Volta Voices March-April 2009 Magazine by Alexander Graham Bell Association for the Deaf and Hard of Hearing

VOICES A l e x a n d e r G r a h a m B e l l A s s o c i at i o n f o r t h e D e a f a n d Ha r d o f H e a r i n g

W W W. A G B E L L . O R G • V O L 1 6 , N O . 2 MARCH /APRIL 2009

VOICES V

VOLUME 16 • NUMBER 2 • MARCH /APRIL 2009

F E AT U R E S

So Your Child has a Hearing Loss: Next Steps for Parents

Edited by Catherine Murphy

Learn about the process of hearing loss screening and diagnosis, and approaches to language development.

Steps to Take for Access to Sound By Melody Felzien and Judy Harrison, M.A.

This article provides an overview on what parents can expect from early intervention providers and the various ways their child can access sound and learn spoken language.

Pasos a seguir para acceder al sonido Por Melody Felzien y Judy Harrison, M.A.

Este artículo proporciona información general sobre lo que los padres pueden esperar de proveedores de intervención temprana y las diferentes formas en que su hijo puede acceder al sonido y aprender el lenguaje oral.

Hearts for Hearing: Creating Life-Changing Opportunities through Early Intervention

By Teresa H. Caraway, Ph.D., CCC-SLP, LSLS Cert. AVT

Hearts for Hearing in Oklahoma City, Okla., is a model early intervention program for infants and young children with hearing loss.

What the Research Shows: Emergent Literacy Skills, Prelinguistics and Metacognition

By Melody Felzien

Parents increasingly need access to research about the health care and education options available to their children. This regular series summarizes research on spoken language development published in the fall 2008 issue of AG Bell’s premier journal, The Volta Review.

Alex ander

Graham

Bell

A s s ocia t ion f or t he D ea f and H ard o f H earin g

3 4 1 7 volta place , n w, w a s hin g t on , dc 2 0 0 0 7 • w w w. a g bell . or g

VOICES Advocating Independence through Listening and Talking

— Adopted by the Alexander Graham Bell Association for the Deaf and Hard of Hearing Board of Directors, November 8, 1998

Ale x ander Gr aham Bell Association for the Deaf and Hard of Hearing

3417 Volta Place, NW, Washington, DC 20007 www.agbell.org | voice 202.337.5220 tty 202.337.5221 | fax 202.337.8314 Volta Voices Staff

Cover: The children and listening and spoken language specialists of Hearts for Hearing: (top as her mother, Amanda, helps; ( center ) Maria Loera holds up her son Juan; ( bot tom

lef t)

right)

Tami Elder works with Nora Watson

Teresa Caraway works with Harper Orr.

Photo Credit: Aimee Adams Photography

DE PA R TME NT S

Voices From AG Bell • Early Intervention and Spoken Language Development.........................3 By Jay Wyant

• Conversations with Alex Graham........................................................ 37 • Tips for Parents: Strategies for Parents Who Have a Young Child with Hearing Loss............................................................ 35 By Eric Mann

In This Issue • Early Intervention.....................................................................................5 By Melody Felzien

Production and Editing Manager

SoundBites................................................................................................8

Director of Communications

KIDS ZONE • Around the World................................................................................. 38

Melody Felzien

Catherine Murphy

By Sarah Crum

Director of Advertising and Exhibit Sales

Garrett W. Yates Design & Layout

Paul T. Mickus

PixelPoint Design & Production, LLC

AG Bell Board Members

IN EVERY ISSUE

Contributors..................................................................................................6 Directory of Services................................................................................ 40 List of Advertisers..................................................................................... 52 Want to Write for Volta Voices?................................................................. 52

President

John R. “Jay” Wyant (MN) President-Elect

Kathleen S. Treni (NJ) Secretary-Treasurer

Christine Anthony, M.B.A., M.E.M. (IL) Immediate Past President

Karen Youdelman, Ed.D. (OH) Executive Director

Alexander T. Graham (VA)

Members

Donald M. Goldberg, Ph.D. (OH)

S AV E T H E DAT E • M A R K YO U R CA L E N DA R

AG Bell announces the

2009 Leadership Opportunities for Teens (LOFT) program July 5-9

Washington, D.C.

LOFT is specifically designed for teens who are deaf or hard of hearing and use spoken language. visit www.agbell.org for more information.

Irene W. Leigh, Ph.D. (MD) Michael A. Novak, M.D. (IL) Dan Salvucci, M.Ed., Ed.M., CCC-A (MA) J. Paul Sommer, M.B.A. (MA) Peter S. Steyger, Ph.D. (OR) Joanne Travers (MA)

Volta Voices (ISSN 1074-8016) is published six times a year. Periodicals postage is paid at Washington, DC, and other additional offices. Copyright ©2009 by the Alexander Graham Bell Association for the Deaf and Hard of Hearing, Inc., 3417 Volta Pl., NW, Washington, DC 20007. Postmaster: Send address changes to Volta Voices, Subscription Department, 3417 Volta Pl., NW, Washington, DC 20007, 202/337-5220 (voice) or 202/337-5221 (TTY). Claims for undelivered issues must be made within 4 months of publication. Volta Voices is sent to all members of the association. Yearly individual membership dues are $50. Volta Voices comprises $30 of membership dues. Subscriptions for schools, libraries and institutions are $62 plus $12 for international postage where applicable. Back issues, when available, are $7.50 plus shipping and handling. Articles published in Volta Voices do not necessarily reflect the opinions of the Alexander Graham Bell Association for the Deaf and Hard of Hearing. Acceptance of advertising by Volta Voices does not constitute endorsement of the advertiser, their products or services, nor does Volta Voices make any claims or guarantees as to the accuracy or validity of the advertisers’ offer. PUBLICATIONS MAIL AGREEMENT NO. 40683045 Return Undeliverable Canadian Addresses to: P.O.Box 503, RPO West Beaver Creek, Richmond Hill, ON L4B 4R6

V OLTA V OIC E S • M A R C H/ A P R I L 2009

V O I C E S

F R O M

A G

B E L L

Early Intervention and Spoken Language Development Dear Fellow Members, Welcome to this special edition of Volta Voices on early intervention. Every day, parents of infants and children newly diagnosed with hearing loss consult AG Bell’s Web site, online newsletter and publications for information and resources on listening and spoken language. This edition of Volta Voices is designed to help these parents navigate the early intervention process and help them make informed decisions when considering communication approaches. If you are a parent of an older child who is deaf or hard of hearing, you probably remember those initial few months after your child was first diagnosed as an anxious time, having to overcome the initial shock of being told your child is deaf while being asked to make critical decisions that will affect your child’s language, education, relationships and professional outcomes for the rest of his or her life. For such parents, one of the first items you should be asked to consider is whether to introduce audition to your child through the use of hearing aids and/or cochlear implants. Why is Audition Important?

One of the questions a lot of new parents ask AG Bell is “what do you mean by ‘audition’ and why is it so important if I want a spoken language outcome for my child?” Audition is simply the act of hearing. For children who are deaf, it usually relates to either amplifying residual hearing with hearing aids or providing sound through cochlear implants. The

children then “learn how to listen” – to make the most of the sounds they hear and apply it the development of spoken language. It’s important for parents to realize that being deaf is more than not being able to hear. It’s about how the child will acquire language, particularly spoken language. In order to understand why a hearing loss creates a potential obstacle for spoken language development, it’s important to understand the function of hearing in the role of learning how to talk. Newborns with typical hearing are exposed to a variety of sounds and sound stimulation, beginning even in the womb. At first, infants can hear sounds, but not understand them. It is only through many months of listening to all kinds of sounds, particularly talking, singing or “cooing,” that the baby begins to understand the basic meaning of spoken language. When people talk to babies, you will notice they use a lot of voice inflection and repetition, a variety of speech patterns and a variety of emotions. Babies with typical hearing eventually begin to understand that different speech patterns have unique meanings. Professionals in the field tell me that these different patterns and the use of vocal pitch changes are called the suprasegmentals of spoken language. They carry a great deal of meaning, help clarify our spoken messages and give the newborn baby his or her first understanding of spoken language. This development of “receptive language” lays the groundwork for the later implementation of expressive language, such

as speech. This is the same pattern of development that we can expect from today’s children with hearing loss. As the parent of a hearing toddler, I can tell you that while the receptive/ expressive development of language appears to be nearly automatic (how many parents can attest to their child learning a word they’d rather the child not use?), parental involvement makes a real difference in the quality and breadth of language development. For children with hearing loss, such intervention – by both families and professionals – is critical. Audiologists, teachers, speech language pathologists and others are key to helping parents work with their children to improve audition capabilities. More babies with hearing loss are being helped earlier than ever before thanks to the availability of newborn hearing screening and quicker transition to early intervention programs. With properly fitted hearing aids during infancy, early cochlear implants when appropriate and effective auditory intervention, we can maintain high levels of expectations for many children who are deaf to develop excellent listening and spoken language skills. The Choice of Spoken Language

The second most popular question AG Bell receives from parents is usually, “I’m faced with so many options, how do I decide? What assistance can AG Bell provide?” First and foremost, parents should (continued on next page)

QUESTIONS? COMMENTS? CONCERNS? Write to us : AG Bell • 3417 Volta Place, NW, Washington, DC 20007 V O LTA V O ICES • MARCH/APRIL 2009

Or email us : voltavoices@agbell.org

V O I C E S

F R O M

A G

Early Intervention and Spoken Language Development (continued from previous page)

consider all the options available to them and select the best option, or options, for their family based on their own unique circumstances. AG Bell fully supports the recommendation by the Joint Committee on Infant Hearing, published in 2007 by the American Academy of Pediatrics, which in part states “families should be made aware of all communication options and available hearing technologies in an unbiased manner.” AG Bell believes that no matter what path a family may choose, everyone should honor and value that family’s decision regarding what communication outcome they choose to pursue.

B E L L

Many organizations collectively represent the full spectrum of communication outcomes. These organizations are available to assist families in the decision-making process, after they choose a particular path, and beyond. You can find a list of key organizations on AG Bell’s Web site at www.agbell.org. For children and adults who are deaf or hard of hearing and use spoken language, AG Bell serves as a resource and advocate. AG Bell supports the development of spoken language through evidence-based practices focusing on the use of audition and appropriate technologies. For families who choose to include other communication approaches in addition to spoken language, AG Bell continues to provide support and resources with regard to listening and talking. The good news for parents today is that the last 10 to 20 years have seen

dramatic improvements in hearing technology for children who are deaf or hard of hearing. The convergence of improved technologies with universal newborn hearing screening programs means that today’s children and their families have a greater opportunity to achieve their dreams. There really is no better time to celebrate spoken language for children with hearing loss.

Jay Wyant President Editor’s note: Background information provided in the section “Why is Audition Important?” was provided by the Handbook for Educators, MED-EL Corporation.

V OLTA V OIC E S • M A R C H/ A P R I L 2009

E D I T O R ’ S

N O T E

Early Intervention

his special issue of Volta Voices focuses on early intervention and educating parents of a child newly diagnosed with hearing loss on what to expect from the process. To help parents navigate the myriad of procedures and options available, these articles provide information on the significance of hearing loss, options for language development and what to expect in the early years of a child’s language development. AG Bell President Jay Wyant begins this issue by discussing why audition is important to the development of language. He explains how children with typical hearing develop spoken language and how access to audition can help a child with hearing loss develop language the same way. Two articles in this issue discuss the specific steps and processes for identification of hearing loss, sound amplification and early intervention. “So Your Child Has a Hearing Loss” describes what happens during and after the initial newborn hearing screening and diagnosis. Parents will learn about what tests will be performed, what types of professionals they will meet and the communication approaches to consider, as well as other factors such as the emotional impact, financial implications and the importance of self-advocacy. If a spoken language approach is chosen, “Steps to Take for Access to Sound” provides an overview on the early intervention process and what parents should expect from their local programs. In addition, the article includes information on the types of hearing devices used for sound amplification and what types of follow-up therapies parents can expect to help their child “learn to listen.” “Hearts for Hearing” is a snapshot of a model program for early intervention. Dr. Teresa Caraway, the cofounder of the Oklahoma City, Okla.,

V O LTA V O ICES • MARCH/APRIL 2009

program discusses how the program coordinates with hospitals and state government to assist infants who are diagnosed with hearing loss. As a result, Hearts for Hearing is able to provide sound amplification and begin language development services within two to three weeks of an infant’s birth. This month’s “Tips for Parents” covers “tips and tricks” to help an infant adapt to sound amplification technology, such as hearing aids or cochlear implants, and how to engage the whole family in the “learn to listen” process. “Around the World” features one family’s experience with the early intervention process, from the diagnosis to the early days of their son’s sound amplification. This issue also introduces a new column from AG Bell Executive Director Alexander T. Graham. “Conversations” will regularly feature discussions with leaders of government, industry, education and health care, both within and outside the AG Bell community. This month’s “Conversations” features a dialogue with Justin Ogden, president of AG Bell’s Indiana Chapter. Finally, “What the Research Shows” provides a summary of research

presented in the fall 2008 issue of The Volta Review. In keeping with the theme of early intervention, this edition features two research articles focusing on literacy and spoken language development of infants and young children under 5 years of age. Early intervention continues to be an important and highly requested topic. Please stay tuned to Volta Voices, AG Bell Update and www.agbell.org for the most current information and updates on changes and advances in early intervention processes and regulations. As always, if you have a story idea or would like to submit an article for publication, please contact me at editor@agbell.org with your comments and suggestions. Sincerely,

Melody Felzien Editor, Volta Voices

V O I C E S

C O N T R I B U T O R S

Teresa H. Caraway, Ph.D., CCC-SLP, LSLS Cert. AVT, author of “Hearts for Hearing: Creating Life Changing Opportunities through Early Intervention,” is the co-founder and chief operating officer of Hearts for Hearing, an early intervention program based in Oklahoma City, Okla. A Listening and Spoken Language Specialist (LSLS) Certified Auditory-Verbal Therapist (Cert. AVT), Dr. Caraway served as the inaugural president of the AG Bell Academy for Listening and Spoken Language and continues serving on the board as past president. She previously served on the board of directors of AG Bell and AuditoryVerbal International (AVI). Dr. Caraway has been recognized by the Oklahoma SpeechLanguage-Hearing Association with the Gwen Cacy Award for outstanding clinical skills. She is also an adjunct assistant professor at the University of Oklahoma Health Sciences Center, an international consultant and a workshop presenter on auditory-verbal practice.

Sarah Crum, author of “Around the World” and “SoundBites,” is a student intern at AG Bell. She is a sophomore at Georgetown University working towards a

degree in American Musical Culture. She is also currently an assistant news editor for The Hoya, Georgetown University’s student newspaper. Crum plans to pursue a career in journalism.

Judy Harrison, M.A., co-author of “Steps to Take for Access to Sound,” is director of programs at AG Bell. Harrison represents AG Bell on the Joint Committee on Infant Hearing and is currently president of the Council on Education of the Deaf. She is an experienced teacher of the deaf who has worked as an early interventionist with children who are deaf and hard of hearing and their families; as an educational consultant specializing in cochlear implants; and for a cochlear implant manufacturer. Harrison has a Bachelors of Arts degree in Speech Pathology from Rutgers University and a Masters in Education of the Deaf from Gallaudet University.

ing, government/public affairs and conference development. In addition to earning a Bachelor of Arts degree in Political Science from Lynchburg College in Lynchburg, Va., Graham has a Masters of Science in Organizational Effectiveness and a Masters of Business Administration from Marymount University in Arlington, Va. His late mother had a hearing loss as a result of a childhood illness.

Eric Mann, author of “Tips for Parents: Strategies for Parents Who Have a Young Child with Hearing Loss,” is a group marketing specialist with SunTrust Bank and a member of the bank’s council on disability advocacy. He lives in Henrico, Va., with his wife, Jeanne, 5-year-old son Raleigh and 3-year-old daughter Julia, who has a profound hearing loss. Julia received her first cochlear implant when she was 13 months old and her second implant in January 2009.

Alexander T. Graham, author of “Conversations,” is the executive director of AG Bell. Before joining AG Bell in October 2007, Graham served as the executive director for the Society of Competitive Intelligence Professionals. Graham’s experience includes managing financial, human resource and strategic planning programs as well as membership, market-

Catherine Murphy, editor of “So Your Child has a Hearing Loss: Next Steps for Parents,” is director of communications at AG Bell. She has worked in the public relations field for almost 20 years with an emphasis on media relations and communications strategy. Previous experience includes political campaign management, award-winning marketing communications and public relations strategy for publicly traded telecommunications firms, and public affairs management for the American Water Works Association. Murphy received her B.A. in Communications from Ohio State University. Her brother, Michael, was born profoundly deaf and recently received a cochlear implant.

V OLTA V OIC E S • M A R C H/ A P R I L 2009

SOUNDB CA L E N DA R O F E V E N T S

NEWS BITES

7/5-9

AG Bell to Co-Chair DHHA

AG Bell is pleased to announce the 2009 LOFT program will take place July 5-9, 2009, in Washington, D.C. One of AG Bell’s most acclaimed programs, LOFT is open to teens 15-18 who are deaf or hard of hearing who use spoken language. For more information, visit www.agbell.org.

7/23–25

Function” (EF). Vital to the development of problem solving, social competence and academic readiness, EF is a cognitive or thinking process that influences and controls behavior such as working memory, organizational strategies and inhibition. Understanding EF can help professionals identify where cognitive breakdowns occur, and may also help highlight a child or adult’s areas of strength and talent. Symposium attendees will have the opportunity to explore techniques and strategies in applying executive function to their respective prac-

AG Bell will host its 2009 Listening & Spoken Language Symposium at the Union Station Marriott July 23-25 in St. Louis, Mo. The theme for the 2009 Symposium will be “Executive

tices. Continuing education units (CEUs) will offered. For more information about the event or to register, visit www.listeningandspoken language.org or call (866) 337-5220.

On January 14, 2009, the Deaf and Hard of Hearing Alliance (DHHA), a consortium of groups representing children and adults with hearing loss, met to discuss goals for the new year. The meeting was the first with Director of Communications Catherine Murphy representing AG Bell as the new co-chair of DHHA for the 2009-2010 term. Agenda items included an update from Kareem Dale, the disability director for the Obama Transition Team, and discussion on legislative initiatives for the new Congress, particularly the reintroduction of the Early Hearing Detection and Intervention (EHDI) Act reauthorization legislation. Last year, the bill passed unanimously in the

House of Representatives but stalled in the Senate Health Education Labor and Pensions committee due to Senator Kennedy’s illness. DHHA also discussed health care reform, classroom acoustics and new member recruitment. For more information on DHHA, please visit www.dhhainfo.com.

AG Bell Launches “Hear Our Voices” Online Exhibit AG Bell has launched a new online exhibit “Hear Our Voices,” featuring AG Bell members talking about what it means for them to “Talk for a Lifetime.” The exhibit can be found at www.agbell.org. AG Bell President John R. “Jay” Wyant stated, “Hear Our Voices is a great way to see – and hear! – first-person accounts from individuals and their parents about the experience of developing spoken language. It also reminds all of us about the commitment necessary to be able to do what so many take for granted – the ability to talk for yourself.”

Grace’s Law Enacted New Jersey’s “Grace’s Law” was signed into law by Acting Governor Richard Codey on December 30, 2008. The law mandates that beginning March 30,

V OLTA V OIC E S • M A R C H/ A P R I L 2009

DBITES 2009, New Jersey insurance companies will be required to cover the cost of hearing aids for children ages 15 years and younger for up to $1,000 every 24 months. The coverage includes the purchase of a hearing aid for each ear when medically necessary and as prescribed or recommended by a licensed physician or audiologist. AG Bell member Jeanine Gleba proposed the insurance coverage to help those who can not afford hearing aids. Grace’s Law is named after Gleba’s daughter, who has a congenital hearing loss. Congratulations all those involved for their hard work and success in enacting this important legislation.

New Antiviral Drug Developed to Treat CMV, Other Viral Infections A new experimental antiviral drug has been developed that could lead to use in treatments for cytomegalovirus (CMV), HIV, influenza, Hepatitis C virus infection (HCV) and other serious viral infections. Nature Medicine published findings by Peregrine Pharmaceuticals, Inc., showing that its drug, bavituximab, can cure animals with lethal virus infections. CMV has been linked as a cause of deafness in infants who contract the virus. According to Dr. Philip Thorpe, professor of pharmacology at the University Texas Southwestern Medical

V O LTA V O ICES • MARCH/APRIL 2009

Center at Dallas, the drug attacks the defense mechanism used by the virus instead of the virus itself. The drug is currently in clinical trials for the treatment of HCV and HIV.

Scientists Identify New Gene Linked to Deafness Researchers from the National Institute on Deafness and Other Communication Disorders (NIDCD) and a group of international scientists have uncovered a gene that causes deafness in humans. The study was published in the November 2008 issue of Nature Genetics. The

Compiled by Sarah Crum and Melody Felzien

researchers uncovered the gene from a larger genetic region that had previously been associated with nonsyndromic deafness. Nonsyndromic deafness, the most common form of inherited hearing loss, occurs without additional symptoms such as blindness or a kidney or heart disorder. The gene responsible for this type of deafness in humans was unknown to scientists until now. The researchers also identified four mutations that affect the gene, resulting in deafness in families studied. This is the first example of a mutated gene causing a hereditary disorder.

