Supporting Each Other: Teachers of the Deaf and Educational Audiologists

It’s a typical Monday. One of your students has a dead hearing aid battery. Another is experiencing some static through her FM system. In another classroom, the student pass-around microphone is no longer synced with the soundfield tower. As teachers of the deaf/hard of hearing we are called upon to troubleshoot, re-sync, inspect and clean amplification on a daily basis. We know our students and their equipment well and have no choice but to learn how it all works together! Teachers and other school staff come to depend on us to help resolve problems with the hearing technology, including equipment malfunctions. But this is only one part of our job as the bulk of our time is spent consulting with staff and directly instructing our students. The ideal situation would be if every school we work in had an educational audiologist on the team. School teams may not understand the need for both an audiologist and a TOD so we have to make efforts to help them understand the role we each play in the student’s education. When there is no educational audiologist on the team, there is generally little or no contact between the audiologist and the school. It is critical that the TOD and audiologist collaborate and communicate regularly to ensure optimal access for our students in school.

In explaining the differences and overlapping responsibilities of the TOD and audiologist to school staff, some factors to consider include:

     

Additionally, teachers of the deaf/hard of hearing see the application of hearing technology in the classroom and the student’s access. We have important information to share about a student’s academic progress, speech and language development, auditory comprehension and equipment use in the classroom. We must also communicate with the audiologist around problems with equipment in case adjustments need to be made. I find communicating with the audiologist via an email the easiest but phone calls or in-person visits are sometimes options as well.

Audiologists are knowledgeable about equipment and the student’s hearing needs from observing the student in the booth. They must communicate about technology to the TOD/HOH including changes in FM settings, adjustment to CI maps and HA settings (e.g. activation of noise reduction options) as this will affect the student at school. This information is often communicated in reports which can be sent directly to the TOD with parent permission.

Teachers of deaf/hard of hearing and audiologists are both important members of a student’s team. How do you collaborate with your student’s audiologists?

Making Self-Advocacy Meaningful

As teachers of the deaf and hard of hearing, we understand the importance of fostering self-advocacy skills in all our students, even our preschoolers! Our students all have goals and objectives focused on self-advocacy because this early, supported practice helps them to develop life long confidence in alerting others to their listening and learning needs.  But, before students can alert others to their needs, they need to understand their hearing loss, amplification, and the benefits and limitations of their amplification. It is also important that students know what their self-advocacy objectives are. We work together to decide which aspects of their advocacy goals can be tackled first.

Advocacy is not always easy or comfortable, even for adults! So how can we get our students to willingly work in this critical area? Here are some ideas:

Student Presentations Have students create presentations to share with their teachers or peers about their specific hearing loss. Using provided organizers and outlines, students as young as preschool can take part. PowerPoint, iMovie, and homemade posters and books are some formats that I’ve used with students. Finding a motivating medium to work with keeps everyone engaged while working on the project.  Be sure to weave language objectives into self-advocacy practice by having students use a variety of structures to explain their hearing loss and how their amplification works. For a more detailed description of such presentations see my earlier post here .

Letter Writing Students can send regular letters, newsletters or emails to teachers describing their needs in specific classes. One colleague has her middle school student write monthly letters to her teachers from the CIA (Cara’s Implant Advocacy), putting a spy twist on what could otherwise be a mundane task for a middle school student. 

Communication Notebooks Some students have communication books which they take ownership of, writing what is working well and what needs improvement in their classes. Under the guidance of the TOD, SLP, or other designated adult, this is a valuable record of the student’s perspective in classes and can be used to spark discussions of how to handle difficult listening situations.

Meetings Several of my students meet with me and their teacher(s) on a regular basis. Prior to meeting, the student and I meet as the student fills out an organizer requiring them to write what is working and what needs improvement in their classes. They also write any specific questions they have for their teacher. This structured format allows the student to practice with me before approaching a teacher. Teachers are generally receptive to the feedback and often ask for a copy of the student’s notes!

