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The Texas Speech-Language-Hearing Association(TSHA — pronounced “tish-uh”) publishes a monthly newsletter, “The Communicologist”, and last month’s issue (August 2008) featured an article about EaR Booksand Ellie’s Ears! Here is the article, reprinted in full, below:
Senior TCU Student Authors Book Entitled Ellie’s Ears
You never know what experiences will shape your future. For Elizabeth Boschini, a senior speech pathology major at Texas Christian University, it was knowing a fellow student in her fifth grade classroom who was deaf. The relationship with this student started Elizabeth toward her goal of becoming a speech-language pathologist who will work with children with cochlear implants. She also plans to become a Certified Auditory-Verbal Therapist® post graduation.
This focused student has already found a creative way to start helping the clients she is learning to work with. She has authored a book, Ellie’s Ears, about an 8-year-old deaf girl with bilateral cochlear implants.Elizabeth and the book’s illustrator, Rachel Chaikof, have been friends for years, having met through the Alexander Graham Bell Association for the Deaf and Hard of Hearing group on Facebook. Initially, Elizabeth was going to write the book and try to illustrate it herself. Rachel, a bilateral cochlear implant user and a photography major at Savannah College of Art and Design, quickly joined her friend’s project by helping with the art. The result is a wonderful book in which Ellie discusses her journey to a cochlear implant (CI), including the use of hearing aids and discussions about the different modes of communication. Many of the scenarios are based on Rachel’s personal experiences as a CI user.
The illustrations showing Ellie with her implants fill a void for children with CIs who now have someone in a book who looks “just like them.” Readers will love seeing Ellie with her pigtails! The author hopes that the book will be used by parents, doctors, educators, and others to help demystify CIs and inform the public about the process. Elizabeth would love to see the book in pediatricians’ offices, hospitals, schools, and libraries all over the country.
What started out as a single idea continues to evolve. Elizabeth and Rachel are planning to write more books that will target children with hearing loss and with cochlear implants. Their next project is already underway. It is titled Happy Birthday to My Earswith a target audience of children birth to 5 years of age. This book will focus on the first year of hearing after a little boy receives his cochlear implants. Boschini and Chaikof are also among the creators of the website Deaf Village(www.deafvillage.com), an aggregator of hearing loss related blogs from around the world.
Elizabeth and Rachel are not profiting from their book sales. All proceeds are donated back to organizations that benefit children with hearing loss. The book, Ellie’s Ears, is available for purchase online at http://stores.lulu.com/earbooks. The author and illustrator also maintain a webpage and blog called Cochlear Implant Online (www.cochlearimplantonline.com).
On Monday September 1, 2008, THISarticle appeared in the New York Daily News. Apparently, the U.S. Tennis Association donated tons of old tennis balls to help cover chair legs in a 4-year-old CI user’s mainstream classroom. Pretty cool*.
Classroom acoustics are an important part of helping deaf student succeed in the mainstream. While the easy to clean tile floors and large open spaces of most elementary school classrooms make them ideal for the messy, experiential learning that is so crucial to development in the first few years of school, they also add up to an acoustic nightmare for a student with impaired hearing. Even a 15-20 dB loss (as quiet as leaves rustling!) can have significant educational impact. How can you help?
First of all, these suggestions are worth NOTHING without properly working equipment. There is no substitute for well-maintained and well-programmed hearing aid(s) and/or well-maintained and well-mapped cochlear implant(s).
An FM or Soundfield system can help amplify the speech of teachers and classmates, bringing it louder and clearer and CLOSER to the student with hearing loss. FMs and Soundfields help to give students a more favorable Signal to Noise Ratio — that is, the signal (teacher’s voice) is amplified louder than the noise (background sounds in the classroom), making it easier for a student to listen to important information.
Decrease the reverberation and distortion of sound bouncing off of floors and walls by adding rugs, tennis balls, sound panels, cork boards, etc. to absorb sound around the room.
Be mindful of the physical location of the classroom within the building — is it next to the boiler, water heater, or air conditiong unit? Does it overlook the playground, or back up to the gym?
