sound practice in action
Posted by Paige Stringer on April 28, 2015 12:04 AM
The sounds of children laughing and chatting on the playground are what first greet visitors approaching the gates of the early intervention building at Thuan An Center in Vietnam. One would think this was a typical playground scene found anywhere in the world, and it is, save for one extraordinary element. These young children, vocally communicating with each other and their parents, are all deaf or hard of hearing. This is one example of success resulting from the hard work that has been done in Vietnam over the last several years to make it possible for such young children with hearing loss to learn to listen and speak.
Thuan An Center is a residential school for the deaf established in the 1800’s by a French priest. The grounds with its colonial buildings have retained much of its old-world flair. About 200 boys and girls older than 7 years of age who are deaf come here from provinces around South Vietnam to board and acquire a sign language-based education. In the late 1990’s, the director of Thuan An Center, Nguyen Thanh Thu Thuy, took part in a training program in Europe that taught about the benefits of early intervention in helping young children with hearing loss learn to listen and talk. She learned that all children develop language in the first years of life. And, that it is critical to introduce sound to children who are deaf or hard of hearing through hearing aids or cochlear implants as soon as possible and provide early intervention services to foster their listening and spoken language abilities. Thuy returned to Thuan An Center determined to establish such early intervention services at her center for toddlers and children under 6 years of age with hearing loss. She struggled at first because it was a challenging undertaking in a country that lacked the necessary knowledge and expertise to make such a venture successful.
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My first visit to Thuan An Center was in 2008 as part of a volunteer assignment to teach English. Thuy had never met an adult such as myself who was born with hearing loss and yet communicates solely through listening and spoken language. Upon introductions, Thuy immediately led me into her office, sat me down, and asked me to share my background. I told her about how I was identified with severe to profound hearing loss at 11 months of age and fit with hearing aids while my family was living in England as expatriates. I shared with her the audiology and early intervention services that I and my family received in those first years in both England and in the United States. That early support enabled me to enroll into mainstream schools throughout my academic career starting at kindergarten. After earning a Master’s degree, I held various marketing positions, including at Fortune 100 companies, for several years.
I knew that services for children with hearing loss in low and middle income countries such as Vietnam were not at the same level as in the United States and other higher income countries. However, I was still touched by Thuy’s intense interest and marveling reaction to my life experiences that derived as a result of the early support I received. As I engaged with the children at Thuan An Center over the next several weeks and learned from their teachers about their limited future education and employment prospects, it struck a chord with me. It did not seem right that these children would have reduced opportunities in their lives simply because of the lack of awareness and resources for pediatric hearing loss that exists where they were born.
There are no audiology degree programs in Vietnam. Most of the teachers and therapists working with children with hearing loss have undergraduate degrees in special education. There are no advanced degrees in deaf education. Only in recent years has a speech pathology certificate program been established.
During that first visit to Vietnam, I did teach English. However, it soon became clear that my purpose was going to be much broader. Thuy brought me with her to various meetings with colleagues and academics. She would nudge me, “Paige, just say something. Say anything.” I would say a few words and she would point at me with eyebrows raised. Her eyes dancing in excitement, she remarked to anyone who would listen, “See! See what is possible for someone born with a severe to profound hearing loss?”
I asked Thuy what would be most useful in her efforts to develop services for children with hearing loss in her country. She could have focused on her own school and the needs of her own fledging early intervention program. Instead, she expressed an urgent wish for a training program that would educate teachers, therapists, and other professionals throughout her country about how to help children 0-6 years of age with hearing loss learn to listen and talk. A training program would transfer essential knowledge to the Vietnamese so they could provide direct service to the children and also prepare them to train others in the country. The whole system of early education for these children could then improve and become more widely available to families. It was a powerful vision and one that I immediately got behind.
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After returning to Seattle, Thuy and I communicated via email to develop a proposal for a multi-year program to bring training in audiology, early intervention, auditory-verbal practice, and speech pathology to Vietnam. I shared our vision with professionals in my city working in audiology and auditory-verbal practice and they volunteered to lend their expertise to the effort. We worked together to develop a curriculum that they and others in their respective fields would teach in Vietnam.
As I sought funding and support from organizations to bring our proposal to life, I recognized an opportunity to develop an alternative model to what currently existed to address pediatric hearing loss in developing countries. The Global Foundation For Children With Hearing Loss was established in 2009 with this model in mind.
The Global Foundation For Children With Hearing Loss takes a comprehensive, long-term view to the issue of pediatric hearing loss. Our approach is to collaborate with local partners across education and hearing health care in a developing country to identify and address gaps in the country’s support system for babies and young children with hearing loss learning to listen and talk. We promote early identification of hearing loss. We provide training to professionals and families about best practices in audiology, early intervention, and auditory-verbal practice. We help establish new processes. We work to raise awareness about pediatric hearing loss and how it can be addressed.
Our Vietnam Program launched in July, 2010 with a Summer Training Program involving 95 teachers and therapists representing 35 schools across 20 provinces in South Vietnam. In 2011, we added our audiology training program for audiology technicians. Soon after, we started a hospital program to train medical professionals and ENT doctors. We also initiated training sessions to parents of children with hearing loss so they could learn how to support their child’s listening and spoken language development. Today, our Vietnam Program touches over 250 education and healthcare professionals working in hospitals, clinics, and schools across North and South Vietnam who collectively serve over 1,000 children with hearing loss and their families.
We provide hearing aids to children in need as part of the clinical aspect of our audiology training efforts to give the Vietnamese opportunities to practice what they are learning. The children are then supported ongoing by the technicians we train. Our curriculum is taught by a team of about 40 Global Foundation For Children With Hearing Loss volunteer professionals in speech pathology, audiology, otolaryngology, and auditory-verbal practice from the United States and other countries. They volunteer their expertise and time to this effort throughout the year.
A key tenant of our program is to prepare the Vietnamese participants to not only do the work themselves, but then to train others, making the benefits exponential and sustainable. Our program has created a network of support across audiology, otolaryngology, auditory-verbal therapy, and deaf education that is strengthening the system for families of children with hearing loss in Vietnam.
Moving forward, the Global Foundation For Children With Hearing Loss plans to establish regional audiology centers and provide additional training to address the need for more accessible pediatric audiology care in the provinces. In July 2015, the Global Foundation will graduate a group of Vietnamese therapists and teachers from its program. These teachers and therapists will be involved in future training of additional Vietnamese professionals in Global Foundation programs in Vietnam.
The Global Foundation For Children With Hearing Loss has received attention from other developing countries for its successful model. We are currently exploring opportunities to expand our work to other developing countries that have requested our support.
Back at Thuan An Center, an early intervention building was constructed on school grounds in 2011. Thuy chose a bright yellow for the façade as a “symbol of hope and promise for families”. Today, the center’s 70 students range between 1.5 to 6 years of age who are all fit with hearing aids and cochlear implants and are learning to listen and talk. The Global Foundation has been training all of their early intervention teachers and therapists as part of its program over the years. The center recently established an audiology booth that is staffed by a technician we trained. In each year since its inception, growing numbers of children have “graduated” out of the Thuan An Center early intervention program to attend the local mainstream school.
The collaboration between the Vietnamese and the Global Foundation For Children With Hearing Loss is a demonstration of what is possible when a committed group of caring professionals and families across the world share a vision and work together to make positive change.
Founder and Executive Director
Global Foundation For Children With Hearing Loss
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