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									My Best Friend or My
 Worst Nightmare?
Collaboration to manage hearing
        EHDI Conference
         March 4, 2005
          Atlanta, GA

• Presented by:
• Jan Stroud, M.S., CCC-A
• Tracy Pate, M.S., CCC-SLP, Cert. AVT
        Don‟t forget!
• Please sign up for a handout
  delivered through email.
• We are talking specifically about children
  having severe to profound hearing loss.
• Parents have actively chosen to use
  technology to access residual hearing.
• Parents have chosen to teach their
  children oral communication.
• Presumptions are based on our
  professional experiences, which may be
  different than your own.
Why this title?
   Where do we start?
• It‟s like building a house…..
     *Parents are the foundation
     *Audiologists are the walls & roof
           (External structures)
     *Early Interventionists are the
     internal structures that make the
     house work.
• Need foundations to build the house
• There are different types of
  foundations, but most types are equally
• Should family differences change
  recommendations and information
• Don‟t deprive parents of their

• Walls, roof (external structures)
• Effective audiological management is
  the starting place in this process.
• Weak link could be based on
  experience and/or skill set.
 Physical Barriers to Sound
1. Medical complications
    •   Otitis media (in various forms)
         Potential conductive hearing loss in addition
           to sensori-neural hearing loss
         Chronic condition can have negative effects
           on development and well being
        What can we control/not control?
        1. Frequent tympanometry to monitor middle
           ear status
        2. Vent in earmold
        3. Referral to a good ENT physician
        4. Referral to allergist/other medical
Physical Barriers to Sound

2. Inconsistent hearing aid use
  Parent acceptance of diagnosis
    Do they believe you? Do they REALLY
   understand what hearing loss is? Do they
   believe that technology will help the situation?
   Do they believe technology will cure the
  Family dynamics
    Parent/child bonding; parent/child interaction;
   marital dynamics
 Parents need to understand why it is
   so important. Explain auditory brain
  development to them.
 Parents should actively choose a plan
   to accomplish this goal.
 Provide them with options or ideas to
   help the process along, BUT don‟t let
   them forget the goal.
Incentive + Means + Reinforcement =

   Goal accomplished!
     Early Intervention
• They are the internal structures of
  the house.
• These structures are necessary to
  turn the house you are building into a
  functioning home.
• Functional listening skills = auditory
  brain development
    Who teaches what?
• How to read an audiogram, how we
  hear, how we learn to communicate, &
  the value of technology
• Sound awareness
• Function/care/maintenance of
• Concepts of listening age versus
  chronological age versus language age
Don‟t overstep your bounds!
• Parents often „shop‟ for information in the
• Realize that parents often tell the wrong
  person what they are concerned about (I.e.
  tell early interventionist that they don‟t
  think that the earmolds fit correctly).
• Refer back to the person who is primarily
  responsible for final „say-so‟.
• It‟s okay to say “I don‟t know” BUT it
  should always be followed with “I will help
  you find the answer”.
  Collaboration barriers
• Same level of seriousness conveyed
  to the parents.
• Understanding the big picture.
• Issues with “too much knowledge”
  outside our field. Role releasal is
  fine, BUT don‟t take it too far.
• Undermining other professional‟s
  validity (not intentionally)
Jan Stroud or Tracy Pate
Arkansas Children‟s Hospital
800 Marshall Street, Slot #113
Little Rock, AR 72202
(501) 364-4319

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