SOUNDB S O U N D B I T E S

NEWS BITES (continued) Infrared Light May Improve Cochlear Implant According to a report in New Scientist magazine, the use of infrared light, which stimulates neurons in the inner ear, may improve cochlear implants. A team of scientists at Northwestern University demonstrated this by shining infrared light directly onto the neurons in the inner ears of deaf guinea pigs. The researchers recorded activity between the inner ear and the brain, which produces frequency maps. These maps are indicators of the quality of sound information sent to the brain. According to Claus-Peter Richter, M.D., Ph.D., who headed the research, the light simulation produced sound quality that was as sharp as those found in hearing guinea pigs. The use of infrared light would allow the implant to transmit more direct information to the brain.

leading producers of specialty acrylics resistant to chemical agents. Phonak’s covers received a rating of “0,” which means they are completely non-toxic based on a standard cytotoxicity scale. They also are rated 0-0.4 on a clinical dermal irritation test scale, which means they produce negligible skin reactions. These tests are compliant with the International Organization for Standardization (ISO) and U.S. Food and Drug Administration Good Laboratory Practice regulations.

D-PAN Features ASL Music Videos The Deaf Performing Artists Network (D-PAN) is a nonprofit organization founded to make music and music culture accessible to individuals who are deaf and hard of hearing. The goal of D-PAN is to create career and learning opportunities for the deaf and hard of

hearing community in the entertainment industry. To that end, D-PAN has created a string of music videos featuring performers who are deaf or hard of hearing performing songs in sign language such as “Waiting on the World to Change” by John Mayer and “Beautiful” by Christina Aguilera. For more information and to view the music videos, visit www.D-PAN.org.

Sprint to Provide Numbers for Sprint Relay Users Sprint recently announced that 10-digit phone numbers will be available on services such as Internetbased Relay (IP), Instant Messaging Relay (IM), Video Relay Service (VRS) and Federal VRS for customers who are deaf and hard of hearing. Callers will be able to directly contact Spring Relay users instead

Phonak has reported that the material it uses to manufacture hearing aid covers has been certified as non-toxic and nonskin-irritant, according to independent laboratory biocompatibility testing. Phonak offers eight different colors of shell materials for hearing instruments and has worked with one of the

Newborn Hearing Screening Now Mandatory in Germany Beginning in 2009, newborn hearing screening in Germany will be mandatory in neonatal wards and covered by public health insurance. The hearing screening is performed with a probe that is inserted to the ear canal, measuring otoacoustic emissions (OAE) from the inner ear. If there are no emissions, a followup test through brainstem audiometry is necessary. OAE screenings are recommended for newborns because the screenings can detect hearing loss early, lead to quicker evaluation and intervention, and increase the chance for the infant to develop language and literacy skills.

Phonak Introduces New Hearing System

Nicholas Hill ( left), the director of “Lose Yourself” music video, with Sean Forbes ( right), co-founder of D-PAN.

Phonak introduces the world’s smallest wireless hearing system, Audéo YES, which is based on the V OLTA V OIC E S • M A R C H/ A P R I L 2009

Photo credit: Deaf Performing Artists Network

Phonak Offers Certified Hypoallergenic Materials

of using a toll-free number. According to Sprint, IP and VRS users will be assigned a local 10-digit number and can directly receive calls and make emergency 911 calls. Customers will have to send a request and register their location through Sprint Relay before being assigned a number. For more information, visit www.sprintrelay.com.

DBITES Communication Optimized Real-audio Engine (CORE) platform. Audéo YES uses SoundRecover technology, allowing high frequency sounds to be audible by compressing and shifting signals into a lower frequency region. This region can be more easily heard by the hearing system-wearer, enabling people with a hearing loss to understand speech optimally. Audéo YES is compatible with many wireless devices including mobile telephones, navigation systems and MP3 players, and is offered in a variety of color combinations.

New Software Improves Speech Development and Literacy Skills In January, Teaching Handwriting Reading and Spelling Skills (THRASS)

launched the new THRASS Phoneme Machine at the BETT show, the world’s largest educational technology show. The Phoneme Machine has the potential to more than double the normal rate of progress for reading and spelling in English. The Phoneme Machine uses human lips to pronounce the sounds of English words and offers a Cued Speech option in which movements of the hands are displayed alongside the moving lips as the cues are demonstrated in a video box. The Phoneme Machine is a resource for teachers, parents and professionals, and is used in many schools in the United Kingdom and throughout the world. For further information about the new version of the Phoneme Machine, visit www.thrass.co.uk/ bettshow09.htm.

V O LTA V O ICES • MARCH/APRIL 2009

Researchers Developing Video Technology for Cell Phones University of Washington researchers have started developing software that allows two-way video calls on cell phones for manual communication. The project, called MobileASL, is being funded through grant money from The National Science Foundation. Because of the low data-transmission rates of U.S. cell phone networks, researchers have had to adapt new video technology that will transmit within the network and maintain high video quality. The team plans to conduct further research this year. For more information, visit www.mobileasl. cs.washington.edu.

SHARED INTEREST GROUPS The Auditory-Verbal Shared Interest Group (AV SIG) is continuing to analyze feedback from the AV SIG meeting during the AG Bell Convention last June. According to the attendees, the most important areas for research include what produces successful results and data to confirm current theory and practice of auditory-verbal approaches or intervention. Specific areas of interest include sequential bilateral cochlear implants, children and families who are bilingual, and clients who have multiple disabilities. In addition, AV SIG co-leaders are using the feedback in discussions with AG Bell to use AG Bell Web services catered to SIGs. We look forward to making use of this new technology to support our practice and mentorship.

SOUND S O U N D B I T E S

CHAPTERS

The Oregon Chapter of AG Bell will host its annual conference Saturday, May 16, 2009, on the campus of the Oregon Health Science University (OHSU). The conference features Dr. Dale Atkins, who will present the keynote address on family and sibling relationships. The conference is sponsored by Cochlear Americas. Breakout sessions include: “Current Research in Hearing and Deafness” by Dr. Peter Steyger, “Music and Hearing Loss” by Michael Page of Advanced Bionics, “FM Systems and Other Cochlear Implant Accessories” by Alex Hatton of Cochlear Americas and Megan Quilter of Phonak, and “Bilateral Cochlear Implantation” by Dr. Sean McMenomey and Dr. Don Plapinger. For registration information, contact Tucker-Maxon Oral School at (503) 235-6551 or tminfo@tmos.org.

NAMES IN THE NEWS

The Utah Chapter of AG Bell held its 5th Annual Fall Conference last November for over 120 parents, professionals and professionals in training, and adults who are deaf or hard of hearing. The conference sessions were based on the theme “Hear-n-Happy – living a full and productive life with hearing loss.” The keynote speaker, John Anderson, a mainstream adjustment counselor at Clarke School for the Deaf, addressed the complex issues of navigating group situations and loneliness, which are often challenging for students in inclusive educational settings. Mike Page, Au.D., CCC-A, spoke about new technologies designed to make music more accessible to individuals with hearing loss. In addition, a panel of four teenagers who are deaf or hard of hearing talked about dating, involvement in sports, participation in high school clubs, dancing and part-time jobs. Information was also presented about Utah’s newborn screening program, strategies to incorporate speech, language and listening throughout the day for toddlers, parenting strategies using the “Love and Logic“ program, and answers to audiological questions.

AG Bell Board Member Peter Steyger, Ph.D., was recently elected to the Board of Directors of the Deafness Research Foundation (DRF). DRF is a national source of private funding for research in hearing science, providing over 2,200 grants totaling more than $24 million since its founding in 1958. Burt Tansky, the chairman and chief executive officer of the Neiman Marcus Group, was honored with the Jule Styne Humanitarian Award at the 25th anniversary gala for the Children’s Hearing Institute. AG Bell Executive Director Alexander T. Graham and Director of Professional Programs Judy Harrison attended the event. Tansky has been a board member and benefactor since the Institute began in 1983. He has witnessed first hand how innovative technology and therapies benefiting children with hearing loss as his son, daughter-in-law and granddaughter all have a hearing loss. The event raised close to $1 million for the Institute. Mike Orscheln has been named President and Chief Executive Officer for Phonak U.S. and former CEO Cathy Henderson Jones has been named Executive Director of Corporate Relations. Orscheln joined Phonak in October 2007 as

its Chief Operating Officer, and Jones has been with Phonak since 1996 as Director of Education and Customer Services, becoming President and CEO in 2002. In addition, Jones was recently elected president of the Better Hearing Institute for 2009 and has served on its board of directors for several years.

IN MEMORIAM AG Bell member Judith S. Gravel passed away on December 31, 2008, after a long battle with cancer. Dr. Gravel was involved in hearing and speech science for nearly 40 years and was considered one of the world’s leading authorities on pediatric audiology. Her work was published in dozens of articles and in respected peer-reviewed journals, leading textbooks, The Volta Review monographs and conference proceedings. She was also a gifted lecturer and in high demand for keynote addresses and presentations. Dr. Gravel’s work will continue to improve the lives of children with hearing loss and their families for many years to come. Donations in Dr. Gravel’s honor can be made to the Judy Gravel Pediatric Audiology Fund c/o The Vanderbilt Bill Wilkerson Center, 1215 21st Avenue South, Nashville, TN 37240.

V OLTA V OIC E S • M A R C H/ A P R I L 2009

Edited by Catherine Murphy

So Your Child has a Hearing Loss: Next Steps for Parents

This article was reprinted and updated from “So Your Child Has a

Hearing Loss: Next Steps for Parents” published in 2000 by AG Bell.

Your child with a hearing loss can succeed – in school, in work and in life. It is important you keep this in focus, whatever your child’s age or degree Photo credit: Zach Nash

of hearing loss. While you will have the support of many professionals, ultimately you as parents will make many decisions about what is in the best interest of your child based on his or her unique circumstances. As with all children, there is no magic formula for raising a child with a hearing loss. However, your child will succeed if you maintain a positive attitude, educate yourself about hearing loss, seek out the best resources, and take an active role in your child’s language development and education. This article provides an overview on what to expect if your child is diagnosed with a hearing loss.

Rachel Hernandez and her daughter, Lily, outside of the Hearts for Hearing program in Oklahoma City, Okla.

Emotional Impact of the Diagnosis

About 95 percent of children who are deaf have parents where one or both are hearing (Gallaudet Research Institute, 2006). In addition, about half the cases of hearing loss in children is a result of unknown causes. Grief and denial are natural responses for hearing parents to have when they find out their child has a hearing loss. Grief is a common emotion and an honest expression of disappointment and fear of the unknown. If it is not acknowledged or dealt with, it can lead to denial of a child’s problem, which in turn can lead to procrastination in taking constructive action. Acknowledging grief, painful as it may be, allows parents to more effectively nurture their child.

In addition to this initial stage of grief, parents are confronted with the immediate need to make decisions about their child’s future. Parents may consider requesting a referral to a qualified therapist to help them work through the initial emotional impact of learning their child has a hearing loss, and to develop strategies for making decisions about the child’s and family’s future needs. Parent’s Checklist: From Newborn Hearing Screening to Communication Options

✓

Newborn Hearing Screening. As a result of Early Hearing Detection and Intervention (EHDI) legislation enacted in 2000, most hospitals today screen for hearing loss V OLTA V OIC E S • M A R C H/ A P R I L 2009

Every moment that goes by before the final diagnosis is time that cannot be regained toward putting your child on a path... [to] language development before a newborn is discharged from the hospital. The screening is performed by nurses, aides or other hospital personnel. Early detection simply means identifying a hearing loss at a very early age, hopefully in the first few days of life. The initial exam is referred to as a “screening” because the results are not definitive. A followup diagnosis is required to confirm a hearing loss.

✓

Diagnosis. If an initial screening comes back “positive,” then a second screening and follow-up testing are performed to confirm whether a hearing loss is present and, if so, the type and nature of the loss. This should be performed by an audiologist (someone with an advanced degree and appropriate licensure/ certification to evaluate hearing). It is imperative that parents not procrastinate on having the follow-up tests performed. Over half of newborns identified with a potential hearing loss are not given a second screening within the recommended three-month time frame. If it is ultimately determined your child has a hearing loss,

V O LTA V O ICES • MARCH/APRIL 2009

every moment that goes by before the final diagnosis is time that cannot be regained toward putting your child on a path of intervention and getting the assistance your child may need for language development. Once a hearing loss is confirmed, your pediatrician should refer your child to an ear, nose and throat specialist, also known as an otolaryngologist, who can provide information on various approaches for your child based on his or her unique circumstances as well as rule out any underlying causes for the hearing loss, such as an obstruction in the middle ear. In addition, you should select an audiologist with whom you feel comfortable and confident in helping you successfully manage your child’s hearing loss. Whomever you select will be someone you will work with closely, potentially for many years to come. It is entirely within your rights to “shop” for an audiologist by scheduling initial meetings with several practitioners. When seeking an audiologist for your child, inquire whether your practitioner has experience working with pediatric patients and be sure to observe his/ her level of rapport with your child during your initial visit. You can locate audiologists in your area by asking for referrals from your pediatrician and/or otolaryngologist, as well as by asking for referrals from other parents of children with hearing loss. To find an audiologist in your area, visit the American Academy of Audiology (AAA) at www.audiology.org or the American Speech-Language-Hearing Association (ASHA) at www.asha.org.

✓

Communication Approaches. One of the most important and immediate decisions parents of a child diagnosed with hearing loss are faced with is what communication approach, or approaches, to choose for their child. As a parent, you will find the information on communication approaches often conflicting and confusing, and one of your most difficult tasks will be to choose the best option for your child.

How Young Children’s Hearing is Screened and Evaluated Hearing screening methods for infants and children are non-invasive and painless. • ABR (Automated Brain Stem Response): Sounds are presented through earphones while the baby rests quietly or sleeps. Brainstem responses to sound are measured through small electrodes, which are taped on the baby’s head. These responses are processed by a computer. • OAE (Otoacoustic Emissions): A small probe tip is inserted into the baby’s ear canal. It measures the function of the inner ear, or cochlea. This screening can also be performed on a sleeping infant. • Behavioral Testing: These types of tests are used when a child is old enough to turn his or her head in response to sound or play a game. These tests measure the quietest sounds your child can hear and your child’s ability to understand words. • Acoustical Impedance tests can be administered to children of all ages and can help identify middle ear problems (e.g., presence of fluid and status of eardrum) through a non-invasive and computerized technique.

The decision-making process should include your audiologist and an otolaryngologist, as well as contacting other families in similar situations, visiting local school programs and learning about other resources in your area. Family support programs can be found through your local AG Bell Chapter (check www.agbell.org for a list of chapters by state). Ultimately, your decision will depend on your child’s unique circumstances, such as degree of hearing loss, and the availability of programs in your community. Large metropolitan areas may offer many options, while rural areas may only have a few. Parents should consider the (continued on next page)

So Your Child has a Hearing Loss (continued from previous page)

following when selecting a communication approach:

• Visit the available programs in your community. Call your local school district and ask for the person in charge of parent/infant programs for children with hearing loss, and make

• Communicate with other parents and professionals about local programs. What does your audiologist think of the local public school program? Is there a better one in a nearby school system? Ask your audiologist to connect you with a parent of a slightly older child who could give advice about the local programs. Also ask about the quality of the programs beyond the preschool level. Another good source of information is AG Bell chapter members. Visit www.agbell.org for a full list of chapters and contact information.

Communication Approaches The following are various communication approaches used by individuals who are deaf or hard of hearing. In some cases, just one approach is used; in other cases, several approaches are used. Which approach, and whether to use more than one, is up to your discretion based on your own unique circumstances. • Listening and Spoken Language. This approach focuses on teaching children how to maximize use of residual hearing and/or hearing gained through the use of hearing aids or cochlear implants. This approach emphasizes “learning how to listen” through the exclusive use of auditory skill development. The use of manual communications is not encouraged during therapeutic sessions. The goal is to ultimately ensure that the child’s language skills and spoken language ability are on par with their typical hearing peers in their respective age group. • Cued Speech. This is a visual communication system combining eight handshapes (cues) and four placements around the mouth and face that represent different sounds of speech. These cues are used simultaneously with speaking. The hand shapes help the child distinguish sounds that look the same on the lips, such as “p” and “b.” Because this system is phonetically based, it also aids in the development of spoken language. Cued Speech is an option for a child who may not be able to learn spoken language entirely though hearing aids or cochlear implants or for a child in a multi-lingual household, as the cues can be used in any language. • Total Communication. Total communication uses a combination of methods to help a child develop language, including a form of sign language, finger spelling, speech reading, speaking and hearing assistive devices. The sign language used in total communication is not a language in and of itself, like American Sign Language (ASL), but an artificially constructed language following English grammatical structure. • American Sign Language. In this method, ASL is taught as the child’s primary language, and English as a second language. ASL is recognized as a true language in its own right and follows its own syntax and grammar. ASL is the dominant language of the Deaf community in the U.S.

• Visit the AG Bell Academy for Listening and Spoken Language Web site at www.agbellacademy.org to learn if there is a Listening and Spoken Language Specialist (LSLS) in your area. This professional can offer guidance on local resources and information on communication approaches. • After you have called or visited programs and practitioners in your area and completed your research, make a list of educational options available along with your impression of the quality of each program and its potential to help you reach your family’s desired outcome for communication and language development.

✓

Financial Considerations. Raising a child with a hearing loss can add financial challenges to a family’s resources. Investigate and take advantage of all the financial assistance opportunities available to you. • Health care coverage. Although most major insurers will cover a cochlear implant, many do not cover hearing aids or an additional surgery should you choose to have bilateral implants for your child. Several states have now enacted legislative mandates for group and individual health care insurance companies to cover the cost of hearing aids for children. The same holds true for any type of therapy you wish to pursue, such as speech therapy. Be sure to check with your insurance carrier to see what is, and isn’t, covered under your plan. Finally, ask your EHDI provider if there are hearing aid loaner programs available in your state. • Medicare. If you qualify for Medicare, cochlear implant surgery may be covered, but hearing aids may not. Also check to see if the surgical procedure for cochlear implants are covered in its entirety. The same holds true for any follow up “mapping” or spoken language therapy you should pursue after the surgery. It is important to be informed on what is covered and what is not.

V OLTA V OIC E S • M A R C H/ A P R I L 2009

Photo credit: Paul Mickus

• Read about all the options available today. AG Bell recommends Choices in Deafness, Third Edition by Sue Schwartz, Ph.D., (available from Woodbine House Publishers at www.woodbinehouse.com). Several Web sites can also help you learn about all the options available, including www.agbell.org, www.handsandvoices.com and www.deafchildren.org.

an appointment to visit the program. You can also visit www.oraldeafed.org for a list of private programs in your area. Even if you are unsure about choosing a private option, visiting such a program gives you a frame of reference for evaluating your public school’s program and for requesting specific accommodations.

hearing and other educational programs for young children offer services for free or on a sliding scale, depending on your income level. Check www.agbell.org for a complete list of financial aid options available nationwide in your area.

Photo credit: Paul Mickus

• Nonprofit Assistance. Organizations such at the Let Them Hear Foundation, Starkey Foundation, AG Bell, Lion’s Clubs, and many others offer financial assistance, grants, donation of hearing aid devices and other types of monetary support. Also, many speech,

V O LTA V O ICES • MARCH/APRIL 2009

• Hearing Assistive Device Manufacturers. Another potential resource to consider is what type of financial assistance programs are available from the hearing aid or cochlear implant manufacturer you are considering for your child. Many companies offer assistance in contacting your health care insurance company or Medicare to obtain approval for coverage.

in providing greater opportunities for children who are deaf or hard of hearing as well as future generations. Get involved in local organizations representing children who are deaf or hard of hearing, in your local school programs, and with other parents to ensure the best possible outcome for your child, whatever communication approach you choose. The next article, “Steps to Take for Access to Sound,” will provide an overview on what parents can expect if a spoken language outcome is desired. Reference Gallaudet Research Institute. (2006). Regional

Self-Advocacy

and national summary report of data from

Most importantly, become an advocate for yourself and your child. It is only through the perseverance of parents like you that we have come this far

the 2006-2007 annual survey of deaf and hard of hearing children and youth. Washington, DC: GRI, Gallaudet University.

By Melody Felzien and Judy Harrison, M.A.

