The River School Emphasizes Integration of Kids With Hearing Loss

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The River School—tucked along a tree-lined street in Washington, D.C.’s Northwest quadrant, alongside the Potomac River—specializes in the oral education of young children with hearing loss. But unlike other programs that silo and segregate deaf children from their typically hearing peers, the private school has developed an inclusive, mutually beneficial program that urges literacy and speech skills in both sets of students at the same time.

The ASHA Leader recently spent a sunny spring morning at the school. Here’s who we met and what they do.

On the other side

Jennie Massad has always had a personal connection to her job.

The preschool teacher wears a hearing aid for her moderate-to-severe hearing loss—an instant link to her students who also have aids or cochlear implants. But after the birth of her daughter, Amelia, and the diagnosis of Amelia’s hearing loss, Massad gained another connection to the River School—as a parent.

Massad’s worked at the school for eight years and appreciates the staff’s focus on the students and serving their needs. “[Amelia’s] teachers are aware of pushing language a little bit more and exposing her more,” Massad says, “where in the regular daycare, they’d be aware of it, but they may have a lot of other kids and it’s just not the top priority.”

With 11-month-old Amelia in the school’s infant program down the hall from her own classroom, Massad attends her daughter’s once-a-week treatment sessions, typical of most students with hearing loss. (Children 18 months or older participate in classroom programs, while the school takes babies as young as 6 weeks into its daycare.)

The school serves about 230 students—39 of whom have a hearing loss, according to Julie Verhoff, River’s audiology director—and employs a team of specialists to educate them. Each class includes a dedicated SLP to assist general educators like Massad, while audiologists offer support by troubleshooting issues with assistive technology. A handful of psychologists, therapists and other specialists fill out other offices.

And while it’s still a long way off for Amelia, students who complete third grade—the highest level of instruction offered at the River School—flow into mainstream public or private schools in the area, typically with ease.

 

Sounding it out with ‘Mouth Time’

On the April weekday morning of our visit, Fiacre Douglas sits on a carpeted floor, encouraging students to blow cocoa powder into the air.

Douglas is considerably older than your typical second-year speech-language pathology graduate student, but his enthusiasm for this new path shows in his interactions with students. As a student clinician at the River School this semester (the school calls him an intern), he’s been supervised by Samantha Wasilus—one of the school’s SLPs—and enjoys hands-on experiences in the classroom.

The cocoa powder—or “dino dust,” as Douglas and Wasilus call it to fit their current “back in time” theme—is one of today’s Mouth Time tools. Mouth Time, a River School innovation, takes place for 15 minutes a day in each class to help students develop literacy skills.

Sitting cross-legged in a semi-circle, the kids practice making a “ch” sound by placing their dino-dust–covered palms up to their lips. Each successful production receives a chocolate-y, chalky explosion as reward, followed by squeals of delight (and a meticulous lick of the hand for leftover specks). Later in the quick productive session, the children sound out words using symbols written on “dinosaur eggs.”

“What’s great about Mouth Time is that the kids all learn these symbols for the shape of their mouth, and how the words are formed, before they actually learn what the letters look like,” says Douglas, who recently completed his clinical placement and earned his master’s degree from George Washington University. “For the kids who have special needs for hearing, we’re making sure they’re hearing the word, they’re understanding the word and they’re learning it—as well as the other kids who don’t have those issues.”

 

Haley Blum is a writer/editor for The ASHA Leader. hblum@asha.org. 

 

Free Custom Hearing Protection for Professional Musicians

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Musicians performing at the Bonnaroo and CMA music festivals near Nashville—both of which begin tomorrow—will receive free custom ear plugs that allow them to hear the notes clearly just at a lower volume. The plugs normally cost around $200 a pair.

The Vanderbilt Audiology Clinic and MusiCares sponsor the program, now in its second year at Bonnaroo. In addition to fitting them with custom plugs, audiologists from Vanderbilt educate the musicians on how important it is to protect their hearing. They also teach them about long-term effects of not wearing ear plugs.

Read more about the free hearing protection program.

How to Encourage Hearing Protection: It’s All in the Attitude

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A quick Google query tells us that “attitude” is a settled way of thinking or feeling about someone or something, typically one that is reflected in a person’s behavior.

Millie likes to go to the shooting range with family members. Her caring family makes sure to protect her hearing. (Millie is a rescue pup belonging to Christine Sanders, a senior in the Department of Communication Sciences and Disorders at Valdosta State University.) If only all parents understood the importance of hearing protection.

In 2009, I participated on a research team studying hearing protection use and attitudes of young adults toward exposure to loud sound. Our target population was college-age adults in the U.S. We compared results to a similar age group in Sweden. The data suggested that, by comparison with the Swedish sample, American young adults are less likely to view loud sound as a health hazard.

