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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
[email protected]
[email protected]