In a mainstream environment, especially for younger children, who cannot yet read directions independently, children need to be able to LISTEN to LEARN, so these modifications are very important. However, it is also important for children to learn how to self-advocate and “make do” in difficult listening situations — these will, inevitably, be a part of their lives. My philosophy? For school, make every acoustic accommodation necessary – you ability to “make do” with a less-than-perfect auditory signal isn’t worth a thing if you never learn to read! For the rest of life, however, strike a balance between optimizing conditions vs. optimizing the child’s RESPONSE to conditions that are less than ideal – that way, they will be equipped to deal with whatever comes their way.
*NOTE: There is one inaccuracy in this article. The article states that, “[T]he [cochlear implant] device cannot distinguish between background or foreground noise”. This is not true. The Cochlear Freedomprocessor has multiple microphones to gather sound input from both in front of and behind the user. There are programming strategies that change the input ratio between the microphones to help optimize hearing in background noise. For example, the SmartSound Focus program increases the ratio of the front microphone (focusing in on the speaker, in front of you) and decreases the input of the back microphone (decreasing the impact of background noise all around you). This does not mean that classroom acoustics are unimportant, but it is also important to know that CI processors and programming strategies ARE designed to help with this common hearing problem.
To learn more and read about sound processing strategies…
COCHLEAR: SmartSound 2 processing strategies, interactive demonstrations, and videos HERE
MED-EL: Opus speech processor’s “Automatic Sound Management” system HERE
Many, many digital hearing aids also have dual microphones now and programs to provide similar benefits in background noise. There are way too many types of hearing aids to list here, but be sure to talk to your audiologist — you, or your child, might already have this capability on the hearing aids you are wearing right now!
I’m currently traveling throughout Europe and am taking a long break from blogging on CI Online, but I need to pop in to talk about a book that I read while relaxing on the beach and riding on trains. Lea Watson, an Auditory-Verbal therapist in Glouchester, Massachusetts, recommended a book to me called, Reluctant Genius: The Passionate Life and Inventive Mind of Alexander Graham Bell by Charlotte Gray.This one big heavy book, which has over 400 pages, is packed full of incredible information about this man and the history when Bell lived. The sources are very well cited by the author, and, thus, the information is very accurate. It was very important for me to read some books on Bell because I’d like to understand why the organization, Alexander Graham Bell Association for the Deaf and Hard of Hearing {AGBell} was named after this man, and also, I’ve been hearing throughout the internet that Bell believed in eugenics of the deaf community which did not make sense to me because AGBell would not have named its organization after him. From my reading, I could not find any evidence that he was a eugenecist.
I’d like to point out some fascinating facts that I’ve learned about him:
Bell’s mother was deaf. He communicated with her using the two-handed manual alphabet.
Bell was very unsure if the oral language was appropriate for all deaf children: Here is a quote by Bell enclosed in the book: “It makes my very heart ache to see the difficulties the little children have to contend with on account of the prejudice of their teachers. You know that here all communication is strictly with the mouth…and just fancy little children who have no idea of speech being made dependent on lip-reading for almost every idea that enters their heads. Of course their mental development is slow. It is a wonder to me that they progress at all.”
Bell invented the “glove alphabet”, another visual communication method.
Bell’s father was the one who was against the idea of sign language simply because he wanted to promote Visible Speech, an oral method to teach the deaf. Here’s the excerpt from the book:
“At Hartford, Alec began to see the potential of sign language, alongside lip-reading, as a teaching tool. He mentioned to his father, in a letter that he was learning sign language. Melville was furious, and the next letter that Alec received from Brantford included a scolding Melville wanted Alec to promote the Visible Speech gospel, and its use in deaf education was, in its inventor’s view, only one of its many applications.”
Mabel Hubbard, Bell’s wife, was deaf and raised with the oral approach. Hubbard’s father advocated for the oral approach to be included as ANOTHER OPTION for deaf people. In the early 1800’s, when Hubbard was growing up, the oral approach did NOT exist in the United States. Thus, Hubbard and her family had to live in Europe for a few years so that she could go to a school that specialized in teaching her lip-reading. Because her father did not want other families to have to move to Europe, he advocated to add the oral approach in the United States.
Bell felt that the lip-reading method was a valuable option because deaf children who were able to learn to lip-read could participate fully in the hearing world. He did not want deaf people to be isolated.
