A Diagnostic Process
Working it out together
Every infant and their family require an individual programme of care. That programme needs to be worked out together week by week, month by month, through balancing family needs and values with guided observations and coaching. Together you and I will work out your child's listening ability; identify targets for development; monitor and assess how your child progresses; decide how both we and your child move on from there.
Parents are at the centre of this approach. You are the driving force in accessing your child's progress right from the start. With the identification of deafness you may feel that you have a whole new batch of learning to do, of behaviours to observe, of unfamiliar goals to reach. You do have! But with careful and sensitive guidance you can do it. Indeed, you are the only people who can make, revise and update the "right" decisions for your child. The purpose of my work is to support you, guide you and coach you in the extra knowledge and skills you may need along the way.
Your baby first
Your child is more than a pair of ears! First and foremost your child is a very active "bundle" to love, cherish and celebrate. The wonder of your child as an individual, to learn about and to love, has to be the basis for all we do.
Confidence and self-esteem
Nurturing a happy and self-confident child who is meeting his or her potential in life, is probably more important to you or I than the mode in which they communicate. Whilst auditory-verbal techniques are my passion, they are not my priority. Your child's social and psychological development depends upon their interaction with you, their play and their enjoyment of the world. So that's where we begin. We play, we celebrate successful interaction and we discover.
Learning to listen
The general process of how we all learn to listen as babies and young children is well documented (References) for hearing and for deaf children, with moderate to profound impairments, using digital or implanted technology (References).
We know the order of events, we have them broken down into small observable "steps" and we know the techniques to foster each step along the way. Practitioners around the globe have been trialling such techniques on young deaf children for decades. There is lots of guidance available. What we have to do is to apply that guidance and those techniques to your child, your style of parenting and your family routines - so that they become a way of life for your child, and so that your child has the opportunity to develop what is generally referred to as a "listening attitude".
In so doing we need to monitor how your child progresses through each step of development, target the next steps and evaluate the rate and ease of progress.
Learning to listen is a process that begins in the womb, so the sooner we can begin to use technology and techniques to stimulate that process, the sooner your child is likely to catch up.
Children who have begun to hear sounds in the womb, generally begin using single word speech around their first birthdays. Within that year and a bit they have been "working" hard at making sounds and words meaningful.
Children whose hearing is impaired also need that time to begin to learn to listen before they start to speak. We often use the term "hearing age" as an indicator of how long a child has had the opportunity to learn to listen. For example, a child who first really uses well functioning hearing aids at 12 months of age has a "hearing age" of 6 months when they are actually 18 months old. A three year old who has only really begun to detect sounds from a cochlear implant at 24 months will have a hearing age of 12 months. So at first it is more realistic to develop listening and speech skills to match the child's "hearing age" rather than their actual age. However as we progress, we become more focused on reducing the gap and in your child developing "age appropriate language".
Age appropriate language
Achieving age appropriate language skills in time for mainstream schooling is a very common, and often a not unrealistic goal. Auditory verbal practitioners keep their and your expectations high by constantly reviewing the development of a child's auditory comprehension and receptive language and the transfer of these skills to speech.
Vocalizations and speech
I have studied and detailed the process of development of vocalizations and speech in deaf children using hearing aids and cochlear implants in my research publications. Again, generally speaking there is a clear "process" of development from the very first coos and gurgles to stringing spoken words together.
We also have a great master in the work of Daniel Ling who has studied, trialled and presented both playful and more formal strategies to foster every speech sound a deaf child could wish to make. Ling's work is also behind many useful tools and videos to help us ensure that your child is learning to talk in a typical and articulate manner. Many of these I have evaluated in my research and in my practice See 'Usefull Links'.
Nursery and school placement
Current educational thinking in the UK advocates inclusive education and therefore generally supports the education of young deaf children in local preschools and primary schools. There can be many benefits to educating your child in a local school, amongst which are that other hearing children can provide good linguistic models for your child and an age appropriate, local peer group.
Choosing a local preschool with a suitable acoustic environment can however be a challenge. I am here to help you in that process and to help smooth the transition to preschool with guidance in technological and educational changes that may be required.
I have experience of a wide range of educational provision and have supported very many families through statutory assessments and statementing.
I am also here to support your links with families with children who may help to provide an appropriate deaf peer group for your child and to foster social activities that may run alongside mainstream provision.
© 2006 Dr Helen Robinshaw | design by dee-gee.co.uk