Steps to Take for Access to Sound with a newly diagnosed

hearing loss, the decisions to be made can seem overwhelming

and the outcomes unknown. This article provides an overview on what to expect after you’ve received the diagnosis that your child has a hearing loss and the “next steps” if you’ve chosen to pursue listening and spoken language for your child. Early Intervention

“Early Intervention” is a term that describes the identification and treatment of developmental or physical challenges during the ages of birth to 3 years old. For families of children with hearing loss, the early intervention period represents the time when decisions are made regarding a desired communication outcome and for planning the steps necessary to attain the chosen end result. Early intervention is extremely important since, for an infant or child who is deaf or hard of

hearing, timing is essential. The human brain learns language during the first six years of life – the first three years being the most critical. Therefore, it becomes increasingly difficult to acquire language after this period of life. Fortunately, most states offer early intervention (also known A young child with a profound hearing loss talks into a microas parent/infant prophone. The different parts of his cochlear implant are visible. grams) through the local outcome, so make sure you speak up public school or health care systems and emphasize your preference. To for parents who have children with read about a model early intervenhearing loss, up to age 3 years old. tion program, please read “Hearts for The early intervention system will Hearing” on page 26. evaluate your child and develop a plan Early intervention specifically for a with your family for intervention and spoken language approach consists language development. This is called mainly of two components: the use an Individualized Family Service Plan of technology to provide auditory (IFSP) and a case manager, or service stimulation, and listening and spoken coordinator, will work with you to create this plan. The amount of therapy or language therapy – using hearing technology to its fullest potential by intervention services varies by state, so be sure to ask your case manager or teaching the child how to “listen” with the device and to translate what he or service coordinator about the level of she is hearing into spoken language. service you can expect. This includes providing sound through Ideally, a good early intervention hearing aids or cochlear implants; the program provides an explanation of right kind of therapies for the child; the various communication options counseling and support for parents; available, and training in the commuand teaching parents how to stimunication option selected by the family late their child’s speech and language and based on the advice of the professional team evaluating the child. In the production. The earlier the infant has access to auditory stimulation, the case of spoken language, the program earlier he or she can take advantage of will provide a consultation on acquirthe benefits of hearing, or “listening,” ing hearing aids and assistive listenand learn to talk. ing devices (such as an FM system), evaluation for a cochlear implant, and Auditory Stimulation parent counseling. The emphasis of and Hearing Assistive these programs is on working with Devices the family, not just with the child with hearing loss. Parents are entitled to To ensure your child develops spodecide their child’s communication ken language, he or she must receive

V OLTA V OIC E S • M A R C H/ A P R I L 2009

Photo credit: Funtup Productions

As a parent of an infant

The earlier the infant has access to auditory stimulation, the earlier he or she can take advantage of the benefits of hearing, or “listening,” and learn to talk consistent access to sound, especially speech. The type of hearing assistive device used for auditory stimulation will depend on the age of the child and the severity of the hearing loss. It is very important that you speak to your audiologist about the options available to your child and what technology may best suit his or her needs. Regardless of what device your family chooses, the goal will always be to teach the child how to make the best possible use of hearing and to “learn to listen.”

Hearing Aids One of the first steps will be to fit your child with hearing aids. Infants as young as 2 weeks old can be fitted with hearing aids. Regardless of the range of hearing loss, fitting your baby with hearing aids right away improves your child’s access to sound and maximizes the window of opportunity to acquire language. Depending on the degree of your child’s hearing loss, hearing aids will enable your baby to hear many

V O LTA V O ICES • MARCH/APRIL 2009

sounds, including environmental sounds (a dog barking or a rattle shaking) and the sound of speech. Hearing aids work by boosting the intensity (or loudness) level of sounds at different frequencies (or pitches). Hearing aids can also be programmed to fit the needs of individual hearing patterns, such as boosting intensity level for high frequency sounds that your child may not hear at all and less for low frequency sounds that your child may hear better. It is important to note that hearing aids do not correct hearing the same way that glasses correct vision. Individual sounds may be somewhat distorted. Hearing aids amplify all sounds, so it may be difficult for your child to distinguish and understand your voice from background noise in loud environments. Regular sessions with an auditory-verbal practitioner will help your child distinguish these sounds. There are four main types of hearing aids: behind the ear (BTE), in the ear (ITE), in the canal (ITC) and implantable hearing aids. ITE and ITC hearing aids are not appropriate for young children, so BTEs are most frequently recommended. The type of hearing aid is selected following a comprehensive audiological evaluation. Speak to your audiologist about the available options and appropriate technology. Your audiologist will select the most appropriate hearing aid for your child and fine-tune the level of amplification the hearing aid provides based on the degree of hearing loss. The early stages of hearing aid use for an infant or young child typically requires frequent visits with the audiologist as the family observes the child’s response to sound to make appropriate adjustments to the device. Most of the time, two hearing aids are recommended for your child if the hearing loss is in both ears. Research studies on adults show that people who have a hearing loss in both ears, but habitually wear only one aid, lose the ability to recognize speech in the other ear. For infants and young

Parents’ Hearing Aid Survival Kit The following items are recommended to ensure the hearing aids performance and longevity: • Hearing aid batter tester – to check the battery level each day. • Hearing aid stethoscope – to perform a daily listening check. • Forced-air stethoscope – to remove moisture and ear wax from the sound channel of the earmold. • Hearing aid dehumidifier – to store hearing aids overnight. • Earmold lubricant – to facilitate earmold insertion and reduce the likelihood of acoustic feedback. • Earmold disinfectant – to keep your child’s ears healthy and happy!

Excerpted from ASHA, Let’s Talk, May/June 99, pp.43-44

children developing their brain’s auditory pathways, it is critical to provide that auditory stimulation. If your child has a hearing loss in both ears, using two hearings aids prevents auditory deprivation and helps your child to localize sound and hear better in noisy environments. Unfortunately, hearing aids are expensive and many insurance companies will not cover the cost. However, several states have recently enacted mandates to force insurance companies to cover, at least partially, the cost of hearing aids for children. Make sure you check your insurance policy before purchase. Ask your audiologist about your purchasing options as well as possible funding sources in your community or hearing aid loaner programs. There are many national organizations that provide funding for hearing aid purchase, including the Let Them Hear Foundation, Starkey Foundation, Lions Clubs and others. AG Bell also provides financial assistance programs for the purchase of (continued on next page)

Steps to Take for Access to Sound (continued from previous page)

hearing aids or other associated costs, such as speech therapy. More information about the different types of hearing aids and funding options can be found at www.agbell.org.

Cochlear Implants Introduced in the 1970s, cochlear implants were developed to help individuals who are profoundly deaf and gain little or no benefit from hearing aids. When hearing is functioning normally, the inner ear converts sound waves into electrical impulses, which are sent to the brain and recognized as sound. A cochlear implant works in a similar manner – when surgically placed behind the ear and in the

cochlea, the electronic device is able to bypass damaged ear cells and stimulate the auditory nerve to restore partial hearing. Cochlear implants provide enhanced sound detection and a greater potential for understanding speech. If your child receives little to no benefit from hearing aids, has a severe-to-profound hearing loss and is at least 12 months old, he or she may be a candidate for a cochlear implant. Although the Food and Drug Administration (FDA) recommends cochlear implant surgery for children no younger than 12 months, many children as young as 6 months old are having the surgery with few reports of complications. As with any surgery performed under general anesthesia, there are always risks parents should be aware of. Speak with your audiologist about an evaluation as well as the benefits and risks of the surgery before

Steps to Receiving a Cochlear Implant n Step One: Evaluation Most cochlear implant centers take a team approach when determining a child’s implant candidacy. The team will include an audiologist, speech language pathologist/therapist, surgeon, educator and psychologist in addition to the family. The child will undergo audiological, medical, learning and/or psychological assessments to determine if a cochlear implant is an appropriate course of action. Some children have already completed a variety of hearing tests along with speech and language evaluations by the time they meet with a cochlear implant team. However, in most cases, the cochlear implant team will still need to perform their own battery of tests. Parents should be prepared to bring their child to several appointments before the cochlear implant team can make a final recommendation on whether or not to proceed with the surgery.

n Step Two: Surgery The surgery itself takes two to four hours and can be completed as an outpatient procedure or, at most, a one-night stay. There may be some mild discomfort, but generally children respond well and can usually resume reasonable normal activity in a few days. Parents should allow four to six weeks for the area around the implant to fully heal. The child will not hear with the implant during this period and will not use a hearing aid in the implanted ear(s).

n Step Three: Device Programming or “Mapping” After the area around the implant has healed, the child will return to the audiologist to receive the external device, or the sound processer. The sound processor is placed over the implant and then connected to the audiologist’s computer to be programmed. This process is known as “mapping.” The audiologist activates the electrodes individually and determines hearing sensitivity by taking measurements of sound based on the child’s reactions or on neurologic responses. These measurements are used to program the sound processor for the child. As the listener adapts to their new hearing, the sound processor will require adjustments to provide optimal sound stimulation. It may take several mapping sessions for your child to progressively benefit from the implant. To ensure the full benefits of the implant, your child will require follow-up services.

choosing the procedure. Research suggests that a cochlear implant can significantly improve the speech development and listening skills of a child with severe-to-profound hearing loss. However, results are dependant on the individual child’s strengths and needs, the involvement and motivation of the family to help their child succeed, and the quality of the rehabilitation and therapy program after the implant is activated. Most health insurance companies and managed care organizations provide some level of coverage for cochlear implant services, including the necessary and ongoing programming of the device and aural (re)habilitation. Federal health plans, such as Medicare and the Veteran’s Administration, provide benefits for all cochlear implant services. Federal law requires that all state Medicaid agencies provide coverage for all or part of cochlear implantrelated services for children under 21 years old. Parents should check with their health care provider to determine the level and amount of benefits their child will receive. There is extensive information available about cochlear implants, the implant process and their benefits. Please visit www.agbell.org or the FDA cochlear implant site at www.fda.gov/cdrh/cochlear for a comprehensive overview of the cochlear implant. Again, always consult your audiologist to determine the best assistive technology device for your child. Early Stages of Listening and Spoken Language Development

The most important step after providing your child with access to sound through hearing aids, cochlear implants or both is to begin listening and spoken language therapy. This type of therapy will help your child learn how to hear and speak. Although your child is hearing sounds, he or she still needs to learn to understand the sounds by learning to listen, maximizing his or her potential of applying V OLTA V OIC E S • M A R C H/ A P R I L 2009

sound into spoken language. This type of therapy will help your child learn how to hear and speak. According to the AG Bell Academy for Listening and Spoken Language, this technique facilitates acquisition of spoken language through listening. Parents can expect to actively participate in listening and spoken language skill development. Individuals specializing in auditory-verbal practice help children who are deaf or hard of hearing develop spoken language and literacy primarily through listening. Through guidance, coaching and demonstration, parents become the primary facilitators of their child’s spoken language development. Ultimately, parents and caregivers will gain confidence that their child can have access to a full range of academic, social and occupational choices throughout life. It is essential that parents establish an environment at home that

facilitates listening and spoken language. This includes speaking to your child even when his or her eyes are focused away from you, insuring your child’s hearing devices are working properly, practicing a variety of listening activities with your child as learned during therapy sessions, and including other family members in the therapy at home. Therapy sessions after the child’s hearing devices have been provided are essential to establish speech and language skills. You and your auditory-verbal practitioner should strive for typical speech and language development. The AG Bell Academy provides resources on what parents should expect at home and in the speech and language development of their child. Please visit www.agbellacademy.org/Information_ for_Parents.htm for more information about listening and spoken language specialists, therapy and education.

Conclusion

The convergence of technology with early identification and intervention, and progressive therapies designed to maximize the benefits of that technology have allowed children who are deaf or hard of hearing to have access to spoken language like never before. Parents should carefully consider all the options when choosing a communication approach for their child and should seek out recognized and highly qualified professionals during the decision-making process. Portions of this article were adapted from “So Your Child Has a Hearing Loss: Next Steps for Parents” published in 2000 by AG Bell.

Ready for a Change?

Explore AG Bell’s New Online Career Center! The AG Bell Career Center is the premier electronic recruitment resource for the hearing health and deaf education field. Here, employers and recruiters can access YOU, the most qualified talent pool with relevant work experience to fulfill their staffing needs. Employers post jobs online for a fee, search for qualified candidates based on specific job criteria, create an online resume agent to email qualified candidates daily and, as an additional benefit, have immediate access to statistics showing online activity in realtime. For job seekers, the AG Bell Career Center is a FREE service that provides access to employers and jobs. In addition to posting their resumes, job seekers can create a search agent to provide instant email notifications of jobs that match your own criteria.

The right job is waiting for you! Visit AG Bell’s Career Center at careers.agbell.org today!

Alex ander

Graham

Bell

A ssociatio n f or the D ea f a n d H ard o f H eari n g

V O LTA V O ICES • MARCH/APRIL 2009

Por Melody Felzien y Judy Harrison, M.A.

Pasos a seguir para acceder al sonido

Como padre de un

bebé con diagnóstico reciente de pérdida de la audición, las decisiones que deben

tomarse pueden parecer abrumadoras y los resultados desconocidos. Este artículo proporciona una descripción general de lo que puede esperar luego de recibir el diagnóstico de que su hijo tiene una pérdida auditiva y los “pasos a seguir” en caso de que haya decidido optar por que su hijo aprenda a escuchar y el lenguaje oral. Intervención temprana

“Intervención temprana” es un término que describe la identificación y el tratamiento de desafíos físicos o del

desarrollo desde el nacimiento hasta los 3 años de edad. Para las familias de niños con pérdida auditiva, el período de intervención temprana representa el tiempo en que deben tomarse las decisiones con respecto al resultado deseado de comunicación y en el que se planifican los pasos necesarios para lograr el resultado final elegido. La intervención temprana es extremadamente importante dado que, para un bebé o niño sordo o con problemas de audición, el tiempo es esencial. El cerebro del ser humano está programado para aprender el lenguaje durante los seis primeros años de vida –los tres primeros son los más importantes. Por lo tanto, se torna cada vez más difícil adquirir el lenguaje luego de este período de vida. Afortunadamente, la mayoría de los estados ofrece intervención temprana (también conocidos como programas para padres y bebés) a través de los sistemas locales de atención médica y educación escolar pública para padres cuyos hijos tienen pérdida auditiva, hasta los 3 años de edad. El sistema de intervención temprana evaluará a su hijo y desarrollará un plan con su familia en cuanto a la intervención y el desarrollo del lenguaje, que se denomina Plan individual de servicios familiares (IFSP, por su sigla en inglés). Un administrador de casos, o coordinador de servicios, lo ayudará a coordinar sus actividades y las de los profesionales para crear este plan. La cantidad de terapia o servicios de intervención que brinda un estado varía, por lo que debe asegurarse de preguntarle al administrador de su caso o coordinador de servicios sobre los niveles de servicio que puede esperar.

Lo ideal sería que un buen programa para padres y bebés brindara una explicación de las diferentes opciones de comunicación disponibles y capacitación para la opción de comunicación que eligió la familia y basada en el asesoramiento del equipo de profesionales que evalúa al niño. En el caso del lenguaje oral, el programa proporcionará una consulta sobre la adquisición de audífonos y dispositivos de ayuda auditiva (como un sistema FM), evaluación para un implante coclear y orientación para los padres. El énfasis de estos programas es trabajar con la familia, no sólo con el niño con pérdida auditiva. Los padres tienen el derecho de elegir la opción de comunicación para su hijo, por lo que deben asegurarse de expresar su opinión y enfatizar su preferencia. Para leer sobre un programa modelo para padres y bebés, lea “Hearts for Hearing” en la página 26. La intervención temprana para un enfoque de lenguaje oral consiste principalmente en dos componentes: el uso de tecnología para proporcionar estimulación auditiva y terapia de la audición y el lenguaje oral: usar la tecnología auditiva en la mayor medida posible al enseñarle al niño cómo “escuchar” con el dispositivo y a traducir lo que está escuchando en el lenguaje oral. Esto incluye proporcionar sonido mediante audífonos o implantes cocleares; proporcionar el tipo adecuado de terapias para el niño; brindar orientación y apoyo a los padres; y enseñarles a los padres cómo estimular el habla y la producción del lenguaje del niño. Cuanto más temprano el bebé tenga acceso a la estimulación auditiva, más pronto

V OLTA V OIC E S • M A R C H/ A P R I L 2009

podrá aprovechar los beneficios de “oír”, o escuchar, y aprender a hablar, y así aprender el lenguaje oral. Estimulación auditiva y dispositivos de ayuda auditiva

Para asegurarse de que su hijo desarrolle el lenguaje oral, éste debe recibir un acceso constante al sonido, especialmente, al habla. El tipo de dispositivo de ayuda auditiva que se utilizará para la estimulación auditiva dependerá de la edad del niño y la gravedad del problema auditivo. Es muy importante que hable con el audiólogo sobre las opciones disponibles para su hijo y qué tecnología será más adecuada para sus necesidades. Independientemente del dispositivo que elija su familia, el objetivo siempre será enseñarle al niño de qué manera utilizar mejor la audición y que “aprenda a escuchar”.

Kit de supervivencia de audífonos para padres Se recomiendan los siguientes elementos para garantizar el funcionamiento y la larga duración de los audífonos: • Verificador de batería del audífono, para controlar el nivel de la batería todos los días. • Estetoscopio para audífono, para realizar un control auditivo diario. • Estetoscopio de aire a presión, para eliminar la humedad y la cera del canal auditivo del molde auricular. • Deshumidificador para audífono, para almacenar los audífonos por la noche. • Lubricante para molde auricular, para facilitar la introducción del molde auricular y reducir las probabilidades de retroalimentación acústica. • Desinfectante para molde auricular, para mantener los oídos de su hijo sanos y contentos.

Extraído de ASHA, Let’s Talk, mayo/junio de 1999, págs.43-44

V O LTA V O ICES • MARCH/APRIL 2009

Audífonos Uno de los primeros pasos será colocarle audífonos a su hijo. Se pueden colocar audífonos a bebés de hasta 2 semanas. Independientemente del rango de pérdida auditiva, colocarle audífonos a su bebé de inmediato mejora el acceso del niño al sonido y maximiza las oportunidades de adquirir el lenguaje. Según el grado de pérdida auditiva de su hijo, los audífonos le permitirán escuchar muchos sonidos, inclusive sonidos del medio ambiente (un perro ladrando o el sonido de un sonajero) y el sonido del habla. Los audífonos funcionan al incrementar el nivel de intensidad (o el volumen) de los sonidos en diferentes frecuencias (o tonos). También pueden programarse de acuerdo con las necesidades de patrones auditivos individuales, como incrementar el nivel de intensidad para sonidos de alta frecuencia que su hijo no escucha en absoluto y reducirlo para sonidos de baja frecuencia que su hijo escucha mejor. Es importante destacar que los audífonos no corrigen la audición de la misma manera que las gafas corrigen la visión. Los sonidos individuales pueden verse distorsionados en cierta medida. Los audífonos amplifican todos los sonidos, por lo que a su hijo le puede resultar difícil distinguir su voz de ruidos de fondo en entornos ruidosos y comprenderla. Su hijo podrá distinguir estos sonidos mediante sesiones regulares con un profesional de la audición y el habla. Hay cuatro tipos principales de audífonos: detrás de la oreja (BTE), dentro del oído (ITE), dentro del canal (ITC) y audífonos implantables. Los audífonos ITE e ITC no son apropiados para niños pequeños, por lo que los BTE son los que se recomiendan con mayor frecuencia. El tipo de audífono se selecciona luego de una evaluación audiológica completa. Hable con el audiólogo sobre las opciones disponibles y la tecnología adecuada. El audiólogo elegirá el audífono más adecuado para su hijo y ajustará el nivel de amplificación que proporciona

el audífono según el grado de pérdida auditiva. En un bebé o un niño pequeño, las primeras etapas de uso de audífonos requieren visitas frecuentes al audiólogo en las que se realizan los ajustes adecuados al dispositivo, a medida que la familia observa la respuesta del niño al sonido. La mayoría de las veces, se recomiendan dos audífonos para niños, en caso de que la pérdida auditiva esté presente en ambos oídos. Estudios de investigación en adultos demostraron que aquellas personas que tienen una pérdida auditiva en ambos oídos, pero que normalmente utilizan sólo un audífono, pierden la capacidad de reconocer el habla en el otro oído. Para los bebés y niños pequeños en desarrollo de las vías auditivas del cerebro, es fundamental proporcionar esa estimulación auditiva. Si su hijo posee una pérdida auditiva en ambos oídos, el uso de dos audífonos impide la privación auditiva y ayuda a su hijo a ubicar el sonido y a escuchar mejor en ambientes ruidosos. Lamentablemente, los audífonos son costosos y la mayoría de las compañías de seguros no cubre el costo. No obstante, recientemente varios estados aprobaron mandatos para forzar a las compañías de seguros a cubrir, al menos en forma parcial, el costo de los audífonos para niños. Asegúrese de consultar su póliza antes de realizar una compra. Pregúntele al audiólogo sobre las opciones de compra, así como fuentes posibles de financiación en su comunidad o programas de préstamo de audífonos. Hay muchas organizaciones nacionales que proporcionan financiación para compras de audífonos, que incluyen Let Them Hear Foundation, Starkey Foundation, Lions Clubs y otras. AG Bell también proporciona programas de ayuda financiera para la compra de audífonos u otros costos relacionados, como la terapia del habla. Podrá encontrar más información sobre los diferentes tipos de audífonos y opciones de financiación en www.agbell.org. (continuación en la página siguiente)

Pasos a seguir para acceder al sonido (continuación de la página anterior)

Implantes cocleares Los implantes cocleares se crearon en la década de 1970 para ayudar a las personas con sordera total y que no obtienen beneficios, o muy pocos, con audífonos. Cuando la audición funciona normalmente, el oído interno convierte las ondas sonoras en impulsos eléctricos, que se envían al cerebro y se reconocen como sonidos. Un implante coclear funciona de manera similar: cuando se lo implanta quirúrgicamente detrás del oído y dentro de la cóclea, el dispositivo electrónico evita las células auditivas dañadas y estimula el nervio auditivo para restaurar una audición parcial. Los implantes cocleares proporcionan una mejor detección sonora y un mayor potencial

para entender el habla. Si su hijo recibe beneficios reducidos a nulos con los audífonos, tiene una pérdida auditiva grave a total y tiene al menos 12 meses de vida, podrá ser candidato para un implante coclear. Aunque la Administración de Drogas y Alimentos de EE. UU. (FDA) recomienda no realizar cirugías de implantes cocleares en niños menores de 12 meses, a muchos niños de hasta 6 meses se les ha realizado la cirugía y se han notificado pocos casos de complicaciones. Al igual que con toda cirugía realizada con anestesia general, siempre existen riesgos que los padres deben conocer. Hable con el audiólogo sobre una evaluación, así como sobre los beneficios y riesgos de la cirugía antes de considerar el procedimiento. Las investigaciones sugieren que un implante coclear puede mejorar significativamente el desarrollo del habla y la capacidad auditiva de un

