Providing services to school-age children with hearing loss involves a host of professionals from clinical and school settings, including audiologists, speech-language pathologists and teachers. No single professional can provide everything these children need to achieve optimal outcomes. It takes all of them working together with each other and the child’s parents.
Toward this end, we created an innovative program for students with hearing loss at Arkansas Children’s Hospital in Little Rock, Arkansas. Like most children’s hospitals, we offer clinic-based audiology and speech-language pathology services to children from birth to 21 years of age.
We also developed a program providing contracted, school-based audiology services and specialized assistance for school professionals working with students with hearing loss. Many of our school-based team members also work in the clinic. This gives us a comprehensive perspective on information and issues we need to share between clinic and school.
We used these insights to develop tools that help us work more collaboratively toward helping each student reach their potential:
Privacy and information sharing
Although we all appreciate and understand the need for patient and student privacy, it creates challenges that can slow down or even stop the flow of information among professionals. Obtaining the appropriate releases of information (ROI) is a shared responsibility of clinic-based and school-based team members.
A few tips and tricks might ease the burden on any one professional:
- If the clinic needs specific forms completed to share information with the school personnel, the clinic should make the form available in print or electronically for school-based partners.
- Several years ago, Arkansas Children’s Hospital developed an ROI specifically designed for sharing information among the hospital, clinics and schools. The release clearly states the parent is giving the hospital permission to share the specific information with the school and that the school can share information back to the clinic. You can download this ROI from our public website.
- In our audiology clinic, we keep copies of these ROIs in every sound room. All staff know how important it is to get these releases signed, so information about a child’s hearing—even if there’s no hearing loss—can be easily shared with a child’s preschool or school.
- Our school-based staff routinely share an electronic copy of this ROI with our contracted school districts at the beginning of every school year. This way, if we neglect to get the release at the clinic or if the release expires during the school year, the school staff can easily ask the parent sign a new release.
- Not all students we see in our school-based contracts are patients in our hospital clinic. So our school-based teams work with a variety of clinical audiology providers, who we help replicate our process.
It’s easy to say communication is important. It’s much harder to actually make constant communication happen. If a student’s clinical audiologist doesn’t communicate with the student’s school-based team—and vice versa—the student suffers. If hearing technology isn’t used correctly at school, the student misses out on instruction. If the school-based SLP notices the child can’t produce a sound this week that he produced last week, this needs to be communicated to the clinical audiologist in case it points to a change in the child’s hearing or a problem with his assistive technology.
Develop a communication plan at the beginning of a school year involving clinic-based and school-based teams to ensure the teams stay in contact. Good communication takes time—and therein lies the issue. The use of technology, such as email, can help reduce time commitment, as long as privacy is protected. We loop in family members and the student when appropriate.
We have probably all read Aesop’s fable “The Boy Who Cried Wolf.” Sometimes we replicate the boy’s mistake by making “blanket” recommendations. As an audiologist, if I send the same laundry list of accommodations to a teacher for a child with unilateral hearing loss and another child with bilateral profound, sensorineural hearing loss and has cochlear implants, I shouldn’t be surprised when the teacher doesn’t respond or follow through.
Yes, preferential seating is a good recommendation for anyone with hearing loss, but each student will have different needs and challenges. Make specific accommodations for each student. Enlist contributions from several team members—along with the student (if appropriate) and family—to decide what the student needs to access their education.
All children need a community to support them. As audiologists and SLPs, let’s be collaborative when it comes to children with hearing loss.
Donna Fisher Smiley, PhD, CCC-A, is an audiologist and audiology supervisor for Arkansas Children’s Hospital and serves on the coordinating committee of ASHA Special Interest Group 9, Hearing and Hearing Disorders in Childhood. SmileyDF@archildrens.org.