1. My Best Friend or My Worst Nightmare? Collaboration to manage hearing loss

2. EHDI Conference March 4, 2005 Atlanta, GA Presented by: Jan Stroud, M.S., CCC-A Tracy Pate, M.S., CCC-SLP, Cert. AVT

3. Dont forget! Please sign up for a handout delivered through email.

4. Presumptions 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.

5. Why this title?

6. Where do we start? Its 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.

7. Parents Need foundations to build the house There are different types of foundations, but most types are equally viable Should family differences change recommendations and information sharing? Dont deprive parents of their responsibilities.

8. Audiology 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.

9. 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 intervention

10. 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 situation? Family dynamics Parent/child bonding; parent/child interaction; marital dynamics

11. 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 dont let them forget the goal.

12. Incentive + Means + Reinforcement = Goal accomplished!

13. 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

14. 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 technology Concepts of listening age versus chronological age versus language age

15. Dont overstep your bounds! Parents often shop for information in the beginning. Realize that parents often tell the wrong person what they are concerned about (I.e. tell early interventionist that they dont think that the earmolds fit correctly). Refer back to the person who is primarily responsible for final say-so. Its okay to say I dont know BUT it should always be followed with I will help you find the answer.

16. 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 dont take it too far. Undermining other professionals validity (not intentionally)

17. Contacts Jan Stroud or Tracy Pate Arkansas Childrens Hospital 800 Marshall Street, Slot #113 Little Rock, AR 72202 (501) 364-4319 stroudjs@archildrens.orgtroudjs@archildrens.org patetb@archildrens.orgatetb@archildrens.org