August 20, 2015.
By: Shefali Shah
It is with great pleasure that I write this month’s blog, as it is a topic that has been suggested by a parent at Sound Steps. This makes it so much more imperative because he has identified this as an area that needs to be explained to new families as they begin their journey with their baby and hearing. I have written this blog in simple non-technical language, so as to help you better understand the path that you have chosen.
Ninety percent of children with hearing loss are born to parents with normal hearing. Most parents want to raise their baby with hearing loss to listen and talk like other children of the same age because spoken language is the mode of communication for these families.
Given that age-appropriate spoken language skills is the goal, it follows then that the early and appropriate fitting of modern hearing devices (hearing aids or cochlear implants) must be the priority.This is the work of an audiologist. However the audiologist does not work in isolation. The ultimate benchmark is the child’s level of functioning, with effective amplification. An LSLS professional is uniquely trained in Auditory-Verbal Therapy to stimulate, monitor and assess your child’s development via listening alone and to guide you in the areas of audition (or listening), language (that which the child both understands and expresses himself in), cognition (or thinking), speech and communication. Therefore, the areas of work of both audiologist and LSLS professional are mutually supportive. Both need to collaborate closely in order to deliver best outcomes to your baby or young child with hearing loss and to you: the family.
The audiologist will measure and then manage the child’s hearing loss, recommending hearing aids best suited to your child’s hearing loss and will set the hearing aids at levels that will allow your child to access spoken language optimally. The aim of hearing aid fitting is to ensure that the child detects and is guided to understand as much of spoken language as the hearing aid technology allows. It is the work of the therapist to observe, record and guide your observation so that together, you understand to what extent the child is benefitting from hearing aids. All this is achieved based on diagnostic information of how the child functions at home, in social gatherings, in therapy and in class. The litmus test is in everyday living and how your child is functioning in “real time”.
Based on this information, audiologist and therapist discuss together with you the need for cochlear implantation. Once cochlear implanted, the collaboration continues, to ensure that your child is actually accessing in terms of his or her listening behaviour, the hearing potential that the audiologist has set the processor at. As formal and speech perception assessments continue in audiology, the therapist works with you and the audiologist, as they cross-check that your child’s spoken language development and behaviour reflect what “the hardware” has provided in audiology. Similarly, the therapist is constantly monitoring your child’s development to see if it is in tandem with the audiological settings. The formal assessments done in therapy also help provide critical information on how much your child understands of this enhanced access and applies to everyday conversational skills. E.g. The therapist may observe that the child’s responses to the sounds /u/ and /i/ are inconsistent; you support this observation and togther discuss and schedule a MAPping appointment that will address this perception. The audioligist will measure and record her findings in audiology while you and the therapist observe the child to see if the changes made reflect in your child’s improved perception of these sounds. As the collaboration and fine tuning continues, your child achieves an optimal, age-appropriate level of functioning. As your child’s development stabilises and is consistently corroborated by feedback from you and school teachers alike, as well as from the resuts of formal assessments administered by the therapist, you and your child graduate from the early intervention service. On-going audiology will continue to monitor your child’s hearing levels on an annual basis.
It is the experience and skills of this professional collaboration and the all-embracing support of your family, that makes your baby with hearing loss’ transition to learning, listening and talking fun, timely and seamless.