3), and his parents have been learning Auslan for nearly a year, and even their new puppy Aisha has joined in, already responding to sign for ‘sit’, ‘come’ and ‘bed.’

“Even with his implants, there are many scenarios where he won’t be in an ideal situation to access quality sound or any at all, like the bath or shower, at the beach or in the pool, at the park or in a noisy restaurant, this is why it is important for us to learn Auslan and become a bilingual family,” explained Shanie.

For the Sunbury-based family, building a community of support around them has been an integral part of Knox’s progress. When Shanie and Andy’s family and friends heard of his diagnosis, they jumped at the chance to learn Auslan.

“It really takes a village! We had about 25 friends and family complete Level 1 Auslan remotely during lockdown last year. Auslan is such a beautiful and expressive language. At Knox’s first birthday celebration everyone there was able to sign happy birthday to him. It was so special, I’ve never seen him so engaged,” said Shanie.

Video credit: Channel Nine News

For media enquiries please contact

Clara Devlin
Media and Communications Coordinator
The Royal Victorian Eye and Ear Hospital
0412 887 170