If you provide services to families in the home or via teletherapy, you have the advantage of helping them apply AV techniques to their natural environments in real time. But that’s not always possible. How can center-based clinicians or teachers make what they do with families “translate” once the families leave their clinic or school? How can we make center-based services realistic for parents?
Life is BUSY! While it’s fun to read books and play with games and toys in therapy, implementing these activities at home can sometimes seem challenging for families who don’t have a lot of extra time. If you’re a therapist who does home visits, you may even run into a situation where parents feel they “don’t have time” to participate in your sessions and have to use the time to catch up on chores while you interact with their child. How can we make this work?
Imagine you are working on a big carpentry project (this will be more of a stretch for some of us than others!). What would be more helpful to you? A person handing you just one nail at the right time, but nothing else, or a person who gives you a whole toolbox from which to choose after first showing you how to use each tool? Kind of obvious, right? A nail helps you in this minute. It gets the job done but nothing more. A toolbox, on the other hand, has infinite uses and gives you more control (you’re not waiting for someone to hand you the next nail). Coaching parents is much the same.
Hearing loss is a neurological emergency. If parents choose a listening and spoken language outcome for their child, time is of the essence, and the to-do list is immense: get a full audiological evaluation, fit hearing technology, aggressively manage that technology to make sure it’s doing what it should, make sure the child wears the technology all waking hours, find a good Auditory Verbal Therapist, attend therapy, talk talk talk, read read read, sing sing sing, advocate, fight with insurance, learn a bunch of new jargon, talkreadsing some more… and, oh, don’t forget all of the other responsibilities of your life, either. They’re still there, waiting for you at the end of the day when you’re exhausted and never want to talk, read, OR sing another word in your life.
When I coach other professionals, I tell them to work smarter, not harder! I like to pick just one book and make it work for ALL of the children I see in a week. My schedule is filled with listeners of all different ages, developmental levels, and needs, but with some creative thinking, you can take a classic story like Goldilocks and the Three Bears and find a gold mine of goals inside. Here are THIRTY ways to make the Three Bears work for (nearly) everyone on your caseload.
Nutritionists advise diners to think about building a “balanced plate” of proteins, carbohydrates, fruits, and vegetables for every meal. Eating too much of one thing isn’t good for your health! An Auditory Verbal session can be imagined in the same way. Too much focus on one type of goal or activity doesn’t help children achieve the well-rounded communicative competence that we want them to have. So, how do you build a balanced plate in an AV session?
When I first started as a therapist, I felt like every minute of the session had to be filled with chatter… and that chatter usually ended up being mine. I assumed that any “dead air” would make the parents think that I was being lazy, or wasn’t doing my job, or didn’t plan enough for the session. Big mistake! In those first years, I missed so many opportunities to just wait it out. I jumped in before even giving the child a chance to breathe, let alone respond. In fact, it’s almost impossible to OVERestimate the amount of processing time a child needs.
This is a common question (more like agonized wail) I hear from parents, both in person and online. You go through the entire process of CI candidacy and surgery, and then… the child doesn’t want to (or just plain won’t) wear the cochlear implant processor. Where do we go from here!?!
Acoustic highlighting is a key strategy in Auditory Verbal Therapy. By changing the way that we present verbal information (for example, adding emphasis, repetition, or intonation), we can help children tune in to specific aspects of the signal, such as a new word or missed speech sound. There are many different ways to acoustically highlight, but don’t fall into the trap of thinking they’re all equally good in every situation. Just as you carefully choose colors to fill in a coloring page, be careful to choose the right highlighter for the job. Learning that acoustic highlighting exists is just step one. Here are some thoughts on how to take your highlighting skills to the next level!
While learning to listen and speak is possible for many children who have hearing loss, there are some children who, for reasons of additional disabilities or other complicating conditions, can learn to listen with technology but may struggle to produce spoken language. What choices should parents and professionals consider when deciding how to best help these children? Below, I’ll discuss two case studies of children in this situation and some factors to consider when planning intervention.