Pasos para recibir un implante coclear n Primer paso: Evaluación La mayoría de los centros de implantes cocleares toman un enfoque en equipo para determinar si un niño es candidato para un implante. El equipo incluirá a un audiólogo, un patólogo o terapeuta del habla y el lenguaje, un cirujano, un educador y un psicólogo, además de la familia. El niño se someterá a evaluaciones audiológicas, médicas, del aprendizaje y/o psicológicas para determinar si un implante coclear es una medida apropiada. Antes de reunirse con un equipo de implantes cocleares, a algunos niños ya se les realizó una variedad de pruebas auditivas junto con evaluaciones del habla y el lenguaje. Sin embargo, en la mayoría de los casos, el equipo de implantes cocleares aún deberá realizar su propia serie de pruebas. Los padres deben estar preparados para llevar a su hijo a varias citas antes de que el equipo de implantes cocleares pueda realizar una recomendación final sobre si realizar o no un implante coclear.

n Segundo paso: Cirugía La cirugía en sí demora entre dos y cuatro horas y se puede llevar a cabo como procedimiento ambulatorio o, como máximo, con una noche de internación. Su hijo podrá experimentar algunas molestias leves, pero en general responderá bien y podrá reanudar actividades normales razonables en algunos días. Los padres deben esperar entre cuatro y seis semanas para que el área alrededor del implante cicatrice por completo. El niño no escuchará con el implante durante este período y no utilizará un audífono en los oídos con implantes.

n Tercer paso: Programación o “mapeo” del dispositivo Una vez que el área alrededor del implante se haya cicatrizado, el niño regresará al audiólogo para recibir el dispositivo externo, o procesador de sonido. El procesador de sonido se coloca sobre el implante y luego se conecta al ordenador del audiólogo para programarlo. Este proceso se conoce como “mapeo”. El audiólogo activa cada uno de los electrodos y determina la sensibilidad auditiva al medir el sonido en función de las reacciones del niño o según las mediciones de respuestas neurológicas. Estas mediciones se utilizan para programar el procesador de sonido para el niño. A medida que la persona que escucha se adapte a su nueva capacidad de audición, el procesador de sonido requerirá ajustes para proporcionar una estimulación sonora óptima. Para que su hijo se beneficie progresivamente con el implante, se necesitarán varias sesiones de mapeo. A fin de garantizar que el implante ofrezca beneficios completos, su hijo requerirá servicios de seguimiento.

niño con pérdida auditiva grave a total. No obstante, los resultados dependen de las fortalezas y necesidades de cada niño, la participación y la motivación de la familia para ayudar a que el niño tenga éxito y la calidad del programa de rehabilitación y terapia luego de la activación del implante. La mayoría de las compañías de seguros de salud y organizaciones de atención administrada proporcionan algún nivel de cobertura para servicios de implantes cocleares, inclusive la programación necesaria y constante del dispositivo y la rehabilitación auditiva. Los planes federales de salud, como Medicare y la Administración de Veteranos de EE. UU., proporcionan beneficios para todos los servicios de implantes cocleares. Las leyes federales exigen que todas las agencias estatales de Medicaid ofrezcan cobertura para implantes cocleares en niños menores de 21 años. Los padres deben consultar con las compañías de seguros para determinar el nivel y el monto de beneficios que recibirá su hijo. Hay una gran cantidad de información disponible sobre implantes cocleares, el proceso de implantación y sus beneficios. Visite www.agbell.org o el sitio de implantes cocleares de la FDA en www.fda.gov/cdrh/cochlear para obtener información completa sobre el implante coclear. No olvide consultar con el audiólogo para determinar cuál es el mejor dispositivo tecnológico de ayuda para su hijo. Etapas tempranas del desarrollo del lenguaje oral y la audición

El paso más importante luego de proporcionarle acceso al sonido a su hijo mediante audífonos, implantes cocleares o ambos es comenzar la terapia de la audición y el lenguaje oral. Aunque su hijo escucha el sonido, aún debe aprender a entender los sonidos al aprender a escuchar y luego a traducir ese sonido en lenguaje oral. Este tipo de terapia ayudará a su hijo a aprender cómo escuchar y hablar. Según la AG Bell Academy for Listening and Spoken Language, esta V OLTA V OIC E S • M A R C H/ A P R I L 2009

técnica facilita la adquisición del lenguaje oral mediante la audición. Los padres pueden participar activamente en el desarrollo de las capacidades de audición y el lenguaje oral. Personas especializadas en práctica auditiva verbal ayudan a los niños sordos o con problemas auditivos a desarrollar el lenguaje oral y la alfabetización principalmente a través de la audición. Mediante orientación, asesoramiento y demostraciones, los padres se convierten en los principales facilitadores del desarrollo del lenguaje oral de su hijo. En última instancia, los padres y las personas a cargo del cuidado de su hijo tendrán la certeza de que éste tendrá acceso a una gama completa de opciones académicas, sociales y ocupacionales durante toda su vida. Es fundamental que los padres establezcan un ambiente en el hogar que facilite la audición y el lenguaje oral. Esto incluye hablarle a su hijo incluso

V O LTA V O ICES • MARCH/APRIL 2009

cuando no tenga los ojos enfocados en usted, asegurarse de que los dispositivos auditivos de su hijo funcionen correctamente, practicar una variedad de actividades auditivas con el niño que se aprendieron durante las sesiones de terapia e incluir a otros familiares en la terapia en el hogar. Las sesiones de terapia luego de que el niño haya recibido los dispositivos auditivos son esenciales para establecer las capacidades de audición y lenguaje. Usted y el profesional de la audición y el habla deben luchar por conseguir un desarrollo típico del habla y el lenguaje. La AG Bell Academy cuenta con varios recursos sobre lo que los padres deben esperar en el hogar y en el desarrollo del habla y el lenguaje de su hijo. Visite www.agbellacademy. org/Information_for_Parents.htm para obtener más información sobre especialistas, terapias y educación sobre audición y lenguaje oral.

Conclusión

No existe mejor momento para celebrar el lenguaje oral. La convergencia de la tecnología con terapias de identificación e intervención tempranas y terapias progresivas diseñadas para maximizar los beneficios de esa tecnología ha permitido que los niños sordos o con problemas auditivos tengan acceso al lenguaje oral como nunca antes fue posible. Los padres deben considerar detenidamente todas las opciones al decidir sobre un enfoque de comunicación para su hijo y asegurarse de buscar profesionales reconocidos y altamente capacitados durante el proceso de la toma de decisiones. Portions of this article were adapted from “So Your Child Has a Hearing Loss: Next Steps for Parents” published in 2000 by AG Bell.

By Teresa H. Caraway, Ph.D., CCC-SLP, LSLS Cert. AVT

Hearts for Hearing:

more opportunities available for children born deaf or hard of hearing to develop listening, literacy and spoken language skills equal to their peers with typical hearing. Today’s opportunities exist because of three recent advancements: universal newborn hearing screening; hearing technologies, including digital hearing aids and cochlear implants; and auditory-based early intervention or auditory-verbal practice. For infants and young children with hearing loss and their families to benefit from these advances, it is imperative for professionals, programs and service delivery systems to provide state-of-the-art, comprehensive family-centered early intervention. Hearts for Hearing (HFH), a nonprofit organization in Oklahoma City, Okla., strives to capitalize on those advances by continually improving our early intervention services to infants with hearing loss and their families. Ninety-five percent of babies born with hearing loss are born to hearing parents (Gallaudet Research Institute, 2006). At HFH, it is our experience that when clear outcome possibilities for hearing loss are shared with 26

parents and programmatic options are available, 90 percent of parents today choose a listening and spoken language outcome for their child (Hearts for Hearing internal data collection, 2008). The efforts of HFH to significantly improve early intervention for children with hearing loss are based on the parents’ desire for a listening and spoken language outcome and the opportunities created by recent technological and pedagogical advances. A Model Program

The HFH team includes three pediatric audiologists and nine speechlanguage pathologists, eight of whom are certified as Listening and Spoken Language Specialists (LSLS) by the AG Bell Academy for Listening and Spoken Language. The HFH team works collaboratively with numerous partners, including physicians, newborn hearing screening program coordinators, early intervention providers identified by the Individuals with Disabilities Education Act (IDEA) Part C, audiologists, and educators, to improve listening and spoken language outcomes for Oklahoma children who are deaf or hard of hearing and their families. One goal of HFH is to affirm, encourage and inspire others to create program and system changes and to provide early intervention services that support infants and toddlers with hearing loss and their families in reaching their desired outcomes. HFH has established collaborative partnerships with hospital newborn hearing screening programs. As a result, infants who are referred for a

Photo credit: Aimee Adams Photography

There have never been

Tami Elder works with Nora Watson during a therapy session at the Hearts for Hearing program.

full hearing diagnostic by newborn hearing screening procedures complete comprehensive, electrophysiological testing within days of their birth. When an infant’s initial screening indicates a possible hearing loss, the coordinators of the respective hospital newborn hearing screening programs immediately assist the family in scheduling follow-up diagnostic testing at HFH. The HFH team prioritizes these appointments so that the infant and his or her family are seen within at least one week’s time. If the infant is diagnosed with a hearing loss, family counseling begins immediately with the pediatric audiologist and a LSLS, and ear impressions for earmolds are made on the day of testing. Infants and their families return one to two days later to be fitted with their first set of state-of-the-art hearing aids. To ensure this timely access to audition, HFH provides the initial set of hearing aids and a personal FM system to any baby in Oklahoma with significant bilateral hearing loss who does not have Medicaid funding for hearing technology. An Oklahoma legislative V OLTA V OIC E S • M A R C H/ A P R I L 2009

Photos credit: Hearts for Hearing

Creating Life-Changing Opportunities through Early Intervention

Photos credit: Hearts for Hearing

Daniel ( left) and Cyndi Knowsley ( middle ) participate in a therapy session with Dr. Caraway (right) at the Hearts for Hearing program in Oklahoma City, Okla.

appropriation to HFH supports, in large part, the cost of providing this technology. As a result, infants referred to HFH are diagnosed, fitted with their first set of hearing aids and begin auditory-verbal therapy (an auditorybased early intervention approach) by age 2 to 3 weeks. When an infant with a hearing loss is fitted with appropriate hearing technology, the speech and language of others and environmental sounds become accessible and intelligible, and the opportunity for auditory brain development occurs. This is why the team at HFH considers hearing loss a neurodevelopmental emergency. As a result, every infant diagnosed with hearing loss receives quick access to sound so that he or she does not lose precious weeks of auditory brain development (Cole & Flexer, 2007). To maximize the opportunity for continued auditory brain development, ongoing aggressive audiological management of the infant’s hearing loss by a HFH pediatric audiologist is provided. This process follows the American Speech-Language-Hearing Association (ASHA) Guidelines for the Audiological Assessment of Children from Birth to 5 Years of Age (ASHA, 2004). Wearing hearing aids, cochlear implants or both during all waking hours is critical, but ensuring well-fitted amplification for newborns can be challenging. Providing and maintaining well-fitted earmolds is particularly V O LTA V O ICES • MARCH/APRIL 2009

difficult. Typically, infants return to HFH weekly during the first couple of months for hearing aid checks and new earmold impressions. These visits are scheduled to coincide with weekly therapy sessions. Based on our clinical experience, it is not uncommon for a newborn fitted with hearing aids during the first few weeks of age to require 10 to 15 sets of earmolds during the first year of life. The HFH team continues to work closely with the infant and family and, on average, 67 percent of the appointments are shared appointments between the pediatric audiologist and a LSLS. This allows for observation of the child’s responses to audiological exams, promotes optimal hearing aid fitting, advances listening and spoken language development, and enhances information exchange and family support. At HFH, infants and parents attend therapy sessions with a LSLS one hour each week. The foremost goal of auditory-verbal practice is to equip parents and caregivers with specific strategies and techniques to become the primary facilitators for the child’s development of intelligible spoken language through listening abilities. Should weekly travel to Oklahoma City or to HFH’s satellite center in Tulsa present a hardship for a family, distance therapy is provided via the Internet through a home computer and a web camera, or through (continued on next page)

Hearts for Hearing (continued from previous page)

Talking Birth to Six. San Diego, CA:

Conclusion

Everything we know and understand about childhood hearing loss has changed because of newborn hearing screening, advanced hearing technology and auditory-verbal practice. The majority of infants born deaf or hard

Plural Publishing. Gallaudet Research Institute. (2006). Regional

and national summary report of data from the 2006-2007 annual survey of deaf and hard of hearing children and youth. Washington, DC: GRI, Gallaudet University.

V OLTA V OIC E S • M A R C H/ A P R I L 2009

Photo credit: Hearts for Hearing

the family’s local health department or school. This early immersion in listening and spoken language permits natural development of speech and language skills rather than remedial development. Consequently, a child can learn skills at the appropriate ages and stages when the brain is primed to do so, resulting in at least one year of listening and spoken language growth in one year’s time. To continue facilitating a child’s listening and spoken language skills, HFH provides a parent-toddler and preschool class in addition to the weekly therapy sessions. Typically, children 20 to 24 months of age and their parents or caregivers begin attending the parent-toddler group one morning a week. After attending the parent-toddler group for one year, some parents decide to enter their child in the local mainstream preschool, while others decide to enter their child in the HFH preschool classroom for a year prior to attending the local mainstream preschool. The HFH preschool classroom practices “reverse mainstreaming” in the classroom, providing children with hearing loss the opportunity to practice their listening and spoken language skills with peers who have typical hearing. HFH continues to provide consultative support as children enter their local mainstream schools. When professionals and parents work together, children can enter a mainstream preschool with spoken language skills equal to or better than their hearing peers. The journey of teaching a child with hearing loss to listen and talk is best shared with others. Quarterly, HFH provides Saturday Family Workshops to provide family support and comprehensive instruction in child development, audiology, spoken language and speech development. The extended family is encouraged to attend and during the parent education and support time, an intensive listening and

of hearing today can develop exceptional conversational, literacy and academic skills. Yet despite these marvelous opportunities, appropriate early intervention services for children with hearing loss are not widely available. The existing early intervention infrastructure was The Walters family reads outside of the Hearts for Hearing developed at a time program ( from left to right): Hayden, Justin, Jill and Hudson. when most children with language program for the children with hearing loss were not identified until hearing loss is provided. Siblings are 2 to 5 years of age and digital hearing encouraged to participate in learnaids and cochlear implants were not ing activities aimed at developing available. To support today’s infants their brother or sister’s listening and with hearing loss and their families, language skills as well in a sibling supprofessionals have an immediate port group. In the summer, HFH offers responsibility to expand their knowla Summer Day Camp for preschool edge and skills and to work collaborathrough school age children with heartively to create system changes that ing loss to help them continue develop- will provide comprehensive state-ofing exceptional listening and spoken the-art early intervention services to language skills. today’s infants with hearing loss and The professionals at HFH strive to their families. Together, we can create provide up-to-date information and life-changing opportunities for children early intervention services for children who are deaf or hard of hearing to and their families through research, listen and talk for a lifetime. experience and collaboration with Editor’s Note: To learn more about the other health care professionals. As Hearts for Hearing program, please visit a comprehensive cochlear implant www.heartsforhearing.org, or contact center, HFH additionally conducts Dr. Caraway at (405) 548-4300 or extensive research and readily shares teresa.caraway@heartsforhearing.org. findings at professional meetings and in professional publications. HFH is devoted to the continued education References of physicians, early interventionists, American Speech-Language-Hearing audiologists, graduate students and Association (2004). Guidelines for the parents by providing regional workaudiological assessment of children from shops, weeklong professional immerbirth to 5 years of age. Available from sion experiences, mentorship for www.asha.org/members/deskref-journals/ auditory-verbal practice and a clinical deskref/default. rotation site for approximately 55 Cole, E. & Flexer, C. (2007). Children with speech-language pathology and audiolHearing Loss Developing Listening and ogy students.

By Melody Felzien

What the Research Shows: Emergent Literacy Skills, Prelinguistics and Metacognition

For over 100 years, researchers have explored questions about hearing loss and intervention and published their findings in The Volta Review, a 110-year-old scholarly journal founded by Dr. Alexander Graham Bell to provide professionals with information on deafness and development of spoken language. With busy professionals and parents in mind, AG Bell is continuing an ongoing article series that highlights and summarizes research recently published in The Volta Review. The following research was published in the fall 2008 issue of The Volta Review, 108(2).

Literacy Skills in Early Childhood

Researchers have long documented that students with hearing loss have difficulty attaining proficient literacy skills. However, the information about how these skills are attained and the rate of attainment is limited. This information is important because these skills form the foundation for reading words and passages meaningfully (National Reading Panel, 2002). In “Emergent Literacy Skills During Early Childhood in Children With Hearing Loss,” Susan R. Easterbrooks and colleagues (2008) examine the rate of development of three skills considered critical for literacy development in children with typical hearing as well as children who are deaf or hard of hearing: phonological awareness, knowledge of the alphabetic principal and vocabulary level (Ehri et al., 2001; Rayner et al., 2001). Easterbrooks and colleagues assessed emergent literacy skills and outcomes at the beginning and end of a school year for 44 young children (mean age = 5.2 years) who are deaf and hard of hearing and who had some speech perception skills through spoken language. All the participants attended self-contained preschool, kindergarten or first grade classrooms for children with hearing loss and, according to the parents, all the children participating in this study received sound amplification upon identification of hearing loss.

Easterbrooks and colleagues used a variety of measures and tests to gauge phonological awareness, alphabet comprehension and vocabulary levels, both at the beginning and the end of a single school year. By comparing the outcomes over the course of a school year, the researchers were able to measure the rate of attaining literacy skills. The results indicate that the children generally showed gains similar to their hearing peers in knowledge of letter names and common written words, but only progressed on some phonological awareness skills (alliteration,

Vocabulary Phonological Awareness – “Attending to, thinking about and intentionally manipulating the phonological aspects of spoken language” (Scarborough & Brady, 2002, p.312). These skills include blending, segmenting, elision and rhyming. Alphabetic Principal – letters represent phonemes, which can be blended to form words. Volubility – the number of vocalizations per minute. Metacognition – the strategic employment of one’s cognitive processes and resources to construct knowledge, and employ thinking and problem-solving skills to reach understanding and insight into one’s environment (Brown, 1978; Flavell, 1976, 1978, 1979, 1999).