We live in a noisy world. Consider, for example, the fans of the Kansas City Chiefs who proudly proclaimed they broke the Seattle Seahawks record for the loudest outdoor stadium sound level record at 142.4 decibels (dB). By comparison, a jet fighter taking off from an aircraft carrier generates approximately 140 dB. It’s estimated that at 150 dB, the human eardrum ruptures.

Where does our craving for loud sound first develop? Music and speech share similar development characteristics. Consequently, we develop our taste for loud sound at an early age.

If we know that hearing loss due to noise exposure is 100 percent preventable, and attitudes toward health safety or risks are developed earlier in life, then we need to work harder to establish early awareness on the negative effects of loud sounds—ideally in preschool and lower elementary grades.

Unfortunately, most research and campaigns on hearing protection still focus on young adults. Researchers report a growing incidence of hearing loss among young individuals, particularly ages 12 to 19. By the time we survey young adults in college, attitudes regarding the potential danger of noise exposure have already been formed, perhaps five to 10 years earlier.

So, while college-age students are a convenient (and important) source of data, the information obtained from this age group probably reflects the consequences of attitudes most likely developed at a younger age.

In the spirit of Better Hearing and Speech Month, what can we do?

We should amplify our warnings to young people about noise-induced hearing damage. The use (and abuse) of tobacco, drugs, and alcohol get tons of exposure. And texting while driving is certainly a hot issue. However, the effects of noise exposure get little attention. Efforts do exist to inform parents and children, such as Dangerous Decibels and Listen to Your Buds. But they aren’t as widespread as messages on texting or drugs.

As professionals in the field of communications, we should:

  • Develop a mandate for instruction in health and physical education classes regarding the damaging effects of exposure to loud sound.
  • Increase hearing screening frequency at the K-12 level—an area that has in recent years retreated, not expanded.
  • Expand efforts to promote programs such as Dangerous Decibels and Listen To Your Buds to the level of safe driving classes in high school.

Healthier attitudes toward loud sound need to be developed earlier!

 

Ted L. Johnson, AuD, CCC-A, is an associate professor in the Department of Communication Sciences and Disorders at Valdosta State University. He is an affiliate of ASHA Special Interest Group 1o, Issues in Higher Education. theodorejohnson@valdosta.edu.

Interprofessional Pre-screening Shortens the Wait for Autism Diagnoses

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Editor’s Note: In recognition of Autism Awareness Month, we have several posts addressing autism-related issues throughout April. The screening program described here is one of several ASD initiatives at Wichita State University; another that eases children’s visits to the dentist is explored in this month’s April ASHA Leader issue.

 

Recently, I became passionate about expediting identification and diagnosis for young children who show signs and symptoms of autism spectrum disorder (ASD). This desire was fueled by a research project I conducted with Douglas F. Parham and Jagadeesh Rajagopalan; the results revealed that pediatricians and family physicians have not been screening young children for ASD as recommended by the American Academy of Pediatrics (regularly conducting ASD-specific screenings for children two times prior to their second birthday) in Kansas, Iowa and Oklahoma.

Based on these results, I determined that one way I could help advance the identification of these young children would be to develop an authentic interprofessional education opportunity for students in the allied-health and education programs at my university: Wichita State University in Kansas. In the spring of 2012, WSU students, faculty and community professionals agreed to form the Wichita State University-Community Partners: Autism Interdisciplinary Diagnostic Team (AIDT).

The team aims to:

  1. Educate undergraduate and graduate students to better recognize the characteristics of ASD and to be able to participate in screening, assessment and referral of children who demonstrate early signs.
  2. Provide a highly needed service to children and families throughout south-central Kansas.

Since the initiation of this team, faculty, clinical educators and students from eight departments—communication sciences and disorders (audiology and speech-language pathology), early childhood unified special education, clinical psychology, physical therapy, dental hygiene, physician assistant, nursing and public health—have participated. Additionally, the University of Kansas School of Medicine–Wichita (represented by a developmental pediatrician and an advanced practice registered nurse) has been a valued partner and referral source.

Faculty and clinical educators recruit and select students to participate in our screening program. Student participants must enroll in a field-based experience and/or an appropriate class within their respective programs. All stakeholders then do a one-day training prior to the start of each semester on identifying the characteristics of ASD, to screen, to participate in the assessment process and to identify appropriate referrals for children and families. The educators agree to participate in at least four diagnostic sessions each semester, ensuring that students from various professions have multiple opportunities to work together, while observing interprofessional collaboration among university and community professionals.

The partnering developmental pediatrician and the advanced practice registered nurse refer children and families to the screening program based on the “red flag” characteristics parents report on the pediatrician’s developmental history form. The program’s coordinator (that’s me) contacts the family via phone to gather additional developmental information, and then the team meets to discuss that information and other relevant documents.

