sound practice in action
Two of the questions I used to ask myself were: do I need to set up a therapy room in my house? and, How often do I need to sit down and do therapy with my child?
Elizabeth Rosenzweig of Cochlear Implant Online wrote, “in Auditory-Verbal Therapy, parents come to center stage to play a key role in the show.”
As a mom, I realize that active parent involvement in the therapy process is key to my son’s success and came to understand that was crucial for me to learn how to be my son’s pseudo therapist. Even with the best therapy, one hour once a week was not going to be enough for him to develop age-appropriate listening and spoken communication skills.
I have to admit, that although I loved the idea of being in charge of my son’s progress, I was pretty worried during the early stages of my son’s auditory-verbal intervention.
I learned that children with hearing loss need to hear a word or phrase three to four times more often than children with typical hearing before they master it receptively and expressively. I learned that 95% of a child’s receptive and expressive prowess is gained through overhearing adults engaged in conversational exchanges at extended distances.
Prior to cochlear implants, my son couldn’t hear a thing with his hearing aids. How was my son going to overhear my husband and I talk if he couldn’t hear? How was I going to do all that I needed to do, without replicating exactly what our therapist did with Noah every week when she came to our home?
AVT sessions do not consist of the therapist simply disseminating information, but rather, it’s an hour of therapist demonstration and parent practice with the purpose of enabling parents to feel confident using techniques and strategies that encourage the development of spoken language through listening. Auditory-verbal therapists understand that therapy is a process that does not end when their hour does. They guide and coach parents in creating and maximizing listening and spoken learning opportunities within their daily routines.
How was I ever going to find the time, resources, and creativity to replicate what my therapist was able to do every Friday morning in our living room? I felt that I had to set aside specific time to “do therapy” with my son.
Or did I?
It wasn’t long before I learned that my world is my son’s oyster of listening and spoken language opportunities.
My auditory-verbal therapist emphasized that my son’s world (e.g. home, car, grocery store, apple orchard, etc.) is the most natural place for him to learn spoken language through listening.
I was reminded that my husband, my daughter and Noah’s twin brother are Noah’s primary spoken language models. I learned that we, as a family unit, know my son’s skills and interest the best.
The Auditory-verbal therapist taught me how to elicit a response from Noah. I learned to wait, pause and to allow him time for him to process the information he heard and to answer for himself. The therapist guided me though typical developmental norms in listening and spoken language and with her help I learned what Noah needed to learn each week. It was up to me to teach him what he needed to learn.
I quickly learned that it’s not practical or convenient (nor is it natural) to have a specific time during each day to “do therapy.” I learned that I didn’t need a therapy room in my house. I learned that every waking hour consists of golden opportunities that will enable my son to develop listening and spoken communication skills. Every hour of every day in the life of our family became the “real therapy session” as opposed to the therapy session in the therapist’s office or our living room.
The “real therapy session” involved anything and everything. My husband and I could do it any time, any place. It was easy to involve our other children in the activities we planned. We quickly saw that all three of our children benefitted, not just Noah.
When my boys were very little I used to walk them around our neighbourhood and narrate as I walked. I would comment on the trees, the weather, the birds, cars, airplanes, anything I saw that I could talk about and point out to them. When the weather was cold, I took them to a local mall and did the same thing. I became very good at narrating while I folded laundry and cleaned the kitchen. Narrating mundane tasks is therapy. It is real life language. Any opportunity to hear rich language was one I took advantage of.
We went to the library almost every day. I found that the more books that I read, the better Noah’s attention span became. Initially, Noah was only able to listen for just a minute or two. Now at six years of age, he is a bookworm whose appetite for listening to a story seems endless.
Not only did children’s books provide the perfect opportunity for grandparents and other family members to bond together with Noah, but they also served as conversational starters.
Reading another copy of the book that was introduced by our therapist during her therapy session was also something I did repeatedly. For example, Noah and I read “The Carrot Seed” at home after it was introduced during a therapy session. We then bought carrot seeds and planted them in our garden and watched them grow.
Grocery shopping and cooking were full of listening and language learning opportunities. I had to shop and cook anyway! It was tailored to any topic or session target being worked on and was modified at varying ages and stages. When my kids were in high chairs, I used to narrate while cooking. When they were a little older, I would have them find certain foods (colours, shapes, food groups, etc) at the grocery store or the kitchen cupboard. I had Noah and his siblings measure, sort, and put ingredients together. The possibilities are endless when it comes to food and language!
Even today at six years old, Noah is always my first child to ask to help me in the kitchen. But now he is the one narrating to me. He is the one reading the recipe aloud step by step. He is the one commenting on how delicious the ingredients smell, describing how a particular food feels in his hands, how excited he is to taste the final result, and making suggestions of what we should cook next time.
Developing skills that will help integrate listening into the personality of a child with hearing loss does not happen solely in a therapy session. It does not require a therapy room in the house, fancy equipment or a even crafty mom.
I have learned that what is required is an open mind and heart, a willingness to explore the world through your child’s eyes and ears with your knowledge and skills learned from the weekly auditory-verbal therapy sessions.
Resources: Cochlear Implants Online
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KAREN MACIVER LUX