V OLTA V OIC E S • M A R C H/ A P R I L 2009

blending and elision) and not on others (rhyming and syllable segmentation). In addition, the participants showed little growth of vocabulary skills over the year. This is most likely because many children with hearing loss require explicit instruction to acquire vocabulary (Lederberg & Spencer, 2008; Paatsch et al., 2006), while children with typical hearing acquire vocabulary incidentally (Nagy et al., 1997; Saffran et al., 1997). The results also indicate that 75 percent of the participants in this study had sufficient access to sound to develop speech perception skills. This seems to support enrollment in self-contained early childhood classes to successfully help children with hearing loss develop auditory-based phonological skills. In general, strong phonological awareness and vocabulary results in the initial test predicted development of the children’s early literacy skills in

V O LTA V O ICES • MARCH/APRIL 2009

letter-word identification and passage comprehension. Alphabetic knowledge for children with typical hearing also predicted development of literacy skills (Rayner et al., 2001). Taken together, the results suggest that the majority of young children with hearing loss in self-contained early childhood classrooms may be capable of learning the skills that are foundational for literacy development. However, the results also support the importance of developing more effective emergent literacy instruction. Easterbrooks and colleagues recommend adapting instruction used to develop literacy in children with typical hearing to include more explicit instructions for teaching children with hearing loss, especially for skills such as rhyming and vocabulary; a slower, more repetitious pace of instruction because of the children’s weaker phonological skills; and the use of visual

support to help develop phonological structure of words. In addition, instruction has to be catered to the individual child’s current language and phonological skills. Prelinguistic Vocal Development

Studies of prelinguistic vocal development of young children with hearing loss shed light on how infants acquire speech and language. Aspects of vocalizations found to be similar in infants with typical hearing and with hearing loss suggest that these aspects are biologically determined, whereas features that are different between infants with typical hearing and infants with a hearing loss would suggest that auditory perception is crucial for the development of these features. Delays in the onset of canonical (continued on next page)

What the Research Shows (continued from previous page)

babbling (a key marker of prelinguistic vocal development) as a result of hearing loss are extensively documented (see Oller, 2000, for a review). However, relatively little is known about other aspects of prelinguistic vocal development and hearing loss. In “Prelinguistic Vocal Development in Infants with Typical Hearing and Infants with Severe-to-Profound Hearing Loss,” Iyer and Oller (2008) investigate several aspects of prelinguistic vocal development in infants with typical hearing and infants with hearing loss to further characterize the nature of prelinguistic vocal development and determine whether hearing loss affects this development. Eight infants with typical hearing and eight with severe-to-profound hearing loss were matched with regard to a significant vocal development milestone, the onset of canonical babbling, and were examined at three points in time: before, at, and after the onset of canonical babbling. Iyer and Oller studied four aspects of prelinguisic vocal development: volubility; growth in various prelinguistic syllable types, including canonical syllables; production of varied syllable shapes; and glottal stop and glide production. By matching infants by development rather than age, results can help

Students who are deaf or hard of hearing have the ability to manage and reason

the quality of prelinguistic vocalizations, especially canonical syllables. Of course, volubility and other aspects of prelinguistic vocalization should continue to be closely monitored in these infants and, if any deficits are noted, they should be addressed. However, findings from this study indicate that canonical syllables are especially vulnerable to hearing loss, and early interventionists should continue to promote the production of these syllables well beyond the initial emergence to ensure the consolidation of canonical syllable production. Measuring Metacognition

determine level of intervention based on skill development rather than maturation expectations based on chronological age. The results indicated no differences in volubility between the two infant groups. In addition, glottal stop and glide production was similar in both groups. However, the growth of canonical babbling appeared to be slower for infants with hearing loss than infants with typical hearing. In addition, infants with hearing loss showed slower growth of syllable shape production than infants with typical hearing. Based on these results, early interventionists working with infants who have a hearing loss may want to focus their intervention goals on enhancing

Metacognition is the ability of an individual to construct knowledge and involve thinking and problem-solving skills to reach an understanding of a situation (see definition). By studying metacognition in individuals with hearing loss, researchers can evaluate the ability of these individuals to evaluate and make reasoned decisions about common, everyday situations. “Measuring Metacognition: A Prospect for Objective Assessment” discusses a method of objectively measuring metacognition while also evaluating reaction time, an essential component of making decisions in every day life (Al-Hilawani et al., 2008; Al-Hilawani, 2000). Al-Hilawani and colleagues compared the performances of students with typical hearing, students who are deaf and hard of hearing, students with typical hearing who were lowachieving, and students with typical hearing who were institutionally raised by testing them with a newly constructed tool of measuring metacognition that also measured reaction time. The four groups of students were selected to compare performance by hearing status, cognitive system, state of psychological health and quality of daily life experience. The tool created to measure metacognition focused on processing information visually by analyzing images on a computer (continued on page 34)

V OLTA V OIC E S • M A R C H/ A P R I L 2009

What the Research Shows (continued from page 32)

screen in a limited time frame. Results revealed no significant differences between students with typical hearing and students who are deaf and hard of hearing in scores on the testing instrument and in reaction time. The performance of these two groups of students was significantly better in obtaining correct scores and in having less reaction time compared to performances of students who were institutionally raised and low-achieving.

These results indicate that students who are deaf or hard of hearing have the ability to manage and reason about situations in a timely manner, just as students with typical hearing. It appears the visual processing format used in this study allows students with hearing loss to express what they know in a problem-solving manner, reinforcing the successful performance of many individuals who are deaf and hard of hearing in real-life situations. This indicates that they are similar to peers with typical hearing in the ability to monitor, control and reason about

their mental activities and the mental states of others (e.g., Marschark, Green, Hindmarsh, & Walker, 2000). By using the elements identified by this measure of metacognition, teachers can design a curriculum or training program that helps individuals who are deaf or hard of hearing maintain deliberate and conscious control over the way information is processed. To submit a manuscript for publication, please contact The Volta Review managing editor Melody Felzien at editor@agbell.org or (202) 204-4682.

Al-Hilawani, Y. (2000). A new approach to evaluating metacognition in hearing average-achieving, hearing underachieving, and deaf/hardof-hearing elementary school students. British Journal of Special

Education, 27(1), 41–47. Al-Hilawani, Y., Dashti, F., & Abdullah, A. (2008). Measuring metacognition: A prospect for objective assessment. The Volta

Review, 108 (2), 139-154. Brown, A.L. (1978). Knowing when, where, and how to remember: A problem of metacognition. In R. Glaser, (Ed.), Advances in

instructional psychology, vol. 7 (pp. 55–113). Hillsdale, NJ: Lawrence Erlbaum Associates. Ehri, L.C., Nunes, S.R., Willows, D.M., Schuster, B.V., Yaghoub-Zadeh,

size and language modality. Journal of Deaf Studies and Deaf

Education. Marschark, M., Green, V., Hindmarsh, G., & Walker, S. (2000). Understanding theory of mind in children who are deaf. Journal of

Child Psychology and Psychiatry, 41, 1067–1073. Nagy, W., McClure, E., & Mir, M. (1997). Linguistic transfer and use of context by Spanish-English bilinguals. Applied Psycholinguistics,

18, 431–452. National Reading Panel. (2000). Teaching children to read: An

evidence-based assessment of the scientific research literature on reading and its implications for reading instruction (NIH Pub. No. 00-4769). Washington DC: U.S. Department of Health and Human

Z., & Shanahan, T. (2001). Phonemic awareness instruction helps

Services, Public Health Service, National Institutes of Health,

children learn to read: Evidence from the National Reading Panel’s

National Institute of Child Health and Human Development.

meta-analysis. Reading Research Quarterly, 36 (3), 250–287. Flavell, J.H. (1976). Metacognitive aspects of problem-solving. In L.B. Resnick, (Ed.), The nature of intelligence (pp. 231–235). Hillsdale, NJ: Lawrence Erlbaum Associates. Flavell, J.H. (1978). Metacognitive development. In J.M. Scadura & C.J. Brainerd, (Eds.), Structural process theories of complex human

behavior (pp. 213–245). Ayphen and Rijn, The Netherlands: Sijtoff & Noordhoff. Flavell, J.H. (1979). Metacognition and cognitive monitoring: A new area of psychological inquiry. American Psychologist, 34, 906–911. Flavell, J.H. (1999). Cognitive development: Children’s knowledge about the mind. Annual Review of Psychology, 50, 21–50. Iyer, S., & Oller, D.K. (2008). Prelinguistic vocal development in infants

Oller, D.K. (2000). The emergence of the speech capacity. Mahwah, NJ: Lawrence Erlbaum Associates. Paatsch, L.E., Blamey, P.J., Sarant, J.Z., & Bow, C.P. (2006). The effects of speech production and vocabulary training on different components of spoken language performance. Journal of Deaf

Studies and Deaf Education, 11(1), 39–55 Rayner, K., Foorman, B.R., Perfetti, C.A., Pesetsky, D., & Seidenberg, M.S. (2001). How psychological science informs the teaching of reading. Psychological Science in the Public Interest, 2(2), 31–74. Saffran, J.R., Newport, E.L., Aslin, R.N., & Tunick, R.A. (1997). Incidental language learning: Listening (and learning) out of the corner of your ear. Psychological Science, 8 (2), 101–105. Scarborough, H.S., & Brady, S.A. (2002). Toward a common

with typical hearing and infants with severe-to-profound hearing

terminology for talking about speech and reading: A glossary of the

loss. The Volta Review, 108 (2), 115-138.

‘phon’ words and some related terms. Journal of Literacy Research,

Lederberg, A.R., & Spencer, P.E. (in press, 2008). Word-learning

34, 299-334.

abilities in deaf and hard-of-hearing preschoolers: Effect of lexicon

V OLTA V OIC E S • M A R C H/ A P R I L 2009

Photo credit: Mann Family

References

T I P S

F O R

P A R E N T S

Strategies for Parents Who Have a Young Child with Hearing Loss By Eric Mann

J Photo credit: Mann Family

ulia was born in February 2006 with a profound hearing loss in both ears. After multiple rounds of testing, my wife, Jeanne, and I had to decide whether to raise our daughter to communicate using spoken language or to communicate through sign language. Our decision was to raise our daughter as child who can listen and talk, and we began the process of determining what it would require for her to hear and speak. As Jeanne and I prepare to help Julia, now 3 years old, undergo a second cochlear implant surgery to become a bilateral implant user, we are revisiting the tips and tactics that we have learned along the way to be successful when dealing with a child with hearing loss.

Early Detection and Constant Intervention

When we first realized our daughter had a hearing loss, we quickly passed through the “grief period” and began pushing for answers to what we could do to help her. We went through a myriad of tests over several months that ended up telling us exactly what we knew just days after our daughter was born…that she could not hear. Becoming engaged as quickly as possible and staying focused on what’s important were critical to preparing our daughter for success using spoken language. Hearing Aids

Our first step toward a spoken language outcome was a test period using hearing aids. Julia was 8 months old when she began her hearing aid tests and she did not like wearing them. She constantly took them out and threw them at us, or we would catch her chewing on them like her pacifier. Jeanne and I V O LTA V O ICES • MARCH/APRIL 2009

found the following tips helped us make it through this period when dealing with a young infant and hearing aids: • Change your child’s perception of hearing aids. Funky colored ear molds, wild looking ear wraps and cute shirt clips help to show the aid as a useful fashion accessory rather than a boring skin tone device that Julia had to wear. • Help your child adapt to wearing hearing aids. With young children who pull at their hearing aids, try to find a loose knit cap. The cap will help them stay in place, allow them to function properly and divert your child’s attention away from the hearing aids. • Celebrate small successes. Strive for full-time hearing aid use, but recognize that your child may not want to wear the hearing aids all the time. • Talk to your child incessantly. He or she wants to hear you and will begin to wear the hearing aids more often. • Be prepared for anything. Attach the hearing aids to a shirt clip and clip to the back of their clothes. If the aids come out, you want to be sure they are not lost. Have extra batteries, cables, etc., whenever you leave the house. You never know what may happen to the hearing aids. • Ask for help. Julia’s older brother, Raleigh, was a tremendous help in getting his sister to wear her hearing aids. He would talk to her all the time and made sure she did not remove them when riding in the car. Julia responded better to her brother’s urging than to ours. • Divert attention away from the hearing aids. When in the car, have something for your child to do. When

( from left to right): Jeanne, Julia, Eric and Raleigh Mann pose for a family portrait during the holidays.

Julia was bored, she always had fun removing and chewing on her hearing aids so it was critical to provide a fun alternative. Cochlear Implants

After we completed our hearing aid test period, our audiologist determined that Julia was not receiving enough benefit from the hearing aids alone. At this time, Jeanne and I decided to proceed with cochlear implant surgery. When Julia’s cochlear implant was first activated, she was frightened by the unfamiliar sounds. We eased her into wearing the device by breaking up her listening time into small chunks. As she became more comfortable, the time lengthened. Here are some tips that helped Julia’s transition to using the cochlear implant device: • Choose appropriate clothing. Julia began by using a body worn device. We found that “onesies” with a small pocket sewn on the side made wearing this device style so much more manageable. (continued on next page)

T I P S

F O R

P A R E N T S

Strategies for Parents (continued from previous page)

• Again, be prepared for anything. Like the hearing aids, be sure to use a shirt clip with the sound processor and make sure you have replacement parts on hand at all times. • Change your child’s perception of the sound processor. Our sound processor came with assorted color caps. Change the caps as you accessorize and make the device fun to wear. • Help your child wear the sound processor. When Julia was a bit older, we switched to the behind-the-ear processor. Wig tape helped keep the device in place and functioning properly. • Work closely with your child’s audiologist and cochlear implant center. The audiologist has experience working

with a range of young children, and you have the most experience with your child – together you and your audiologist can find some great solutions to any issues that may pop-up.

Online Resources Kids Health – This Web site helped us better understand the cochlear implant: http://kidshealth.org/parent/general/eyes/

The Next Stages

cochlear.html

As Julia gets older and begins school, we will continue to look for new and better ways to help our daughter succeed. We have been fortunate to have a very committed school district, a family who is engaged in her listening, and wonderful doctors, audiologists and teachers who have been tremendous resources every step of the way. If possible, try to get involved with other parents who have children with hearing loss to share tips and stories. There are several online resources that Jeanne and I found useful that can help you transition through these stages with your child.

Alexander Graham Bell Association – Provided us with information beyond the basics: www.agbell.org BEGINNINGS – Our audiologist provided this link to a nonprofit organization that supports parents of children with hearing loss: www.ncbegin.org Chattering Children – This is the program where we began auditory-verbal therapy: www.chatteringchildren.org Listen Up – This Web site provides miscellaneous resources on hearing loss and spoken language: www.listen-up.org

Photos credit: Justin Ogden

V OLTA V OIC E S • M A R C H/ A P R I L 2009

V O I C E S

F R O M

A G

B E L L

Conversations With Alex Graham

hen I first came to AG Bell as executive director in late 2007, I was asked “would you like to have a column in the magazine?” My first reaction was, “what would be the purpose and what would I want to say in a column?” As executive director, I am very fortunate to meet and talk with a variety of people – some from within the AG Bell community and many who are not, such as leaders in government, business and industry, education, and health care. I realized that the best use of space in Volta Voices would be a column dedicated to these individuals and the conversations we shared. Starting with this issue, I hope to provide you with insights from those “conversations” that will benefit you as much as they have me. First up is Justin Ogden, a young, energetic leader from AG Bell’s Indiana Chapter, Hear Indiana. Justin currently serves as Hear Indiana’s board president. In early January, Justin traveled to Washington, D.C., where we discussed a number of issues facing the AG Bell and deaf and hard of hearing communities. Time flew as Justin enthusiastically described a number of programs that the volunteer leaders of Hear Indiana are working on, especially in the area of mentoring and networking for youth. Alex Graham: What motivates you about volunteerism? Justin Ogden: I’m motivated to create a positive influence on those who

benefit from the volunteer work I do at Hear Indiana; to witness the impact and growth of families managing hearing loss while achieving the goals they set for themselves is extremely rewarding. AG: How did you get in involved with the Indiana Chapter of AG Bell? JO: My parents were involved with Hear Indiana since I was a child, and I benefitted tremendously from the work of those who came before me at AG Bell and Hear Indiana. So whether or not I was aware of it, AG Bell has always been a thread in my life. I first became involved as a volunteer at the annual 5K Talk-Walk-Run race, and later joined the board of Hear Indiana to help create a mentoring program in Indiana. After learning from parents that their children were experiencing the same issues I faced as a child with a hearing loss 20 years ago, I felt compelled to act to create a better defining childhood for those kids and families experiencing the same struggles I did with educational institutions and society. AG: What are three things you hope to accomplish as a leader? JO: First, I hope to instill confidence and good moral character among the youth in Indiana who have hearing loss and support for the families, who are their support base, as they deal with the hardships of raising a child with a hearing loss. Second, I would like to bring the Indiana community together to

Photos credit: Justin Ogden

Who is Justin Ogden? Justin is a born Hoosier and native of Indianapolis. He was born with a severe-to-profound hearing loss in both ears. He has always used spoken language, and he has always been fully mainstreamed. After graduating from high school in 2000, he went on to graduate with Honors in Political Science and Philosophy from Butler University in 2004. Since then, Justin has worked as a paralegal specialist for the Department of Justice, U.S. Attorney’s Office for the Southern District of Indiana and is currently considering pursuing a graduate degree.

V O LTA V O ICES • MARCH/APRIL 2009

recognize the untapped potential of those affected by hearing loss. There are many professionals who have a hearing loss working today and capable of achieving the same goals as their peers with typical hearing. Finally, I hope my service creates more opportunities for the next generation of kids to witness older generations of teenagers and adults who share the same experience through an effective mentoring program, internship program, leadership camp and many other opportunities. AG: How has this leadership role impacted other areas of your life? JO: My experience has been humbling and it gives me a greater appreciation for my parents, who gave me the opportunity to learn listening and spoken language. This has allowed me to see the importance of parental support and advocacy for children with hearing loss, and as a leader I hope to help create an environment for parents to become community advocates for their kids. AG: In your opinion, what are the most pressing issues facing individuals who are deaf and hard of hearing and who choose a listening and spoken language outcome? JO: I believe that overcoming the hurdle of discrimination in the workforce is a pressing issue and one that will define many of us seeking to break the mold of typical careers filled by individuals with hearing loss. There simply is not an understanding of hearing loss and there is no recognition of what individuals who are deaf and hard of hearing are capable of achieving every day in the hearing world. We have to work to set the tone for those around us by becoming stronger and more vocal about what we believe is attainable as an individual. 37

K I D S

Z O N E

Around the World By Sarah Crum

school teacher,” she said. “This unchartered territory was new, intimidating and scary. Questions reverberated and ruminated around my mind...I was so confused.” Andrea consulted audiologists and conducted online research to find out more about hearing loss and her family’s options. She focused on educating herself and her family about childhood hearing loss. “We are so very fortunate to have access to an amazing audiologist, speech therapist and other community resources here in Boise,” said Andrea. “Ryder is very well taken care of by his audiologist, Jenna Hoffman, at the Elks Hearing and Balance Center.

Susie Jones, his speech therapist, is absolutely wonderful and has the unique perspective of also having a child who is deaf and uses a cochlear implant.” With help from Hoffman and Jones, Andrea has learned about hearing loss in children, communication choices and available options. “The diagnosis of hearing loss wasn’t life-ending, all-encompassing or insurmountable, just different,” she said. Ryder currently uses bilateral hearing aids. “It was so exciting when Jenna put hearing aids on Ryder for the first time and Ryder smiled when he heard our voices!” she recalls. While it has been a struggle for Ryder to get

V OLTA V OIC E S • M A R C H/ A P R I L 2009

Photos credit: Amestoy Family

yder Amestoy, an adventurous 22-month-old from Boise, Idaho, is able to meet the challenges of his hearing loss with his adaptable personality and support from his family. Ryder was diagnosed with a moderate-to-severe bilateral sensorineural hearing loss at 1 month of age through a newborn hearing screen test. Andrea Amestoy and her husband, Mike, had no reason to think they would have a child with a hearing loss. In fact, Andrea had never before encountered someone with a hearing loss. “I had never heard of or known of anyone deaf or hard of hearing during my years as a pediatric nurse and high

Photos credit: Amestoy Family

used to his hearing aids, Andrea said she has had success using pilot caps. “He doesn’t pull them out when the hat is on. We are weaning him from the hat and he is getting better at leaving them on.” Ryder is enrolled in the Idaho Infant Toddler Program, a program that helps children from age birth to 3 who have developmental delays. Ryder and his brother Wyatt enjoying the garden patch in their backyard. He also attends Talking Toddlers, a spoken an empathetic and caring child. “If language group activities class for chilanother child is crying or upset, he will dren who use cochlear implants and offer them his blanket or go over and hearing aids. Andrea and Mike meet give them a hug,” said Andrea. other parents of children with hearing Andrea advises other parents to “do loss through Idaho Hands & Voices, a everything in your power to make the nonprofit organization that provides best of the situation and utilize all the support for families with children who resources available to ensure success are deaf or hard of hearing. This interfor your child.” Andrea and her family action has allowed her and her family have learned that having a child with to share stories with other parents in a hearing loss was not as challenging similar situations and learn from other as she once feared. “You soon see the parents as well. Andrea said she has wonderful doors that open and the also received amazing support from unique and new opportunities preAG Bell, which she joined when Ryder sented to your family,” she said. was an infant. “I applied for the hearAndrea and her husband hope to see ing aid scholarship and received some financial aid for hearing aids. That was Ryder develop an extensive vocabulary, enjoy school and be successful so beneficial as our insurance doesn’t in any environment. “I don’t want cover hearing aids,” she said. “Ryder has been connected to all available support services since infancy. We have been very fortunate to have these services available and that Ryder was born when newborn hearing screening was in place,” said Andrea. Ryder continues to thrive with help and support from his family. He enjoys playing at the park, keeping up with his older brother, 4-year-old Wyatt, and camping with his family. He is in a “Kindermusik” class and enjoys playing with his instruments. “The teacher noted how much rhythm Ryder had. He was tapping to the beat in sync and rhythm,” said Andrea. Ryder is also

V O LTA V O ICES • MARCH/APRIL 2009

Andrea Amestoy with sons Ryder, in his pilot cap, and Wyatt exploring the nearby area while camping in Pioneerville, Idaho.

hearing loss to be an obstacle for him but more of an opportunity to grow, learn and flourish,” she said. “This is a unique opportunity for Ryder and our family to embrace others who have challenges in life that we don’t have, and to treat them with respect, dignity and compassion.”

D I R E C T O R Y

O F

S E R V I C E S

Directory of Services n Alabama Alabama Ear Institute, 300 Office Park Drive,

Suite 210, Birmingham, AL 35223 • 205-879-4234 (voice) • 205-879-4233 (fax) • www.alabamaearinstitute.org • The AEI AuditoryVerbal Mentoring Program: ongoing professional development / AVI curriculum / Mentoring by LSLS Cert. AVTs®. “The AEI Summer Institute in AuditoryVerbal Therapy” - Two weeks of intense A-V training; AVI Modules and Practicum; hands-on practice of A-V Therapy. Education, research, public policy, family & culturally oriented programs & services.

n Arizona Desert Voices, 3426 E. Shea Blvd., Phoenix, AZ 85028 • 602-224-0598 (voice) • 602-224-2460 (fax) • info@desertvoices.phxcoxmail.com (email). Emily Lawson, Executive Director. Oral school for deaf and hard-of-hearing children from birth to nine years of age. Programs include Birth to Three therapy, Toddler Group, and full day Educational Program. Other services include parent education classes, speech and language evaluations, parent organization and student teacher placements. Desert Voices is a Moog Curriculum school.

n California Auditory Oral School of San Francisco,

1234 Divisadero, San Francisco, CA 94115 • 415-921-7658 (voice) • 415-921-2243 (fax) • Offers auditory-oral day classes for toddlers, PreKindergarten and K-2 levels with daily individual therapy. Also consultation and itinerant teacher of the deaf services; aural rehabilitation for children and adults; family education groups; and workshops. Our experienced staff includes credentialed teachers of the deaf and speech therapists, all with specialized training in CI technologies. Contact Janet Christensen, M.A., at jan@auditoryoralsf.org.

