sound practice in action
Posted by Karen MacIver-Lux on February 25, 2014 12:02 AM
From an early age, I knew I was a privileged little girl.
My idea of privilege, however, had nothing to do with money, popularity, or good looks. For me, it was being able to hear with easy-to-hide hearing aids, and not having to wear eye-glasses like my best friend did. That and being able to hear and speak English, which was downright difficult to learn with a bilateral severe to profound hearing loss with ’70’s hearing technology.
It took my mother, and a small village of trusted professionals to raise me to be the joyful listener and speaker that I am.
Once I grew up I became determined to “give back”, ultimately studying to become an audiologist and training to be an LSLS Certified Auditory-Verbal Therapist (LSLS Cert. AVTTM).
Over the years, I have adopted a number of practices that continue to help me in my endeavours to be the best AVT that I can be. The following tips are a few that I share with budding auditory-verbal therapists:
1. Adopt the 'Yes we Can' Philosophy
What made learning to speak difficult was not only the limitations of the ’70’s hearing technology, but also the many well-meaning professionals who categorically told my mother that I’d never learn to talk, never go to school, and would never get a job.
Luckily for me, if you want my mom to do something, just tell her she can’t do it, and she will do it just to prove you wrong. Despite her determined “yes we can” philosophy, it was extremely disheartening to hear the negativity over and over again. What did it accomplish other than to create days and nights of tears and anxiety? Nothing.
During my years in practice I have observed that parents want and need to feel encouraged in order to see the value of consistent hearing technology use and weekly auditory-verbal therapy sessions. They are, after all, my primary clients.
“Clinical positivity” (reporting positive aspects of clinical findings and observations) is what breeds encouragement and plants the seeds of success.
Some examples of “clinical positivity” include:
• explaining to the parents what their child with hearing loss CAN hear at time of diagnosis,
• pointing out those occasions when their child showed positive outcomes in areas of audition, speech, language, cognition and communication,
• being positive and when in doubt, use expressions like, “I don’t know, but let’s try!”
2. Learn to Listen
Yes, as a therapist I, too, need to learn to listen—not only to the children, but more importantly, their parents/caregivers. When a parent/caregiver begins talking, I have learned to become quiet, lean in, wait (even when there is a pregnant pause), and most of all, maintain eye contact.
When parents speak out of frustration or anger, I try to listen and resist the urge to defend, explain and justify. I focus on being an active and compassionate listener. Summarizing what I heard can be very helpful to them and to me. I respond carefully to their concerns or issues once I am sure of their perspective. I try to put myself in the parents’ shoes and imagine what it must feel like raising a child while feeling uncertain of what the future holds.
I have been guilty of “listening” to parents while putting away toys, wiping the table, or writing notes in my chart.
Please don’t do this. Parents look forward to having the opportunity to share their progress and their child with you, not the back of your head.
3. Keep Your Mentor Close
I am fortunate to have a mentor to turn to for honest feedback, support, and professional guidance.
I don’t always like what I hear, but I’ve learned through experience to listen carefully to what he says, not to take criticism or constructive feedback personally, and when I disagree, to go ahead and try what he suggested because it usually ends up being the best advice. He has earned my trust.
Find a mentor that you admire and trust—a good mentor who takes the time to listen to your stories of challenges and successes, a person who will support and encourage you in your growth as a career professional.
4. Don't Forget the Child's Eye View (and smell)
As a child I endured many years of therapy in a room with grey walls devoid of pictures, cabinets full of toys and treasures hiding behind locked doors, a tiny table and uncomfortable chairs that were either too small or big, and a room so big that the sound reverberated. I vowed that my therapy room (and sound booth) would be a cozy play-land with lots of bright colours, interesting toys, inviting books and pictures to look at. I want the children and their families to see, hear, feel, love, and eagerly anticipate the meaningful auditory and spoken language opportunities I create for them.
Imagine that you are a child who cannot hear. Stuff your ears with earplugs and get on your knees and crawl into your therapy room. What does it look like? What does it sound like? Is your therapy room warm and inviting? Would you want to spend time in this room every week for three to five years?
I suggest refraining from drinking coffee, smoking, or eating strong-smelling foods before conducting a therapy session.
Pay attention to personal hygiene (which includes perfume). As much as I hate to say it, there is nothing worse than sitting for an hour with a therapist who has a pungent smell.
Pay attention to the child’s personal space. I hated it when my therapists tapped me on the shoulder or hands, so I make a conscious effort not to do the same. If I need to be closer than 8 inches to the microphone of the child’s technology in order for the child to detect the entire speech spectrum, then I know I’m too close for the child’s comfort. The child will feel that you are breathing down their neck.
All of these are enough to turn a child who loves to please into a child who refuses to cooperate!
5. Remember the 'Two Weeks and Then Move On' Rule
I’ll never forget the day I started seeing a client who my mentor had been teaching. I remember feeling so nervous! How was I ever going to do therapy as well as my mentor did?
He made the sessions look so easy to do! When it was my turn in the hot seat, I found myself stressing over which techniques and strategies to use and generally, making a big mess of things.
“Rome wasn’t built in a day” I reminded myself, deciding to focus on one technique—study it and practice it for two weeks.
If I mastered the use of the technique during therapy sessions, great! If I didn’t, it was time for me to move on to another technique. I would come back to the un-mastered technique some other time. I even involved the parents in the process of helping me learn and use the techniques and strategies and we had fun learning together and laughing at our mistakes.
Unlike learning to acquire listening and spoken language skills, learning the tricks of the auditory-verbal trade is a career-long process— a process that is bound to be frustrating yet very rewarding at the same time.
To those of you who are budding AVTs, welcome to the world of auditory-verbal practice! For those of us who are seasoned auditory-verbal therapists, we owe it to the children to find ways to raise the bar in auditory-verbal practice.
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KAREN MACIVER LUX