The team conducts the evaluation over two days. The first day, we assess the child’s communication, play and cognitive abilities, using selected tools and strategies based on the child’s strengths and needs. The second day, we administer the Autism Diagnostic Observation Schedule-2 and the Childhood Autism Rating Scale-Second Edition, Standard Version, to provide the developmental pediatrician with diagnosis-relevant information. We also conduct hearing, motor and oral health screenings. The team then meets to discuss the aggregated assessment results, which, in addition to appropriate recommendations and resources, are shared with the family.

We schedule an appointment for the child and family with the developmental pediatrician approximately one week following our assessment. Someone from our team accompanies the family to the appointment to act as a liaison and assist with the examination.

Since the introduction of the AIDT, 133 students, clinical educators, faculty and community professionals across 10 disciplines have come together via this individualized education program field-based experience. Our students and professionals have assessed 24 young children who present with characteristics of ASD, and approximately 85 percent of these children have received a confirming medical diagnosis.

Participants and families alike gain from this experience. Students learn from, with and among others who are committed to interprofessional practice. Families voice their appreciation for receiving diagnostic information from multiple disciplines all at once, so they don’t have to run from place to place to receive it.

Mostly, they value how quickly the AIDT’s work enables them to get their child needed help.

 

Trisha Self, PhD, CCC-SLP, is an associate professor in the Department of Communication Sciences and Disorders at Wichita State University and coordinator of the school’s Community Partners: Autism Interdisciplinary Diagnostic Team. She is an affiliate of ASHA Special Interest Groups 1, Language Learning and Education; and 10, Issues in Higher Education.
Trisha.Self@wichita.edu 

New Global Campaign Takes on Noisy Leisure Activities

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Worldwide, the statistics are sobering:

  • 360 million people have disabling hearing loss.
  • 43 million people between the ages of 12–35 years live with disabling hearing loss.
  • Half of all cases of hearing loss are avoidable through primary prevention.

Of course, none of this likely comes as a surprise to ASHA members, particularly audiologists, who are on the front lines of care for people with hearing loss. The good news is that we are going to hear a lot more about this serious health issue with the help of a high-profile group.

Today, on International Ear Care Day, the World Health Organization is elevating the profile of hearing loss—specifically noise-induced hearing loss—by launching a new campaign called Make Listening Safe.

The campaign educates the public about hearing dangers posed by noisy leisure activities and promotes simple prevention strategies. Young people are the focus because an increasing number are experiencing hearing loss. As the creator of the highly successful Listen to Your Buds campaign, WHO asked ASHA experts to advise on Make Listening Safe. A role the association enthusiastically embraced.

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ASHA used Listen to Your Buds to provide an early warning on potential hearing dangers from misuse of personal music players and the need for safe listening. Today, as this technology is nearly ubiquitous, the campaign is going strong on a variety of fronts.

One of ASHA’s most successful ventures is its safe listening concert series. The series educates young children about protecting their ears in a fun, interactive way by bringing innovative musicians and performances to U.S. schools. A new video showcases the most recent concert series, which took place in six Orlando-area schools in conjunction with ASHA’s 2014 convention.

Misuse of personal audio devices is also a key area of focus for Make Listening Safe. According to WHO, among teenagers and young adults aged 12 to 35 years in middle- and high-income countries, nearly 50 percent are exposed to unsafe levels of sound from the use of these devices.

This is one of the new global estimates being released with the launch of Make Listening Safe. In addition to a high-profile unveiling in Geneva, WHO is issuing a variety of materials featuring statistics on the problem’s scope, the hearing loss consequences and action steps that parents, teachers, physicians, managers of noisy venues, manufacturers and governments can take to make listening leisure activities safer.

ASHA asks members to take up the campaign. Here are just a few ideas on how you can get involved:

  • Utilize the WHO’s eye-catching public education materials—including posters, a fact sheet, and an infographic—with peers, patients, friends and loved ones.
  • Engage in grassroots public education, such as sharing statistics and prevention tips on social media or holding a free hearing screening.
  • Approach local media to pitch a story. The campaign’s launch with accompanying statistics is a great news hook. You can tie the story to your local community by highlighting an event your practice is hosting or offer tips for safe listening at local noisy venues (e.g., stadiums, concert venues/clubs). This is also an excellent consumer health story for a television station, particularly because it offers “news you can use” such as easy prevention tips.

The focus on noise-induced hearing loss in young people is not limited to March. While the WHO campaign will be ongoing, ASHA will also poll the public about safe listening practices. Our results will provide more opportunity for outreach during Better Hearing & Speech Month in May and beyond. Stay tuned!

Click here for more information. Questions may be directed to pr@asha.org.

 

Judith L. Page, PhD, CCC-SLP, is ASHA’s new president. She served as program director for Communication Sciences and Disorders at the University of Kentucky for 17 years and as chair of the Department of Rehabilitation Sciences for 10 years.