Auditory-Verbal Services, 10623 Emerson Bend,

Tustin, CA 92782 • 714-573-2143 (voice) • email KarenatAVS@aol.com • Karen Rothwell-Vivian, M.S.ED. M.A. CCC-A. LSLS Cert.AVT. Listening and Spoken Language Specialist - Certified AuditoryVerbal Therapist providing Auditory-Verbal Therapy and both audiological and educational consultation for children from infancy through college age. Auditory Rehabilitation is also provided for adults. Extensive expertise with amplification, cochlear implants, and FM systems. Auditory-Verbal Therapy Services, 980 E.

Mountain Street, Pasadena, CA 91104 • 626-798-3903 (voice) • bsackett_certavt@live.com (e-mail). Beatriz Sackett, M.S. Ed., LSLS Cert. AVT, bilingual English and Español. Offering Auditory-Verbal Therapy services to children ages six and above and their families. Services provided to children with hearing aids and/or cochlear implants. Llámeme para hablar de su hijo(a) y de cómo la terapia Auditiva-Verbal les podría ayudar.

Echo Horizon School, 3430 McManus Ave.,

Culver City, CA 90232 • 310-838-2442 (voice) • 310-838-0479 (fax) • 310-202-7201 (TTY) • www.oraldeafed.org/schools/echo/index.html • www.echohorizon.org • Vicki Ishida, Echo Center Director. Private elementary school, incorporating an

auditory/oral mainstream program for students who are deaf or hard of hearing. Daily resource support in speech, language, auditory training and academic follow-up. HEAR Center, 301 East Del Mar Blvd., Pasadena, CA 91101 • 626-796-2016 (voice) • 626-796-2320 (fax) • Specializing in audiological services for all ages. Auditory-Verbal individual therapy, birth to 21 years. HEAR to Talk, 547 North June St., Los Angeles, CA 90004 • 323-464-3040 (voice) • sylvia@hear2talk.com (e-mail) • www.hear2talk.com • Sylvia Rotfleisch, M.Sc.A., CED, CCC, LSLS Cert. AVT, Licensed Audiologist, California NPA Certified. Trained by Dr. Ling. Extensive expertise with cochlear implants and hearing aids.

The Alexander Graham Bell Association for the Deaf and Hard of Hearing is not responsible for verifying the credentials of the service providers below. Listings do not constitute endorsements of establishments or individuals, nor do they guarantee quality.

students and adults with cochlear implants. Extensive experience and expertise with cochlear implants, single and bilateral. Mainstream support services, school consultation and assessment for children in their neighborhood school. California NPA certified. No Limits Speech and Language Educational Center and Theatre Program,

9801 Washington Blvd., 2nd Floor, Culver City, CA 90232 • 310-280-0878, 800-948-7712 • www.nolimitsspeaksout.org • Free individual auditory, speech and language therapy for dhh children between the ages of five-and-eighteen as well as a biweekly literacy program, computer training, weekly parent classes and a nationwide theatrical program.

Oralingua School for the Hearing Impaired,

InSight Cinema - The Audience is Reading,

North Campus – 7056 S. Washington Avenue, Whittier, CA 90602 • 562-945-8391 (voice) • 562-945-0361 (fax) • info@oralingua.org (email) • www.oralingua.org (website) South Campus – 221 Pawnee Street, San Marcos, CA 92078 • 760-4715187 (voice) • 760-591-4631 (fax) Where children are listening and talking. An auditory/oral program serving children from infancy to 10 years. Audiological, Speech, Itinerant, AVI Therapy, and other related Designated Instructional Services available. Contact Elisa J. Roche, Executive Director.

Jean Weingarten Peninsula Oral School for the Deaf, 3518 Jefferson Avenue,

West Coast Cued Speech Programs,

2800 28th Street, Suite 380, Santa Monica, CA 90405 • 310-452-8700 (voice) • 310-452-8711 (fax) • www.insightcinema.org • The “Go To” place for all forms of captioned entertainment - blockbuster movies, live theatre, opera, museums, lectures and much more in your area! InSight Cinema is a nonprofit organization dedicated to bringing Captioned Entertainment Experiences to the 31 million deaf and hard-of-hearing patrons in the U.S. Captioning the Imagination of Audiences Nationwide.

Redwood City, CA 94062 • 650-365-7500 (voice) • jwposd@jwposd.org (e-mail) • www.oraldeafed.org/schools/jwposd (website) • Kathleen Daniel Sussman, Executive Director; Kathy Berger, Principal. An auditory/oral program where deaf and hard of hearing children listen, think and talk! Cognitive based program from birth through mainstreaming into 1st or 2nd grade. Students develop excellent language, listening and social skills with superior academic competencies. Cochlear Implant Habilitation, mainstream support services and Family Center offering special services for infants, toddlers and their families.

John Tracy Clinic, 806 West Adams Blvd., L.A.,

CA 90007 • 213-748-5481 (voice) • 213-747-2924 (TTY) • 800-522-4582 (parents) • www.jtc.org • Since 1942, free Worldwide Correspondence Education and onsite comprehensive audiological, counseling and educational services for families with children ages birth to 5 years. Intensive 3-week Summer Sessions (ages 2-5), with sibling program. Online and on-campus options for an accredited Master’s and Credential in Deaf Education.

Let’s Talk About It, 800 Santa Ynez Street,

San Gabriel, CA 91775 • 626-451-9920 (voice) • bk-avt@sbcglobal.net (e-mail) • Bridgette Klaus, M.S. Ed., LSLS Cert. AVT. Providing Auditory-Verbal therapy for children with a hearing loss and their families. Services for individuals with hearing aids and/or cochlear implants, infancy through adulthood.

Listen and Learn, 4340 Stevens Creek Blvd., Suite 107, San Jose, CA 95129 • 408-345-4949 • Marsha A. Haines, M.A., CED, LSLS Cert. AVT, and Sandra Hamaguchi Hocker, M.A., CED • Auditoryverbal therapy for the child and family from infancy. Services also include aural habilitation for older

348 Cernon St., Suite D, Vacaville, CA 95688 • 707-448-4060 (voice/TTY) • www.cuedspeech.org • A resource center serving deaf and hard-of-hearing children and their families. Cued Speech training available to schools/agencies.

n Colorado Bill Daniels Center for Children’s Hearing, The Children’s Hospital - Colorado, Department of Audiology, Speech Pathology and Learning Services, 13123 East 16th Avenue, B030

Aurora, CO 80045 • www.thechildrenshospital.org (website) • 720-777-6531(voice) • 720-777-6886 (TTY). We provide comprehensive audiology and speech-language services for children who are deaf or hard-of-hearing (ages birth through 21years). Our pediatric team specializes in family-centered care and includes audiologists, speech-language pathologists, a deaf educator, family consultant, and clinical social worker. Individual, group and parent educational support and programs are designed to meet each family desire for their preference of communication needs. We also provide advanced technology hearing aid fitting and cochlear implant services.

Rocky Mountain Ear Center, P.C. • 601 East Hampden Avenue, Suite 530, Englewood, CO 80113 • 303-783-9220 (voice) • 303-806-6292 (fax) • www.rockymountainearcenter.com (website). We provide a full range of neurotology and audiology services for all ages, ranging from infants to seniors. Using a multi-disciplinary approach, our boardcertified otologist and doctors of audiology rest and diagnose hearing, balance, facial nerve and ear disorders and we provide full-service hearing aid, cochlear implant and BAHA services. We offer medical and surgical treatment as well as language therapy and support groups, and are actively involved in various research studies.

V OLTA V OIC E S • M A R C H/ A P R I L 2009

D I R E C T O R Y n Connecticut CREC Soundbridge, 123 Progress Dr.,

Wethersfield, CT 06109 • 860- 529-4260 (voice/TTY) • 860-257-8500 (fax) • www.crec.org/soundbridge (website). Dr. Elizabeth B. Cole, Program Director. Comprehensive audiological and instructional services, birth through post-secondary, public school settings. Focus on providing cutting-edge technology for optimal auditory access and listening in educational settings and at home, development of spoken language, development of self advocacy – all to support each individual’s realization of social, academic and vocational potential. Birth to Three, Auditory-Verbal Therapy, integrated preschool, intensive day program, direct educational and consulting services in schools, educational audiology support services in all settings, cochlear implant mapping and habilitation, diagnostic assessments, and summer programs. New England Center for Hearing Rehabilitation (NECHEAR), 354 Hartford

Turnpike, Hampton, CT 06247 • 860-455-1404 (voice) • 860-455-1396 (fax) • Diane Brackett. Serving infants, children and adults with all degrees of hearing loss. Speech, language, listening evaluation for children using hearing aids and cochlear implants. Auditory-Verbal therapy; Cochlear implant candidacy evaluation, pre- and post-rehabilitation, and creative individualized mapping. Post-implant rehabilitation for adults with cochlear implants, specializing in prelingual onset. Mainstream school support, including onsite consultation with educational team,

V O LTA V O ICES • MARCH/APRIL 2009

rehabilitation planning and classroom observation. Comprehensive audiological evaluation, amplification validation and classroom listening system assessment.

n Florida Bolesta Center, Inc and The Auditory-Verbal Learning Institute, 7205 North Habana Avenue,

Tampa, FL 33614 • 813-932-1184 (voice) • 813-932-0583 (fax) • info@bolestacenter.org (email) • www.bolestacenter.org (website) • Non-profit Auditory-Verbal center founded in 1961 to teach deaf and hard-of-hearing children to listen and speak. Children learn to participate fully in hearing families, schools, and communities. No family is turned away based on ability to pay. The Auditory-Verbal Learning Institute develops and sells educational products for parents to help meet the cognitive, language, and social development needs of their deaf or hard-ofhearing children and for professionals who want to expand their Auditory-Verbal skills. Clarke Jacksonville Auditory/Oral Center,

9857 St. Augustine Rd., Jacksonville, FL 32257 • 904-880-9001 (voice/TTY) • info@clarkeschool.org (email) • www.clarkeschool.org (website). Susan G. Allen, Director. A program of Clarke School for the Deaf/Center for Oral Education, serving families with young children with hearing loss. Auditory/ Oral programs include early intervention, preschool, toddler PreK/kindergarten, primary, parent support, individual listening, speech and language services, cochlear implant habilitation.

O F

S E R V I C E S

Orange County Auditory-Oral Program for the Hearing Impaired, Kaley Elementary School,

1600 East Kaley St., Orlando, FL 32806 • 407-897-6420 (voice) • 407-897-2407 (fax) • www.eak.ocps.k12.fl.us • Available to residents of Orange and Lake Counties. We have self-contained classes PreK (3 & 4 yrs) to 5th grade with partial and full-time mainstream options.

n Georgia Atlanta Speech School – Katherine Hamm Center, 3160 Northside Parkway, NW, Atlanta,

GA 30327 • 404-233-5332 ext. 3119 (voice/TTY) • 404-266-2175 (fax) • eestes@atlspsch.org (e-mail) • www.atlantaspeechschool.org • An auditory/ oral and Auditory-Verbal program serving children who are deaf or heard of hearing from infancy to elementary school age. Children receive languagerich lessons and highly individualized instruction in a nuturing environment. Teachers and staff work closely with parents to instill the knowledge and confidence children need to reach their full potential. Early intervention programs, audiological support services, Auditory-Verbal therapy, mainstreaming opportunities and independent educational evaluations. Established in 1938.

D I R E C T O R Y

O F

S E R V I C E S

Auditory-Verbal Center, Inc - Atlanta,

1901 Century Boulevard, Suite 20, Atlanta, GA 30345, 404-633-8911 (voice) • 404-633-6403 (fax) • listen@avchears.org (email) • www.avchears.org (website). Auditory-Verbal Center, Inc - Macon, 2720 Sheraton Drive, Suite D-240, Macon, GA 31204 • 478-471-0019 (voice). A comprehensive Auditory-Verbal program for children with hearing impairments and their families. Home Center and Practicum Site programs provide intensive A-V training for families and professionals. Complete audiological services for children and adults. Assistive listening devices demonstration center.

n Idaho Idaho School for the Deaf and the Blind,

450 Main Street, Gooding, ID 83330 • 208-934 4457 (V/TTY) • 208-934 8352 (fax) • isdb@isdb.idaho.gov (e-mail). ISDB serves birth to 21 year old youth with hearing loss through parent-infant, on-site, and outreach programs. Options include auditory/oral programs for children using spoken language birth through second grade. Audiology, speech instruction, auditory development and cochlear implant habilitation is provided.

n Illinois Alexander Graham Bell Montessori School (AGBMS) and Alternatives in Education for the Hearing Impaired, www.agbms.org •

847-850-5490 (voice) • Debbie.Blackburn@agbms.org (email) • 9300 Capitol Drive Wheeling, IL 60090 •

AGBMS is a Montessori school educating children ages 2-12 who are deaf or hard of hearing or have other communicative challenges in a mainstream environment with hearing peers. Teacher of Deaf/Speech/Language Pathologist/ Reading Specialist/Classroom Teachers emphasize language development and literacy utilizing Cued Speech. AEHI, a training center for Cued Speech, assists parents, educators, or advocates in verbal language development for children with language delays or who do not yet substantially benefit from auditory technology. Child’s Voice School, 180 Hansen Court,

Wood Dale, IL 60191 • (630) 595-8200 (voice) • (630) 595-8282 (fax) • info@childsvoice.org (email) • www.childsvoiceschool.org (website). Michele Wilkins, Ed.D., Executive Director. An auditory/oral school for children ages 3-8. Cochlear implant (re) habilitation, mainstream support services and audiology services provided. Early intervention for birth to age three with parent-infant and toddler classes. Child’s Voice is a Moog Curriculum school.

St. Joseph Institute for the Deaf – Carle,

809 West Park St., Urbana, IL 61801 • 217-326-2824 (voice) • 217-344-7524 (fax) • carle@sjid.org (e-mail) • danielle.edmondson@carle.com (e-mail) • www.sjid.org • Danielle Edmondson, M.A., CCC-A, Director. St. Joseph Institute for the Deaf – Carle, a campus of the St. Joseph Institute system, serves children with hearing loss, birth to age 6. Auditory/ oral programs include early intervention, nursery and preschool classes, cochlear implant rehabilitation, daily speech therapy and mainstream support

services. Challenging speech, personal development and academic programs are offered in a nurturing environment. Early intervention credentialed and Illinois State Board of Education approved. (See Indiana, Kansas and Missouri.)

n Indiana St. Joseph Institute for the Deaf – Indianapolis, 9192 Waldemar Road, Indianapolis,

IN 46268 • 317-471-8560 (voice) • 317-471-8627 (fax) • touellette@sjid.org (e-mail) • www.sjid.org • Teri Ouellette, M.S. Ed., Director. St. Joseph Institute for the Deaf – Indianapolis, a campus of the St. Joseph Institute system, serves children with hearing loss, birth to age 6. Auditory/oral programs include early intervention, toddler and preschool classes, cochlear implant rehabilitation and daily speech therapy. Challenging speech, personal development and academic programs are offered in a nurturing environment. First Steps Provider. (See Illinois, Kansas, and Missouri.)

n Kansas St. Joseph Institute for the Deaf - Kansas City Campus, 8835 Monrovia, Lenexa, KS 66215 •

913-383-3535 (voice) • 913-383-0320 (fax) • www.sjid.org • jfredriksen@sjid.org • Jeanne Fredriksen, M.S., Ed., Director. St. Joseph Institute for the Deaf - Kansas City, a campus of the St. Joseph Institute system, serves hearing-impaired children, birth to age 6. Auditory-oral programs include early intervention, toddler and preschool classes, cochlear implant rehabilitation and daily

V OLTA V OIC E S • M A R C H/ A P R I L 2009

D I R E C T O R Y speech therapy. Challenging speech, personal development and academic programs are offered in a nurturing environment. (See Illinois, Indiana and Missouri).

similar to their normal hearing peers without sign language support. Auditory/oral and Auditory-Verbal programming available.

n Maryland n Louisiana New Orleans Oral School, 4000 West

Esplanade Avenue, Metairie, LA 70002 • 504-885-1606 (voice) • 504-885-2603 (fax) • neworleansoralschool@yahoo.com (e-mail) • www.oraldeafed.org/schools/neworleans • Martha Myers, M.C.D., Director • Auditory/oral school serving children with all degrees of hearing loss from infancy through age 5. Programs offered include early intervention, preschool classrooms, parent support groups, daily listening, speech and language instruction, cochlear implant rehabilitation and support for mainstream placement. New Orleans Oral School admits children of any race, color and national or ethnic origin.

n Maine hear ME now, 19 Yarmouth Drive, Suite 201,

Yarmouth Hall, Pineland Farms, New Gloucester, ME 04260 • 207-688-4544 (voice) • 207-688-4548 (fax) • info@hear-me-now.org (e-mail) • www.hear-me-now.org • Maine’s Oral Deaf Learning Center. Maine’s only OPTION school for infants and children who are deaf or hard of hearing. Utilizing specially trained staff in promoting spoken language and developing listening skills, our loaner hearing aid program, parent infant, toddler, preschool and kindergarten offers the opportunity for children with hearing loss to develop spoken language at a rate

V O LTA V O ICES • MARCH/APRIL 2009

The Hearing and Speech Agency’s Oral Center, 5900 Metro Drive, Baltimore, MD 21215 •

410-318-6780 (voice) • 410-318-6758 (TTY) • 410-318-6759 (fax) • hasa@hasa.org (e-mail) • www.hasa.org • Jill Berie, Educational Director, Olga Polites, Clinical Director, Heather Eisgrau, Teacher of the Deaf/Coordinator. Auditory-oral education and therapy program for young children who are deaf or hard of hearing ages three through five with early intervention services for birth to age 3. Self-contained state-of-the-art classrooms located in the Gateway School approved by the Maryland State Department of Education. Additional services include speech-language therapy, family education and support, pre- and post-cochlear implant habilitation, collaboration and support of inclusion and audiological management. Applications are accepted year-round. Families are encouraged to apply for scholarships and financial assistance. HASA is a direct service provider, information resource center and advocate for people of all ages who are deaf, hard of hearing or who have speech and language disorders.

n Massachusetts Auditory-Verbal Communication Center (AVCC), 544 Washington Street, Gloucester,

MA, 01930 • 978-282-0025 (phone) •

O F

S E R V I C E S

avcc@avcclisten.com (e-mail) • www.avcclisten. com • Listening and Spoken Language Specialists: James G. Watson, MSc, CED, LSLS Cert. AVT, and Lea D. Watson, MS, CCC-SLP, LSLS Cert. AVT. AVCC is a husband-wife team offering parent guidance for infants and preschoolers, school support, adult therapy, world-wide consultation for programs, distance (online) therapy for families, supervision and training (online) for professionals aiming at certification from the AGBell Academy for Listening and Spoken Language. Clarke School East, 1 Whitman Road, Canton,

MA 02021 • 781-821-3499 (voice) • 781-821-3904 (tty) • info@clarkeschool.org (email) • www.clarkeschool.org (website). Cara Jordan, Director. A program of Clarke School for the Deaf/ Center for Oral Education, serving families with young children. Auditory/Oral programs include early intervention, preschool, kindergarten, parent support, cochlear implant habilitation, and support for mainstream placements. The Clarke School for the Deaf - Center for Oral Education, 47 Round Hill Road,

Northampton, MA 01060 • 413-584-3450 (voice/tty) • info@clarkeschool.org (email) • www.clarkeschool.org (website). Bill Corwin, President. Early intervention, preschool, day, and boarding school, cochlear implant assessments, summer programs, mainstream support, evaluations for infants through school age children, audiological services, assistive devices, graduate-teachereducation program.

D I R E C T O R Y

O F

S E R V I C E S

SoundWorks for Children, 18 South Main Street, Topsfield, MA 01983 • 978-887-1284 (voice) • soundworksforchildren@verizon.net (e-mail) • Jane E. Driscoll, MED, Director. Satellite program serving Southern Maine. Katelyn Driscoll, MED, Program Coordinator. A comprehensive non-profit program dedicated to the development of auditoryoral skills in children who are deaf or hard-of-hearing. Specializing in cochlear implant habilitation and offering a full continuum of inclusionary support models from preschool through high school. Early Intervention services and social/self-advocacy groups for mainstreamed students are offered at our Family Center. Summer programs, in-service training, and consultation available.

n Michigan Monroe County Program for Hearing Impaired Children, 3145 Prairie St., Ida, MI

48140-9778 • 734-269-3875 (voice/TTY) • 734-269-3885 (fax) • whitman@ida.k12.mi.us (e-mail) • www.misd.k12.mi.us • Kathleen Whitman, Supervisor. Auditory/oral program, full continuum of services, birth to 25 years. Staff: 21.