Bell was against sending deaf children to RESIDENTIAL schools. He wanted to HELP deaf children to be part of mainstream society.
When Bell first met Helen Keller when she was a little girl, he contacted Edward Gallaudet to figure out TOGETHER how to help with Keller’s issues. Bell and Gallaudet had a very respectful and friendly relationship when they were younger.
Bell was awarded an honorary degree from Columbia Institution of the Deaf and Dumb, an old name for Gallaudet University.
In the late 1890’s, Bell’s relationship with Gallaudet deteriorated due to their differing viewpoints on deaf education. Bell did not like Gallaudet’s idea, which was to teach deaf children sign language, send them to residential schools, and be taught by deaf teachers. He felt that this idea was isolating the deaf children from mainstream society. He wanted deaf children to learn how to be part of mainstream society. He basically wanted to give all of them the opportunity to be PART of the “hearing circle.”
Get your planners out! Here are some great upcoming events for parents and professionals interested in teaching deaf children how to listen and speak. Information is listen below, with my comments in italics.
October 3, 2008 ($150) “Stategies for Teachers of Mainstreamed Deaf and Hard-of-Hearing Students”
(for mainstream teachers who have a deaf or hard of hearing student in their classroom) Learn effective strategies to work with D/HOH students in mainstream school settings. Topics include: hearing loss and its effects on language, academic difficulties, assistive listening devices, and support services.
Elizabeth’s Note: Many school districts have some discretionary funding for professional education for their teachers. See if your deaf child’s mainstream teacher could use some of that money to attend this workshop! The Moog Center has been doing mainstream consulting, and doing it very well, for a long time — they have great tools and suggestions to help mainstream teachers work well with D/HOH students.
October 16-18, 2008 ($350) “Accelerating Spoken Language Development for Deaf and Hard-of-Hearing Students”
(for teachers and Speech-Language Pathologists) This workshop focuses on teaching strategies and techniques for spoken language development in D/HOH children from three to eight years of age. Topics include: assessment, appropriate goal selection, and activities. CEUs are available.
October 23-24, 2008 ($350) “Audiologic ABCs for 1, 2, 3s and More”
(for pediatric audiologists for work with infants and toddlers) This workshop will discuss audiologic diagnosis and management in the context of early intervention and will present methods of monitoring the auditory skill development to help infants and toddlers build a strong auditory foundation for learning to listen and talk. There will be live demonstrations, videotapes, and presentations of relevant case studies. CEUs available.
Elizabeth’s Note: Ditto the discretionary funding for audiologists — especially those in EI programs and/or public school settings!
January 22-24. 2009 ($350) “Pediatric Cochlear Implant Programming”
(for cochlear implant audiologists who work with infants and children) This workshop will focus on cochlear implant programming techniques to optimize access to sound for infants and young children. Protocols for monitoring progress in children at various developmental levels will be discussed. This workshop is interactive, with live demonstrations, relevant case studies, and videotaped examples. Seating is limited. CEUs available.
Elizabeth’s Note: The first cochlear implant mapping I ever saw was at The Moog Center, so I never realized how fantastic their program is until I experienced many other pediatric audiological practices. The right map is CRUCIAL for children with CIs, but, when doing anything with very young children — it’s a tricky blend of art and science, and the audiolgists and Moog have it down pat! Highly recommended.)
February 19-21, 2009 ($350) “The Earlier They Get Started, The Faster They Learn To Talk”
(for teachers and SLPs providing early intervention services to children with hearing loss) This workshop will focus on techniques for helping parents work with their own children as well as strategies for professionals working with very young children to develop spoken language skills. CEUs available.
July 15-19, 2009 “Helping Your Child Learn To Talk”
(for parents of D/HOH children ages 2-5) Parents will learn strategies to help their children learn to talk and children will receive daily individualized instruction from members of the Moog Center staff. Each day will be packed with activities for the children and information for the parents. Children over the age of 3 may receive speech and language evaluations for an additional fee.
Elizabeth’s Note: A great price for a 4 day workshop WITH childcare included… and not just any childcare, but childcare provided by professionals in the field of listening and spoken language. A great opportunity, especially for families in areas where listening and spoken language services are scarce, to get a “jump start” on what you can do to help your child learn to listen and talk.
