It started with an accident on a spring afternoon. Five-year-old James Bateman and his twin, Edward, decided to climb into the barn at their home near Solihull. They were forbidden to go there but, egging each other on, they climbed the ladder into the loft. James lost his footing, though, and fell through a hatch, cracking his head on the concrete floor seven feet below.

His father Terence, now 55, remembers hearing a scream and seeing James running in with a bloody face. The injury obviously needed hospital attention: but while Terence, his wife Teresa, 40, and James waited to see a doctor, they noticed that his nose did not stop bleeding. His face was also swollen and he was screaming with pain: the family was surprised when a doctor told them, after x-rays, that they could go home.

"I wasn't confident," says Teresa. "At home he just wanted to go to bed. He had nosebleeds all through the night. At about seven o'clock in the morning, a nosebleed woke him up. I'd stripped the bed twice in the night, but this was much worse."

James's condition got steadily worse. His nose bled continually, and his head was unbearably painful. He couldn't eat. Clear fluid started streaming from his nose. When he started vomiting, his mother called the hospital. "His eyes were glassy. His whole face was swollen, and he was bruised and battered," she recalls. "He was going unconscious and then he would come to and scream. I've never heard anything like it. The worst thing of all was, he didn't know us. He had no idea who we were."

James was transferred to Birmingham children's hospital head injuries ward. For two days he lapsed in and out of consciousness, screaming and thrashing about. Teresa was at his side, where she was to remain for the next three months; and by the third day, she knew there was something else wrong. "He'd gone deaf," she says. "I just knew. He wasn't responding to anything."

At this point they did not know whether James's deafness was simply a result of the head injury, and would return as he recovered. Then they discovered that he had contracted meningitis through his broken nose, which could have caused the deafness. But it was not until the hospital carried out a brain stem test, over a week after the accident, that they got a prognosis: the consultant told Teresa and Terence that James was profoundly deaf, and would never hear again. "We were in shock, distraught," says Teresa. "To be told he would never hear again - you just can't take it in."

Three years on, Teresa says James's disability has changed the lives of everyone in her family. Not only Edward - who for a time blamed himself for his twin's fall - but sisters Isabel, 11, four-year-old Elizabeth and older brother Charles, 10, have had to get used to less attention as a result.

Terence and Teresa found themselves plunged into a nightmare of complications. James, they were told, needed a cochlear implant, a device that converts sounds into electrical impulses: but no sooner had they heard about the treatment than it was discovered that their son had suffered a rare reaction to his deafness, called labyrinthitis ossificans, which causes bone to grow within the cochlea. The ear was rapidly calcifying, and if it was left for too long, doctors would not be able to fit the device.

It was clear that the operation had to be performed immediately, but this type of implant is still somewhat controversial, and the Batemans were faced with intransigence from the NHS, who would not do a double implant, and from Bupa, who judged the procedure "cosmetic". "I hit a brick wall," says Terence. " They told me it couldn't be done."

The family's solicitor, Sara Burns of Irwin Mitchell, explains that it was never possible to establish the exact cause of James's deafness. Doctors treating James also had contradictory views. One consultant told the Batemans that James's hearing would come back naturally, another said he would be profoundly deaf. His parents were stuck in the middle. Teresa went into action, amassing all the information she could, while Terence telephoned specialists all over the world for advice.

As time was ticking by, Terence contacted his MP. "Three days later we got the go-ahead from the NHS, and the same day, Bupa rang and apologised, and said they would cover it. James had the nine-hour operation almost immediately. It was another few weeks before the implants were activated, and then he had to learn to interpret the electronic signal. At first he hated his new 'ears'." Teresa remembers: "When they were first turned on, he screamed, kicked, took them off and threw them at us."

By this stage James's speech had deteriorated to the point where only Teresa could understand him. They drew pictures, and Teresa's sister made a booklet full of images. When Teresa and a therapist started teaching James to interpret the electronic signals, he cried and threw tantrums. It took three months for him to understand and respond. Three years on, James's speech is very good. Teresa is convinced he was helped by being bilingual: she has brought up all the children to speak Italian. "He already had access to that part of the brain used in translation," says his mother. "Learning to understand the bleeps was like learning another language. Now he can understand words, even difficult ones. He's even doing well in Italian."

It was six months after the fall before James could walk, and he still uses a wheelchair for longer trips. Problems with mobility and balance have been overcome with continual effort. "They told me he would never swim or ride a bike again, but I had to make a point of treating him the same as the others," she says.

But the biggest fallout from the accident has been a change in James's behaviour. He is frightened to take off his "ears" at night, and Teresa stays with him until he goes to sleep. "We had six months of screaming, kicking, all of us crying," she says. "He won't switch off. He can't stand any light, so we all have to be in total darkness."

James is still angry about what happened, and is prone to tantrums. He is capable of smashing up a room, and no longer has a sense of his own strength. "When he wants to do something, he just does it," says Teresa. "He doesn't understand the consequences."

After being the best of friends, James and his twin barely spoke for a long time. Recently, they have started talking about the accident, and they are inseparable once again. "Partners in crime," says Teresa.

Terence admits he has sometimes found life difficult since James's accident. "I fell apart for a while. Probably because they were twins, we tended to idolise them. I'd always thought that to have an imperfect child would be really horrid. Now I'm really tolerant of it."

Teresa is proud of the way her children have learned to cope with a disabled sibling. The two oldest recently sold some toys in aid of a deaf charity, and have a much better understanding of disability. "It is the only good thing that's come out of this," she says.