Redford Union Oral Program for Children with Hearing Impairments, 18499 Beech Daly

Rd. Redford, MI 48240 • 313-242-3510 (voice) • 313-242-3595 (fax) • 313-242-6286 (tty) • Dorothea B. French, Ph.D., Director. Auditory/oral day program serves 80 center students/250 teacher consultant students. Birth to 25 years of age.

University of Michigan Cochlear Implant Program, 475 Market Place, Building 1 Suite A,

Ann Arbor, MI 48108 • 734-998-8119 (voice/tty) • 734-998-8122 (fax) • www.med.umich.edu/oto/ci/ (website) • Terry Zwolan, Ph.D. Director • zwolan@med.umich.edu (email). A multidisciplinary program that provides audiology, speech-language pathology, and medical services to children with severe to profound hearing impairment. Services include pre-operative determination of candidacy, surgical management, post-operative programming and audiological management, speech-language evaluations and provision of Auditory-Verbal therapy, and educational outreach and support provided by a joint grant from the University of Michigan Department of Otolaryngology and the State of Michigan - our Sound Support program: www.med.umich.edu/childhearinginfo/.

n Minnesota Northeast Metro #916 Auditory / Oral Program, 701 West County Road “B”, Roseville,

Minnesota 55113 • 651-415-5399 (voice). The mission of the program is to provide an intensive oral education to children with impaired hearing. Centered-based services are provided in a least restrictive public school environment, combining oral specific early intervention services within the mainstream setting for students pre-school through kindergarten age. Birth to 3 services and parent/child groups are tailored to meet identified needs. Parent and professional workshops are offered. Referrals are through the local school district in which the family live.

Northern Voices, 1660 West County Road B,

Roseville, MN 55113-1714 • 651-639-2535 (voice) • 651-639-1996 (fax) • director@northernvoices.org (e-mail) • Kristina Blaiser, Executive Director. Northern Voices is a nonprofit early education center focused on creating a positive environment where children with hearing loss and their families learn to communicate through the use of spoken language. Our goal is for students to become fluent oral communicators and to join their hearing peers in a traditional classroom at their neighborhood schools.

n Mississippi DuBard School for Language Disorders,

The University of Southern Mississippi, 118 College Drive #10035, Hattiesburg, MS 39406-0001 • 601-266-5223 (voice) • dubard@usm.edu (e-mail) • www.usm.edu/dubard • Maureen K. Martin, Ph.D., CCC-SLP, CED, Director • The school is a clinical division of the Department of Speech and Hearing Sciences and serves children from birth to age 13 in its state-of-the-art facility. Working collaboratively with 22 public school districts, the school specializes in coexisting language disorders, learning disabilities/ dyslexia and speech disorders, such as apraxia, through its non-graded, 11-month program. The Association Method, as refined, and expanded by the late Dr. Etoile DuBard and the staff of the school, is the basis of the curriculum. Comprehensive evaluations, individual therapy, audiological services and professional development programs also are available. AA/EOE/ADAI

V OLTA V OIC E S • M A R C H/ A P R I L 2009

D I R E C T O R Y Magnolia Speech School, Inc., 733 Flag Chapel Rd., Jackson, MS 39209 • 601-922-5530 (voice) • 601-922-5534 (fax) • sullivandirector@comcast.net (e-mail) • www.oraldeaf.org • Anne Sullivan, M.Ed. Family Services (age 0 to 3 served free), Auditory/ oral classrooms, association method classroom, audiological services, mainstream services, evaluations and out-patient services available in an 11-month school year.

n Missouri CID – Central Institute for the Deaf,

825 South Taylor Avenue, St. Louis, MO 63110 • 314-977-0135 (voice) • 314-977-0037 (tty) • aosman@cid.edu • www.cid.edu (website) • Lynda Berkowitz/Barb Lanfer, co-principals. Childand family-friendly learning environment for children birth-12; exciting adapted curriculum focuses on emerging literacy/early childhood development and academic and social preparation for the mainstream; professional workshops and educational materials; inservices for schools; close affiliation with Washington University deaf education and audiology programs.

The Moog Center for Deaf Education,

12300 South Forty Drive, St. Louis, MO 63141 • 314-692-7172 (voice) • 314-692-8544 (fax) • www.moogcenter.org (website) • Betsy Moog Brooks, Director of School and Family School • bbrooks@moogcenter.org. Services provided to children who are deaf and hard-of-hearing from birth to 9 years of age. Programs include the Family School (birth to 3), School (3-9 years), Audiology (including cochlear implant programming), mainstream services, educational evaluations, parent education

V O LTA V O ICES • MARCH/APRIL 2009

and support groups, professional workshops, teacher education, and student teacher placements. The Moog Center for Deaf Education is a Moog Curriculum School. The Moog School – Columbia, 3301 West Broadway, Columbia, MO 65203 • 573-446-1981 (voice) • 573-446-2031 (fax) • www.moogschool.org (website) • Judith S. Harper, CCC SLP, Director. jharper@moogschool.org (e-mail). Services provided to children who are deaf and hard-of hearing from birth to kindergarten. Programs include the Family School (birth to 3). School (3 years to kindergarten). Mainstream services (speech therapy/academic tutoring), educational evaluations, parent education, support groups, and student teacher placements. The Moog Center for Deaf Education is a Moog Curriculum School. St. Joseph Institute for the Deaf – St. Louis,

1809 Clarkson Road, Chesterfield, MO 63017 • 636-532-3211 (voice/TYY) • 636-532-4560 (fax) • mdaniels@sjid.org (e-mail) • www.sjid.org • Mary Daniels, M.A., Principal. An independent, Catholic auditory/oral, day and residential school serving children with hearing loss ages birth through the eighth grade. Auditory-oral programs include early intervention, toddler and preschool classes, K-8th grade, on-site audiology clinic, full evaluations, mainstream consultancy, summer camp, after-school enhancement program, financial aid. Fontbonne University graduate and undergraduate practicum

O F

S E R V I C E S

site. Mainstream academic accreditations (ISACS and NCA), Approved private agent of Missouri Department of Education.

n Nebraska Omaha Hearing School for Children, Inc. 1110

N. 66 St., Omaha, NE 68132 • 402-558-1546 • ohs@hearingschool.org • An OPTIONschools Accredited Program offering auditory/oral education for birth to three, preschool and K – 3rd grades. Serving Omaha and the surrounding region.

n New Hampshire HEAR in New Hampshire, 11 Kimball Drive,

Suite 103, Hooksett, NH 03106 • 603-624-4464 (voice) • www.HEARinNH.org • Lynda S. French, Director. New Hampshire’s only auditory-oral school for children who are deaf or hard of hearing. HEAR in NH serves children with all degrees of hearing loss from infancy through high school. Programs offered include parent/child play groups, preschool, pre-kindergarten, kindergarten and itinerant services for children in their community schools. Summer services, parent education/support, speech/language services and professional workshops are available.

D I R E C T O R Y

O F

S E R V I C E S

n New Jersey HIP and SHIP of Bergen County Special Services - Midland Park School District,

41 E. Center Street, Midland Park, N.J. 07432 • 201-343-8982 (voice) • kattre@bergen.org (email) • Kathleen Treni, Principal. An integrated, comprehensive pre-K-12th grade auditory oral program in public schools. Services include Auditory Verbal and Speech Therapy, Cochlear Implant habilitation, Parent Education, and Educational Audiological services. Consulting teacher services are available for mainstream students in home districts. Early Intervention services provided for babies from birth to three. SHIP is the state’s only 7-12th grade auditory oral program. CART (Computer Real Time Captioning) is provided in a supportive, small high school environment. The Ivy Hall Program at Lake Drive,

10 Lake Drive, Mountain Lakes, NJ 07046 • 973-299-0166 (voice/tty) • 973-299-9405 (fax) • www.mtlakes.org/ld. • David Alexander, Ph.D., Principal. An innovative program that brings hearing children and children with hearing loss together in a rich academic environment. Auditory/oral programs include: early intervention, preschool, kindergarten, parent support, cochlear implant habilitation, itinerant services, OT, PT and speech/language services. Self-contained to full range of inclusion models available.

Speech Partners, Inc., 26 West High Street, Somerville, NJ 08876 • 908-231-9090 (voice) • nancyschumann@hotmail.com (email) • Nancy V. Schumann, M.A., CCC-SLP, LSLS Cert. AVT. Auditory-Verbal Therapy, Communication Evaluations, Speech-Language Therapy and Aural Rehabilitation, School Consultation, Mentoring, Workshops. Summit Speech School for the Hearing-Impaired Child, F.M. Kirby Center,

705 Central Ave., New Providence, NJ 07974 • 908-508-0011 (voice/TTY) • 908-508-0012 (fax) • info@summitspeech.com (e-mail) • www.summit-speech.org • Pamela Paskowitz, Ph.D., CCC-SLP, Executive Director. Auditory/oral services for deaf and hard of hearing children. Programs include Parent Infant (0 to 3 years), Preschool (3 to 5 years) and itinerant services for children in their home districts. Speech and language, OT and PT services available.

n New Mexico Presbyterian Ear Institute – Albuquerque,

415 Cedar Street SE, Albuquerque, NM 87106 • 505-224-7020 (voice) • 505-224-7023 (fax) • Contact: Bettye Pressley, Executive Director. A cochlear implant center, auditory/oral school for deaf and hard-of-hearing children and parent infant program. Serves children from infancy to early elementary school years. Comprehensive audiology, diagnostic and speech therapy services. Presbyterian Ear Institute is a Moog Curriculum School.

n New York Anne Kearney, M.S., LSLS Cert. AVT, CCC-Speech Language Pathology,

401 Littleworth Lane, Sea Cliff, Long Island, NY 11579 • 516-671-9057 (voice). Auditory/Oral School of New York, 2164 Ralph

Avenue & 3321 Avenue “M,” Brooklyn, NY 11234 • 718-531-1800 (voice) • 718-421-5395 (fax) • info@auditoryoral.org (e-mail) • Pnina Bravmann, Program Director. A premier auditory/oral early intervention and preschool program servicing hearing impaired children and their families. Programs include: StriVright Early Intervention (home-based and center-based), preschool, integrated preschool classes with children with normal hearing, multidisciplinary evaluations, parent support, Auditory-Verbal Therapy, complete audiological services, cochlear implant habilitation, central auditory processing (CAPD) testing and therapy, mainstreaming, ongoing support services following mainstreaming.

Buffalo Hearing & Speech Center-Oral Deaf Education Program, 50 E. North Street, Buffalo,

NY 14203 • 716-885-8318 (voice) • 716-885-4229 (fax) • lshea@askbhsc.org (e-mail) • www.askbhsc.org • Buffalo Hearing & Speech Center is a non-for profit organization that offers a auditory/oral program for children ages birth to 5 years who are deaf and hard of hearing. The Oral Deaf Education Program consists of parent/ infant program, early intervention classroom and a preschool program. BHSC also offers innovative services to children and adults with communication and educational needs including a cochlear implant

V OLTA V OIC E S • M A R C H/ A P R I L 2009

D I R E C T O R Y center and comprehensive audiological services. Our dedicated and skilled staff is focused on the mission of improving the quality of life for adults, children and infants in need of speech, hearing or educational services. The Oral Deaf Education Program is a Moog Curriculum School. Clarke School - New York, 80 East End Avenue,

New York, NY 10028 • 212-585-3500 (voice/tty) • info@clarke-nyc.org (email) • www.clarkeschool.org (website) • Meredith Berger, Director. A program of Clarke School for the Deaf/Center for Oral Education, serving families of young deaf and hard of hearing children. Auditory/oral programs include early intervention, preschool, kindergarten, comprehensive evaluations, hearing aid and FM system dispensing and related services including occupational, physical and speech-language therapies. Cleary School for the Deaf, 301 Smithtown Boulevard, Nesconset, New York 11767 • 631-588-0530 (voice/TTY) • 631-588-0016 (fax) • www.clearyschool.org • Kenneth Morseon, Superintendent; Ellen McCarthy, Principal. A statesupported program serving hearing impaired children birth to 21. Auditory/oral programs include ParentInfant Program (school and home based) for children birth to 3, Auditory-Oral Reverse Inclusion Preschool Program for children 3 to 5 and Transition Program for children with cochlear implants who have a sign language base. Auditory/oral programs include daily individual auditory-based speech and language therapy, daily speech push-in, annual and on-going audiological and speech-language evaluations and parent training/support. The mission of the Reverse

V O LTA V O ICES • MARCH/APRIL 2009

Inclusion Auditory-Oral Preschool Program is to best prepare children to enter kindergarten in their own school district. Classes consist of children with hearing loss and their normal hearing peers. League for the Hard of Hearing, 50 Broadway,

6th Floor, New York, NY 10004 • 917-305-7700 (voice) • 917-305-7999 (fax) • 917-305-7888 (TTY) • www.lhh.org • Florida Office: 2800 W. Oakland Park Blvd, Suite 306, Oakland Park, FL 33311 • 954-731-7200 (Voice/TTY) • 954-485-6336 (fax) • National diagnostic, rehabilitation, human-services agency offering comprehensive services to all individuals who are deaf or hard of hearing. Audiology, otology, hearing aid dispensing, communication therapy, technical services, mental health, career development, assistive-devices center, cochlear implant training, museum, noise center, library, publications, education programs, support groups. Lexington School for the Deaf,

26-26 75th Street, Jackson Heights, NY 11370 • 718-350-3300 (voice/tty) • 718-899-9846 (fax) • www.lexnyc.org • Dr. Regina Carroll, Superintendent, Ronni Hollander, Principal - rhollander@lexnyc.org (email). A state-supported program serving hearing impaired children in the Greater New York area from infancy through age 21. Auditory-Oral programs include the Deaf Infant Program (ages 0-3), Preschool classes (ages 3-6) and early Elementary classes. Auditory-Oral programs include daily speech, listening and language services, ongoing audiological support, coordination with hospital implant centers, evaluations and parent support. The school’s academic program follows the New York State

O F

S E R V I C E S

standards. Music/Dance, Physical Education (and swimming), Art, Library, as well as technology are part of the school schedule. Long Island Jewish Medical Center Hearing & Speech Center, 430 Lakeville Road,

New Hyde Park, NY 11042 • 718-470-8910 (voice) • 718-470-1679 (fax) • The Long Island Jewish Hearing and Speech Center provides services for individuals of all ages with communication disorders. The Center serves two tertiary care hospitals, Long Island Jewish Medical Center and North Shore University Hospital, providing both in-patient and outpatient services. As the largest hearing and speech center on Long Island, the Center accepts referrals from physicians, schools, community speech pathologists and audiologists, and self-referrals from Long Island and New York City. The professional staff consists of 14 audiologists, 10 speech-language pathologists, a social worker and a deaf educator. Audiologic services available at Center include complete diagnostic and habilitative services, a cochlear implant program, a voice and laryngeal laboratory and a hearing aid dispensary. Mill Neck Manor School for the Deaf, GOALS (Growing Oral/Aural Language Skills) Program, 40 Frost Mill Road, Mill Neck, NY 11765 •

516-922-4100 (voice) • Mark R. Prowatzke, Ph.D., Executive Director, Francine Bogdanoff, Assistant Superintendent. Publicly-funded integrated preschool program, serving Deaf and hard of hearing children (ages 3-5) on Long Island. Literacy-based program with auditory/oral approach, curriculum aligned with NY State Preschool Standards, art, music, library, audiology, speech, language therapy, related support services and family programs.

D I R E C T O R Y

O F

S E R V I C E S

Nassau BOCES Program for Hearing and Vision Services, 740 Edgewood Drive, Westbury,

NY 11590 • 516-931-8507 (Voice) • 516-931-8596 (TTY) • 516-931-8566 (Fax) • www.nassauboces.org (Web) • JMasone@mail.nasboces.org (Email). Dr. Judy Masone, Principal. Provides full day New York State standards - based academic education program for children 3-21 within district-based integrated settings. An auditory/oral or auditory/sign support methodology with a strong emphasis on auditory development is used at all levels. Itinerant services including auditory training and audiological support are provided to those students who are mainstreamed in their local schools. Services are provided by certified Teachers of the Hearing Impaired on an individual basis. The Infant/Toddler Program provides center- and home-based services with an emphasis on the development of auditory skills and the acquisition of language, as well as parent education and support. Center-based instruction includes individual and small group sessions, speech, parent meetings and audiological consultation. Parents also receive 1:1 instruction with teacher of the Deaf and Hard of Hearing on a weekly basis to support the development of skills at home. Comprehensive audiological services are provided to all students enrolled in the program, utilizing state of the art technology, FM assistive technology to maximize access to sound within the classroom, and cochlear implant expertise. Additionally, cochlear implant mapping support provided by local hospital audiology team will be delivered on site at the school.

New York Eye & Ear Cochlear Implant and Hearing & Learning Centers, (formerly Beth

Israel/New York Eye Ear program). New Location: 380 Second Avenue at 22nd Street, New York, NY 10010 • 646-438-7800 (voice). Comprehensive diagnostic and rehabilitative services for infants, children and adults including audiology services, amplification and FM evaluation and dispensing, cochlear implants, auditory/oral therapy, otolaryngology and counseling.

n North Carolina BEGINNINGS For Parents of Children Who Are Deaf or Hard of Hearing, Inc.,

3714-A Benson Drive, PO Box 17646, Raleigh, NC 27619 • 919-850-2746 (voice) • 919-850-2804 (fax) • raleigh@ncbegin.org (e-mail) • Joni Alberg, Executive Director. BEGINNINGS provides emotional support, unbiased information, and technical assistance to parents of children who are deaf or hard of hearing, deaf parents with hearing children and professionals serving those families. BEGINNINGS assists parents of children from birth through age 21 by providing information and support that will empower them as informed decision makers, helping them access the services they need for their child, and promoting the importance of early intervention and other educational programs. BEGINNINGS believes that given accurate, objective information about hearing loss, parents can make sound decisions for their child about educational placement, communication methodology and related service needs.

CASTLE- Center for Acquisition of Spoken Language Through Listening Enrichment,

5501-A Fortunes Ridge Drive, Suite A, Durham, NC 27713 • 919-419-1428 (voice) • www.uncearandhearing.com/pedsprogs/castle An auditory/oral center for parent and professional education. Preschool and Early intervention services for young children including Auditory Verbal parent participation sessions. Hands-on training program for hearing-related professionals/ university students including internships, two week summer institute and Auditory Verbal Modules.

n Ohio Millridge Center/Mayfield Auditory Oral Program, 950 Millridge Road, Highland Heights,

OH 44143-3113 • 440-995-7300 (phone) • 440-995-7305 (fax) • www.mayfieldschools.org • Louis A. Kindervater, Principal. Auditory/oral program with a ful continuum of services, birth to 22 years of age. Serving 31 public school districts in northeast Ohio. Early intervention; preschool with typically developing peers; parent support; individual speech, language, and listening therapy; audiological services; cochlear implant habilitation; and mainstreaming in the general education classrooms of Mayfield City School District.

V OLTA V OIC E S • M A R C H/ A P R I L 2009

D I R E C T O R Y Ohio Valley Voices, 6642 Branch Hill Guinea Pike, Loveland, OH 45140 • 513-791-1458 (voice) • 513-791-4326 (fax) • mainoffice@ohiovalleyvoices.org (e-mail) • www.ohiovalleyvoices.org (website). Ohio Valley Voices teaches children with hearing impairment to use spoken language as their primary means of communication. We offer an early intervention program for children from birth to 3 years, a preschool program from 3 to 5 years and a school age program to the second grade. We have a full audiological clinic on site. We are a Moog Curriculum school.

n Oklahoma Hearts for Hearing, 3525 NW 56th Street,

Suite A-150, Oklahoma City, OK 73112 • 405-548-4300 • 405-548-4350(Fax) • Teresa H. Caraway, Ph.D.,CCC-SLP, LSLS Cert. AVT and Joanna T. Smith, M.S., CCC-SLP, LSLS Cert. AVT, Jace Wolfe, Ph.D., CCC-A. Comprehensive hearing healthcare program which includes pediatric audiological evaluations, management and cochlear implant mapping. Auditory-Verbal therapy, cochlear implant habilitation, early intervention, pre-school, summer enrichment services and family support workshops are also provided. Opportunities for family, professional education and consultations. www.heartsforhearing.org

n Oregon Tucker-Maxon Oral School, 2860 S.E. Holgate,

Portland, OR 97202 • 503-235-6551(voice) • 503-235-1711 (TTY) • tminfo@tmos.org (e-mail) • www.tmos.org (website) • Established in 1947, Tucker-Maxon is an intensive auditory-oral school that co-enrolls children with hearing loss and children with normal hearing in every class. Each class is taught by a regular educator or early childhood specialist and a teacher of deaf children. Programs for children with hearing loss start at birth and continue through 5th grade. Tucker-Maxon provides comprehensive pediatric audiology evaluations, cochlear implant management, habilitation and mapping, early intervention, and speech pathology services.

n Pennsylvania Archbishop Ryan School for Children with Hearing Impairment, 233 Mohawk Ave., Norwood,

PA 19074 • 610-586-7044 (voice) • 610-586-7053 (fax) • Our Oral Academy is located within a regular elementary school enabling some children to learn with hearing peers in a mainstream classroom with the support of a Deaf educator. Some children learn in self-contained classrooms with other deaf children. We offer a full academic program from preschool through age 14. For more information visit www.cesmsa.org, click registry and our school by name.