Get your planners out! Here is a great upcoming event for parents and professionals interested in teaching deaf children how to listen and speak. Information is listen below, with my comments in italics.
“Play It By Ear!”: Intervention for children with hearing loss to develop spoken language. Presented by Teresa H. Caraway, Ph.D., CCC-SLP, LSLS Cert. AVT, Joanna T. Smith, MS, CCC-SLP, LSLS Cert. AVT, and JAce Wolf, Ph.D., CCC-A from Hearts for Hearingin Oklahoma City, Oklahoma will present on the following topics:
Protocol for audiological management of children with hearing loss
Fitting hearing aids (as young as 2 weeks of age!) bilateral cochlear implantation, children with auditory dysynchrony and other complications
Strategies and intervention techniques to develop auditory skills from detection to conversation
Videotape segments to demonstrate strategies at various auditory skill levels (babies through preschoolers)
Using children’s literature to facilitate development of conversational abilities
How to facilitate auditory skill development and spoken language development to help children with hearing loss become engaging conversationalists
Elizabeth’s Note: Becoming a good conversationalist is a hard skill to develop — even for hearing people! Spontaneous conversation, with anyone, at any time, is the highest level of language use. This is our goal for deaf children in the listening and spoken language approach, so this presentation will be an excellent way to learn techniques to facilitate this upper-level skill. Also, what a great gift it is to give deaf children the ability to be witty, engaging conversationalists — a skill that will serve them well throughout their lives and help them to overcome others’ biases and perceptions.
This workshop is FREE for parents of children who are deaf or hard of hearing. Professional registration is $95 before September 2nd, $130 after. Groups (3 or more people) are $80/each before September 2nd, $115 after. Undergraduate, graduate, and doctoral students in audiology, speech pathology, and deaf education pay just $30 to attend. ASHA, AAA, and AG Bell Academy for Listening and Spoken Language CEUs are available.
The presentations will also be broadcast via videoconference to personnel from schools outside the Fort Worth area. Check the Connect2Texas website for more information.
(Cook Children’s Medical Center’s First Sounds-First Words program is made possible through a generous grant from CVS Caremark Charitable Trust.)
For more information, contact Becky Clem, MA, CCC-SLP, LSLS Cert. AVT, Rehab Education Coordinator and Project Coordinator for First Sounds-First Words by emailing becky.clem@cookchildrens.org or calling (682) 885-7462.
Elizabeth’s Note: Two summers ago, I worked for the Speech-Language Pathology Department at Cook Children’s — they are a top-notch team, and this seminar should be fantastic! I applaud them for making this so inexpensive and accessible, especially to parents. If you’re in the area, and have a child who is deaf or hard of hearing, what a great, FREE way to learn about ways you can help your child to succeed!
Today at work at the Hearing School, I was working on cataloging books for the school library. Basically, it was: scan ISBN, verify author, put on barcode stickers… repeat. Anyway, one book jumped out of the endless piles and really caught my eye. Why? It was authored by Emily Perl Kingsley.
Emily Perl Kingsley… Emily Perl Kingsley… where oh where had I seen that name before???
It bothered me all day. Was she a novelist? Had I read one of the books she’d written for adults? A journalist? Had I read an article by her in TIME or Newsweek? I just couldn’t put my finger on it… how did I know that name???
Then, tonight, as I was updating things for Deaf Villageand browsing around my favorite deaf-related sites, it hit me. Emily Perl Kingsleyis the author of the infamous “Welcome to Holland” piece that is ubiquitous in the field of special education.
CHRONOLOGICAL AGE: How old a child actually is. Time since the child was born.
HEARING AGE: Time since the child has been receiving auditory input through appropriate amplificiation. Time since the child received hearing aids and/or cochlear implants.
For example: ”Susie” was born August 21, 2001. Today is August 21, 2008. Susie’s chronological age is 7-0 (seven years, zero months). If Susie received a cochlear implant at 13 months of age (on September 21, 2002), her hearing age is 5-11 (five years, eleven months) or one year and one month less than her actual, chronological age.