Bucks County Schools Intermediate Unit #22, Hearing Support Program, 705 North

O F

S E R V I C E S

kmiller@bucksiu.org • Kevin J. Miller, Ed.D., CCC-SP, CED, Supervisor. A publicly-funded program serving local school districts with deaf or hard of hearing students (birth -12th Grade). Services include itinerant support, resource rooms, audiology, speech-language therapy, auditory-verbal therapy, C-Print captioning, and cochlear implant habilitation. Center for Childhood Communication at The Children’s Hospital of Philadelphia,

3405 Civic Center Boulevard, Philadelphia 19104 • 800-551-5480 (voice) • 215-590-5641 (fax) • www.chop.edu/ccc • Judith S. Gravel, Ph.D., Director. The CCC provides children with audiology, amplification, speech-language and cochlear implant services and offers support through our Family Wellness Program. We serve families at our main campus in Philadelphia and at our Pennsylvania satellite offices in Bucks County, Exton, King of Prussia, Springfield, and at our New Jersey satellite offices in Voorhees, Mays Landing and Princeton. Clarke Pennsylvania Auditory/Oral Center,

455 South Roberts Road, Bryn Mawr, PA 19010 • 610-525-9600 (voice/tty) • info@clarkeschool.org (email) • www.clarkeschool.org (website). Judith Sexton, Director. A program of Clarke School for the Deaf/Center for Oral Education, serving families with young children with hearing loss. Auditory/ Oral programs include early intervention, preschool, parent support, individual auditory speech and language services, cochlear implant habilitation, audiological support, and mainstream support.

Shady Retreat Road, Doylestown, PA 18901 • 215-348-2940 x1240 (voice) • 215-340-1639 (fax) •

V O LTA V O ICES • MARCH/APRIL 2009

D I R E C T O R Y

O F

S E R V I C E S

Delaware County Intermediate Unit #25, Hearing and Language Programs,

200 Yale Avenue, Morton, PA 19070 • 610-938-9000, ext. 2277 • 610938-9886 (fax) • mdworkin@dciu.org • Program Highlights: A publicly funded program for children with hearing loss in local schools. Serving children from birth through high school. Services include audiology, speech therapy, cochlear implant habilitation (which includes auditory-verbal therapy), psychology and social work.

DePaul School for Hearing and Speech,

6202 Alder Street, Pittsburgh, PA 15206 • (412)924-1012 (voice/TTY) • mk@depaulinst.com (email) • www.speakmiracles.org (website) • Mary Beth Kernan - Family Service Coordinator. DePaul is Western Pennsylvania’s only auditory-oral school serving families for 100 years. A state-approved, private magnet school, DePaul’s programs are tuition-free to parents and caregivers of approved students. Program includes: early intervention services for children birth to 3 years; a center-based toddler program for children ages 18 months to 3 years; a preschool for children ages 3-5 years and a comprehensive academic program for grades K-8. Clinical services include speech therapy, cochlear implant habilitation services, audiological support including cochlear implant mapping, physical and occupational therapy, mainstreaming support, parent education programs and a parent support group.

n South Carolina The University of South Carolina Speech and Hearing Center, 1601 St. Julian Place, Columbia,

SC 29204 • 803-777-2614 (voice) • 803-253-4143 (fax) • Center Director: Danielle Varnedoe, daniell@sc.edu (e-mail). The center provides audiology services, speech-language therapy, adult aural rehabilitation therapy and Auditory-Verbal therapy. Our audiology services include comprehensive evaluations, CAPD evaluations, and cochlear implant evaluations and programming. The University also provides a training program for AVT and cochlear implant management for professional/ university students. Additional contacts for the AVT or CI programs include: Nikki Burrows (803-777-2669), Wendy Potts (803-777-2642) or Cheryl Rogers (803777-2702).

n South Dakota South Dakota School for the Deaf (SDSD),

2001 East Eighth Street, Sioux Falls, SD 57103 • 605-367-5200 (V/TTY) • 605-36705209 (fax) • sdsd@sdbor.edu (e-mail). Serving children and youth with hearing loss by offering services on site and through its outreach program. Academic option includes auditory/oral program for students using spoken language and are preschool through third grade. SDSD utilizes the Sioux Falls School District Curriculum and prepares students to meet state standards. Instructional support in other areas is available as dictated by the IEP, including parent/ child education, speech language pathology, auditory training and special education. Arranges for dual

enrollment of students in their local schools to expand curricular and social options. Outreach staff provides support to families with newborns and children through the ages of 2 years and continues to work with the families and school district personnel of older students who are either remaining in or returning to their local districts. Any student in South Dakota with a documented hearing loss can take advantage of services offered through SDSD, including audiological testing, speech evaluation, and triennial multidisciplinary assessment.

n Tennessee Memphis Oral School for the Deaf, 7901 Poplar

Avenue, Germantown, TN 38138 • 901-758-2228 (voice) • 901-531-7050 (fax) • www.mosdkids.org (website) • tschwartz@mosdkids.org (email). Teresa Schwartz, Executive Director. Parent-infant program, auditory/ oral day school (ages 2 to 6), speechlanguage and cochlear implant therapy, mainstream services.

Vanderbilt Bill Wilkerson Center - National Center for Childhood Deafness and Family Communication, Medical Center East South Tower,

1215 21st Avenue South, Nashville, TN 37232-8105 • 615-936-5000 (voice) • 615-936-1225 (fax) • nccdfc@vanderbilt.edu (email) • www.mc.vanderbilt.edu/root/vumc.php?site=hearing (web). Tamala Bradham, Ph.D., Director. The NCCDFC Service Program is an auditory/oral learning program serving children with hearing loss from birth through 18 years. Services include educational services at

V OLTA V OIC E S • M A R C H/ A P R I L 2009

D I R E C T O R Y the Mama Lere Hearing School at Vanderbilt as well as audiological and speech-language pathology services. Specifically, the Service Program includes audiological evaluations, hearing aid services, cochlear implant evaluations and programming, parent-infant program, individual speech, language, and listening therapy, educational assessments, toddler program, all day preschool through kindergarten educational program itinerant/academic tutoring services, parent support groups, and summer enrichment programs.

n Texas Bliss Speech and Hearing Services, Inc.,

12700 Hillcrest Rd., Suite 207, Dallas, TX 75230 • 972-387-2824 • 972-387-9097 (fax) • blisspeech@aol.com (e-mail) • Brenda Weinfeld Bliss, M.S., CCC-SLP/A, LSLS Cert. AVT®. Certified Auditory-Verbal Therapist® providing parentinfant training, cochlear implant rehabilitation, aural rehabilitation, school visits, mainstreaming consultations, information, and orientation to deaf and hard-of-hearing children and their parents. Callier Center for Communication Disorders/ UT Dallas, Callier-Dallas Facility, 1966 Inwood Road,

Dallas, TX, 75235 • 214-905-3000 (voice) • 214-905-3005 (tty) • Callier-Richardson Facility: 811 Synergy Park Blvd., Richardson, TX, 75080 • 972-883-3630 (voice) • 972-883-3605 (tty) • eloyce@utdallas.edu (email) • www.callier.utdallas.edu • Nonprofit organization, hearing evaluations, hearing aid dispensing, assistive devices, cochlear implant evaluations, psychology services, speech-language pathology services, child development program for children ages 6 weeks to 5 years. The Center for Hearing and Speech,

3636 West Dallas, Houston, TX 77019 • 713-523-3633 (voice) • 713-874-1173 (TTY) • 713-523-8399 (fax) • info@centerhearingandspeech.org (email) • www.centerhearingandspeech.org (website) • CHS serves children with hearing impairments from birth to 18 years. Services include auditory/oral preschool; Audiology Clinic providing comprehensive hearing evaluations, diagnostic ABR, hearing aid and FM evaluations and fittings, cochlear implant evaluations and follow-up mappings; SpeechLanguage Pathology Clinic providing Parent-Infant therapy, Auditory-Verbal therapy, speech therapy, aural (re)habilitation; family support services. All services offered on sliding fee scale and many services offered in Spanish. Denise A. Gage, M.A., CCC, LSLS Cert. AVT® Certified Auditory-Verbal Therapist, SpeechLanguage Pathologist, 3111 West Arkansas Lane,

Arlington, TX 76016-0378 • 817-460-0378 (voice) • 817-469-1195 (metro/fax) • denise@denisegage.com (email) • www.denisegage.com • Over 25 years experience providing services for children and adults with hearing loss. Services include cochlear implant rehabilitation, parent-infant training, individual therapy, educational consultation, onsite and offsite Fast ForWord training. Speech and Hearing Therapy Services,

North Dallas • 214-458-0575 (voice) • speechandhearingtherapy@yahoo.com (e-mail) • www.speechandhearingtherapy.com (website) • Tammi Bailey, MA, CCC-SLP, Aural Habilitation Specialist. Comprehensive Aural Habilitation therapy, specializing in pediatric populations, cochlear implant habilitation, parent-infant/child and individual therapy, Auditory-Verbal therapy, auditory/oral, or total communication offered with strong emphasis on auditory skill development. Home visits or office visits.

V O LTA V O ICES • MARCH/APRIL 2009

Sunshine Cottage School for Deaf Children,

103 Tuleta Dr., San Antonio, TX 78212 • 210-824-0579 • 210-826-0436 (fax). Founded in 1947, the auditory/oral school promotes early identification of hearing loss and subsequent intervention, working with parents and children from infancy through high school. Audiological services include diagnostic hearing evaluations for children of all ages, hearing aid fitting, cochlear implant programming and habilitation, maintenance of soundfield and FM equipment in the classroom. Programs include the Newborn Hearing Evaluation Center, Parent-Infant Program, Hearing Aid Loaner and Scholarship Programs, and Educational Programs (three years of age through 12th grade mainstream), Speech Pathology, Counseling, and Assessment Services. For more information visit www.sunshinecottage.org.

n Utah Sound Beginnings of Cache Valley, Utah State University, 1000 Old Main Hill,

Logan, UT 84322-1000 • 435-797-0434 (voice) • 435-797-0221 (fax) • www.soundbeginnings.usu.edu • lauri.nelson@usu.edu (email) • Lauri Nelson, Ph.D., Sound Beginnings Director • todd.houston@usu.edu (email) • K. Todd Houston, Ph.D., CCC-SLP, LSLS Cert. AVT, Graduate Studies Director. A comprehensive auditory learning program serving children with hearing loss and their families from birth through age five; early intervention services include homeand center-based services, parent training, a weekly toddler group, pediatric audiology, and AuditoryVerbal Therapy. The preschool, housed in an innovative public lab school, provides self-contained Auditory-Oral classes for children aged three through five, parent training, and mainstreaming opportunities with hearing peers. The Department of Communicative Disorders and Deaf Education offers an interdisciplinary graduate training program in Speech-Language Pathology, Audiology, and Deaf Education that emphasizes auditory learning and spoken language for young children with hearing loss.

Utah Schools for the Deaf and the Blind,

742 Harrison Boulevard, Ogden, UT 84404 • 801-629-4700 (voice) • 801-629-4701 (tty) • www.usdv.org • A state-funded program for children with hearing loss (birth through high school) serving students in various settings including local district classes throughout the state and residential options. Audiology, speech instruction, auditory verbal development and cochlear implant habilitation provided.

n Virginia Chattering Children – Richmond Center, 1307 Lakeside Avenue, Richmond, VA 23228 • 804-290-0475 (voice) • NOVA Center, 1495 Chain Bridge Road, Suite 100, McLean, VA 22101 • www.chatteringchildren.org (website) • adavis@chatteringchildren.org (email). Chattering Children, Empowering hearing-impaired children through spoken communication. Infants through school age. Parent-Infant Program, AV Therapy, mainstream support. SPEAK UP (an auditory oral school). Family-centered conversational approach. In-service training and an internship program for graduate students. NoVa Center: 1495 Chain Bridge Road, Suite 100, McLean, VA 22101 (Metro DC area), Tel: (571) 633-0770. Richmond Center: SPEAK UP auditory-oral school and auditory-verbal therapy: 1307 Lakeside Ave Richmond VA 23228. Tel: (804) 290-0475. Contact Anne Davis, Executive Director, Anne Davis, adavis@chatteringchildren.org.

O F

S E R V I C E S

Listen Hear Audiology, 1101 S. Arlington Ridge Rd. #117, Arlington, VA 22202 • 202-997-4045 (voice) • listenhearaudiology@yahoo.com (e-mail) • www.listenhear.net • Rachel Cohen, Au.D., CCC-A • Auditory/oral services provided to children or adults who are hard-of-hearing or deaf using preferred methodology (Auditory/oral, Cued, TC, or ASL) when needed. Auditory (re)habiliation is provided in your home/natural environment or at my office. Birth through geriatric cochlear implant habiliation, aural (re)habilitation, assistive listening device information, parent-infant training and consultation. Lynchburg Speech Therapy, Inc.,

1049 Claymont Drive, Lynchburg, VA 24502 • 434-845-6355 (voice) • 434-845-5854 (fax) • dclappavt@aol.com (e-mail) • Denice D. Clapp, M.S., CCC-SLP, LSLS Cert. AVT®, Director. AuditoryVerbal habilitation services provided for hearing impaired children with all degrees of hearing loss and their families to develop spoken language through listening. Auditory re(habilitation) provided for older children through adults who use cochlear implants to access hearing. Consultations and mainstream educational support for children and their families. Early inter-vention provided in the home.

n Washington Listen and Talk – Education for Children with Hearing Loss, 8610 8th Avenue, NE, Seattle, WA,

98115 • 206-985-6646 (voice) • 206-985-6687 (fax) • hear@listentalk.org (e-mail) • www.listentalk.org (website). Maura Berndsen, Educational Director. Family-centered program teaches children with all degrees of hearing loss to listen, speak, and think in preparation for inclusion in neighborhood schools. Services include early intervention (0 to 3 yrs), Auditory-Verbal therapy (3 to school age), blended pre-school/pre-K classes (3 to 5 yrs), and consultations. A summer program is offered in addition to services provided during the school year.

The Listen For Life Center at Virginia Mason,

1100 9th Ave. MS X10-ON Seattle, WA 98111 • 206-223-8802 (voice) • 206-223-6362 (tty) • 206-223-2388 (fax) • lsnforlife@vmmc.org (email) • www.vmmc.org/listen (website) • Non-profit organization offering comprehensive diagnostic and rehabilitation services from infancy through senior years. Audiology, otolaryngology, hearing aids, implantable hearing aids, cochlear implants, communication classes, assistive listening devices, Aural Rehabilitation, counseling, support groups, school consultations, professional training workshops, community days, library.

n Wisconsin Center for the Deaf and Hard of Hearing,

10243 W. National Avenue, West Allis, WI 53227 • 414-604-2200 (voice) • 414-604-7200 (fax) • www.cdhh.org • Amy Peters Lalios, M.A., CCC-A, LSLS Cert. AVT®. Nonprofit agency located in the Milwaukee area serving individuals with hearing loss, from infants to the elderly. The Birth to Three program works with children from throughout southeastern Wisconsin, providing both auditory/ oral and Auditory-Verbal therapies, including education in the home, toddler communication groups and individual speech therapy. Pre- and postcochlear implant training is provided for school-age children and adults. Communication strategy and speechreading is offered in individual as well as small group sessions.

D I R E C T O R Y

O F

S E R V I C E S

INTERNATIONAL n Australia

List of Advertisers

Telethon Speech & Hearing Centre for Children WA (Inc), 36 Dodd Street, Wembley WA

Advanced Bionics............... Inside Back Cover

6014, Australia • 61-08-9387-9888 (phone) • 61-08-9387-9888 (fax) • speech@tsh.org.au • www.tsh.org.au • Our oral language programs include: hearing impairment programs for children under 5 and school support services, Talkabout program for children with delayed speech and language, audiology services, Ear Clinic for hard to treat middle ear problems, Variety WA Mobile Children’s Ear Clinic, newborn hearing screening and Cochlear Implant program for overseas children.

n Canada

Auditory-Oral School of San Francisco.......................................... 41 Auditory Verbal Center, Inc (Atlanta)............. 6 Central Institute for the Deaf....................... 45 Clarke School for the Deaf............................ 4 DePaul School for Hearing and Speech................................................. 32

Montreal Oral School for the Deaf,

4670 St. Catherine Street, West, Westmount, QC, Canada H3Z 1S5 • 514-488-4946 (voice/ tty) • 514-488-0802 (fax) • info@montrealoralschool.com (email) • www.montrealoralschool.com (website). Parent-infant program (0-3 years old). Full-time educational program (3-12 years old). Mainstreaming program in regular schools (elementary and secondary). Audiology, cochlear implant and other support services.

Saskatchewan Pediatric Auditory Rehabilitation Center (SPARC), Room 21,

Ellis Hall, Royal University Hospital, Saskatoon, SK, S7N 0W8, Canada • 306-655-1320 (voice) • 306-655-1316 (fax) • lynne.brewster@usask.ca (e-mail) • www.usask.ca/healthsci/sparc • Rehabilitative services including Auditory-Verbal Therapy for children with hearing impairments. (Birth through school age). The Vancouver Oral Centre for Deaf Children,

3575 Kaslo Street, Vancouver, British Columbia, V5M 3H4, Canada • 604-437-0255 (voice) • 604-437-1251 (tty) • 604-437-0260 (fax) • www.deafeducationcentre.org (website) • Our auditory-oral program includes: on-site audiology, cochlear implant mapping, parent-infant guidance, auditory-verbal therapy, music therapy, preschool, K, Primary 1-3; itinerant services.

DuBard School for Language Disorders............................... 11 Ear Technology Corporation....................... 47 Harris Communications............................... 31 Illinois State University.................................. 9 Infoture, Inc................................................... 7 Jean Weingarten School............................... 5 John Tracy Clinic......................................... 44 Logital Company, Ltd.................................. 36 Moog Center for Deaf Education.................................27, 39, 49 National Cued Speech Association............... 8 National Technical Institute for the Deaf/RIT..................................... 29, 46 Oticon.................................Inside Front Cover

n England The Speech, Language and Hearing Centre,

Christopher Place, 1-5 Christopher Place, Chalton Street, Euston, London NW1 1JF, England • 0114-207-383-3834 (voice) • 0114-207-383-3099 (fax) • info@speechlang.org.uk (e-mail) • www.speech-lang.org.uk • Assessment, nursery school and therapeutic centre for children under 5 with hearing impairment or speech/language difficulties.

Phonak, LLC..................................Back Cover St. Joseph Institute for the Deaf.................. 43 Sorenson Communications......................... 50 Sound Aid.................................................... 48 Sprint Relay................................................. 38 Sunshine Cottage........................................ 25

VOICES

Tucker-Maxon Oral School.......................... 17 University of Hartford.................................. 42

AG Bell – Financial Aid................................ 13

Let us know how we are doing. Write a Letter to the Editor, and you could see your comment in the next issue.

AG Bell – LSL Symposium........................... 33

Visit www.agbell.org and select “About AG Bell” for advertising information

Submissions to Volta Voices Volta Voices welcomes submissions from both AG Bell members and non-members. The magazine is published six times annually. Its audience consists of individuals who are deaf or hard of hearing, parents of children who are deaf or hard of hearing and professionals in fields related to hearing loss (audiology, speech-language pathology, psychology, otology, social services, education). Visit the Volta Voices page at www.agbell.org for submission guidelines and to submit content. Subjects of Interest n Technology – related to hearing loss, new technology, improvements to or problems with existing technology, or how people are using existing technology, accommodations. n Education – related to public or private schools through post-secondary education, new approaches and teaching methods, legal implications, and issues, etc. n Advocacy – information on legislation, hearing health, special or mainstream education, and accessibility. n Health – audiology issues relating to children or adults with hearing loss and/or their families and friends. n Action – stories about people with hearing loss who use spoken language as their primary mode of communication; deafness need not be the focal point of the article. Editorial Guidelines The periodicals department reserves the right to edit material to fit the style and tone of Volta Voices and the space available. Articles are selected on a spaceavailable and relevancy basis; submission of materials is not a guarantee of use. Transfer of Copyright The revised copyright law, which went into effect in January 1978, provides that from the time a manuscript is written, statutory copyright is vested with the author(s). All authors whose articles have been accepted for publication in Volta Voices are requested to transfer copyright of their articles to AG Bell prior to publication. This copyright can be transferred only by written agreement. Without copyright ownership, the Alexander Graham Bell Association for the Deaf and Hard of Hearing cannot issue or disseminate reprints, authorize copying by individuals and libraries, or authorize indexing and abstracting services to use material from the magazine. Art Submission Guidelines Volta Voices prefers digital images over original artwork. When submitting electronic files, please provide them in the following formats: TIF, EPS or JPG (no BMP or GIF images). Digital images must be at least 300 dpi (at size).

AG Bell – 2009 LOFT Program...................... 2

Letters to the Editor

Media Kit

Want to Write for Volta Voices?

AG Bell – Online Career Center................... 21

Submit Articles/Items to: Volta Voices Alexander Graham Bell Association for the Deaf and Hard of Hearing 3417 Volta Place, NW • Washington, DC 20007 e-mail: editor@agbell.org Submit online at www.agbell.org

V OLTA V OIC E S • M A R C H/ A P R I L 2009