BUT is this really the case?
Did you know that babies’ ears (the physical structures) start to develop around 18 weeks after conception? The physical parts of the ears are fully formed around 25 weeks post-conception, but babies begin to HEAR only 18 weeks after being conceived! So, by the time a child breathes its first breath after a typical 40 week pregnancy, that child already has 22 weeks, or over FIVE MONTHS, of hearing experience. In the womb, a child can hear the mother’s blood circulating and the sounds of digestion, and also sounds from the outside world, like parents’ voices and music. Unborn babies even begin to recognize their mothers’ voices around the 25th week of pregnancy. (See HERE for these great facts and more about human development.)
Unborn babies come into the world with over five months of hearing experience, if they are able to hear. This pre-exposure to the outside world, one that is loud and full of noises, helps hearing children with sensory integration (dealing with the overwhelming flood of sensory stimuli that are part of our world each day). Think about it — as a hearing adult (or a deaf adult with listening and spoken language training) — you are able to attune to the sounds in your environment, to focus on the things that are important (speech) and block out the sounds that are unnecessary distractions (the washing machine humming in the background). Hearing babies have a head start on learning to listen, and learning how NOT to listen. They have already had five months to “practice” navigating the world of sound.
This is why early detection of hearing impairment is crucial, and early amplification is a MUST. Babies can’t wait! If a deaf baby is identified at 3 months and receives hearing aids by month 6, they have already missed out on ELEVEN months of hearing experience. This is not to say that all hope is lost. Obviously, children identified much, much later have been successful learning to listen and talk (think about the days before newborn hearing screening, digital hearing aids, and cochlear implants — deaf children learned to talk then, under much tougher circumstances), just to emphasize the importance of getting your deaf child access to sound as soon as possible. The sooner you start working on listening and spoken language, the better chance you have of closing that gap!
TO LEARN MORE… Carol Flexer, Ph.D., is one of the biggest names in the field of auditory brain development, especially for deaf children learning to listen and speak. HEREis her personal website, and HEREare some fantastic quotes, words of wisdom, and pieces of advice from her books and public speeches.
Recently, there’s been a bit of an uproar in the “disability” community over the portrayal of people who are intellectually challenged and the copious use of the “R-word” (”retarded”) as an insult in Ben Stiller’s latest film, “Tropic Thunder.” This makes me sick to my stomach, and I am so proud that the Special Olympics, along with many other supporting organizations, have launched a fantastic website, the R-Word Campaign, and organized protests against “Tropic Thunder”. This blogeven has a great PSA-style film about the “R-word” AND they’ve included a transcript to make it more accessible to all! I encourage you to check out these sites and click to support the anti-r-word pledge today.
…but what does this really have to do with deafness? After all, it’s a common misperception that people with hearing loss are intellectually limited, so do we reallllllly want to be speaking up for a cause like this? Absolutely, unequivocally, 100% YES! Why? Well, not only is is it a matter of human decency, but also, when it become “okay” to make fun of one disability, it’s only a matter of time before you’re next.
In fact, it’s already happened. Just a few weeks ago, I was flipping through channels on the TV and came across a comedienne performing her stand-up routine on Comedy Central. I have to admit, I first stopped on the channel because she was wearing a really cute purple dress (My school color! Go Frogs!). So, I came for the dress, but I stayed for the… insults!?! As I watched in horror, the woman began to discuss deaf people (I forget the reason why) and began to imitate what I guess she thought was “Deaf Speech”. Not only did she do the chracteristic slurring and nasality (false!) she also proceeded to talk realllllllly slowlllllllly. Um… okay? That just doesn’t even make sense! Differences in voice tone, maybe, but slow speech? Being able to hear has nothing to do with how fast you talk! Trust me, I live in Texas — people here like to mosey around with their words, no matter how good their hearing! So, not only was this woman rude, rude, rude, she also isn’t very logical, either.
I flipped the channel in horror before I could catch her name. A quick Google search and, aha! Our culprit… Lisa Lampanelli. Shockingly, the wretched performance I witnessed on TV is not the first time this lady (and I use that term loosely) has insulted people who are deaf. In a 2007 radio interview, she was quoted as saying, “God hates deaf people,” causing boycotts and protests during her subsequent appearance at RIT.
What infuriates me most about people who think that disabilities are funny is that I would challenge, no, I would DEFY them to look into the faces, and get to know the hearts, of the people they are ripping to shreds all in the name of “entertainment”. You think deaf people can’t speak well, Lisa Lampanelli? I’d like you to meet my students, and students just like them at oral schools and AVT centers around the country. I’d also like you to meet some deaf people who don’t talk, but still could run circles around you intellectually using ASL or whatever method they use to communicate. I’d like you to meet them… and you’d better hope they’re better people than I am, because if you and I were to meet… well, be grateful that, unlike your mother, mine raised me to hold my tongue!
There’s a great old song by Smokey Robinson and the Miracles (click HEREfor music clip with lyrics) that says, “My Mama told me, you better shop around!” Good advice in almost any situation, but it also has some applications in the field of cochlear implant candidacy.
HEREare the cochlear implant candidacy guidelines for adults and children from Boys Town National Research Hospital. While the overall guidelines are controlled by the FDA, individual physicians and surgical centers have some discretion as to whom they choose to implant in their individual cochlear implant programs. While the vast majority of people who receive cochlear implants are so profoundly deaf that there is no question of whether or not they qualify for a CI, there are a small number of cases of “borderline” CI candidates. For example, what if your audiogram shows a hearing threshold just slightly under the 70dB required for adults of the 90dB required for children under 18 months old? What if you gain awareness of low-frequency sound with high-powered hearing aids, but not access to the crucial higher frequencies which contain the sounds of speech? What if one CI center says that, for whatever reason, you just don’t make the cut for candidacy? Is all hope lost? Not at all! Individual surgeons and CI centers have their own preferences, their own discretionary policies, their own quirks and idiosyncrasies. Who knows? The CI center across town might roll out the welcome mat and consider you a prime candidate for a CI.
Now, I’m am not advocating sticking implants in people willy-nilly like there is no tomorrow. There is, and probably always will be, a place for hearing aids in the world of amplification for people with hearing loss. Some people clearly are NOT CI candidates. But for those who are, or even who might be, the access to the high-frequencies sounds of speech provided by a cochlear implant are unparalleled by any other assistive listening device on the market today. It is worth a little time, a little research, a little investment… you are worth it — shop around! In fact, even if you are a clear-cut CI candidate, do yourself a favor and interview at least one additional CI center’s staff of surgeons, audiologists, Speech-Language Pathologists, and/or Auditory-Verbal Therapists. These are the people you will be trusting with your health, your hearing, and your chance to better communicate with the world. Choose a team you feel comfortable with, a team willing to create a relationship with you that will endure for the lifetime of your device (most likely your entire lifetime as well!). It’s worth a second thought!
So, I just returned from a whirlwind weekend trip to New York City. Some of the taxis in NYC have in-cab “TaxiTV” with clips of news, weather, maps, etc. Unlike London, these TV screens do not have a hearing loop (and neither city’s cab TVs have closed captions). The NYC “TaxiTV”s were touch-screen operated (not great for riders with limited visibility… there’s no way, or at least no way I know of, to Braille buttons that are not really buttons, just virtually appear on-screen). They did, however, have a volume control, so at least that’s something for those who get some gain with hearing aids, cochlear implants, or residual hearing. Not great accessibility… BUT while I was watching the screen and taking note of all of the accessibility functions (or lack thereof), there was a great news story playing from one of NYC’s local news affiliates.
The news story profiled a FDNY firefighter who was motivated to start a fire safety program for blind and/or deaf children because her own daughter is vision impaired. The program she started was great, teaching basic fire-safety skills that all children should know. But beyond that, one quote from the story really resonated with me.
The firefighter/founder said (paraphrase), “I wanted my daughter to feel empowered… that she didn’t have to wait around to be rescued… that she herself could be a rescuer.”
Wow. What a powerful statement, and a statement with implications far beyond safety in an emergency situation like a fire. What a wonderful gift we can give to deaf children, all children, and even ourselves — a sense of being a “rescuer” not a victim to be rescued; an empowered hero in our own lives, capable and confident of accomplishing all we hope to do.