How do you help students advocate?

Starting the New School Year Strong

It’s back to school time! As Clarke Itinerant Teachers, we’ve already hit the ground running. Despite the lingering heat, summer is officially over and students are returning to school this week as we frantically check items off of our “to do” lists. Here are a few key people to connect with in the next few days to ensure a smooth start to the new year:

Parents: Call the parents of each student; introduce yourself and find out:

·       How summer went for the student

·       How they like to be contacted (email, phone, text, etc.)

·       Concerns for the upcoming year

·       When last audiology appointment was and any changes (if you don’t have a recent report from the audiologist)

·       Name of managing audiologist and if this person also manages FM (sometimes it’s two different people)

Schools: Identify and coordinate the following school-related information:

·       Student’s school address and main phone number

·       Classroom / main teacher; contact this person and introduce yourself, explain your role

·       Your primary contact (could be SPED teacher, SLP, counselor etc.)

·       Report dates and format. Sometimes schools request a word document, or sometimes we have access to an online IEP manager, for which you’ll need access codes and log-in information.

·       Schedule your In-Service. You may need to coordinate with the managing audiologist if they are doing an in-service at the school.

·       Make sure you have the most recent signed IEP. If not, request it.

·       Request copy of the student’s daily schedule. For elementary students the teacher will have it. For junior and high school students, guidance department will likely be the place to get you a schedule.

Audiologists:

·       Contact the audiologist (HA/CI and FM audiologists if different) to introduce yourself.

·       Request reports if they are not already in the student’s file. *Parents may be required to sign a release and this takes time, so ask early!

·       Find out what each student uses for amplification including make and model of each device.  

·       Identify concerns the audiologist may have for the upcoming year?

·       Discuss how the managing audiologist wants to handle general troubleshooting and how she wants to be contacted when there is a problem with equipment.

Your students! Set up a file/binder for each student that includes:

·       IEP/relevant testing

·       Audiological information including the most recent report and audiogram

·       School information including calendar, contact people (names, email, phone)

·       Family information (names, email, phone)

Summer Break

 Like the students, Hear Me Out is going on break for the summer. I'll return in August with back to school planning tips! 

Summer FM Servicing

As itinerants, there are many things we’re thinking about as the school year comes to a close. I have multiple IEP meetings, in-services for some of my students, transition meetings and June progress reports. My planner is a rainbow of color-coded appointments and due dates! In addition, it is a priority to make sure all of my students’ FM systems make it back to the audiologists for summer servicing. I’m fortunate to work for Clarke where our audiologists manage many of the students that I work with. and In those cases, I know the summer servicing will happen. For students managed by other audiologists, I reach out to them, as well as my school contact, to ensure that this important aspect of FM management takes place.

     Summer servicing of FM systems (sometimes called Remote Microphone Hearing Assistance Technology or Remote Mic. HAT) is an important component of amplification management. Over the course of the school year, cords can deteriorate and fray, batteries weaken, pieces chip and bend, and connections between audioshoes and boots can loosen from wear. Even if equipment is working fine now, proactively servicing the FM system can prevent the student from having to go without it at the start of a new school year if something should break then. Summer is the perfect time for an overhaul since students typically do not use their FM systems during the summer. When students do require FM for summer school or related activities, it is still critical that all equipment is inspected by a managing audiologist before the start of the new school year.

Ensure Delivery to the Audiologist

Work with your team to decide how the FM system will get to the audiologist for summer servicing. Some students have an educational audiologist on their team and that person is responsible for picking up equipment at the end of the year. Sometimes this job falls to the special education liaison, and sometimes I pick up and deliver the equipment myself when my students are managed by Clarke audiologists. Most importantly, I do not assume someone else will handle the delivery –I want to know for sure who will be held responsible for each of my students! Some schools require me to sign a responsibility form when picking up and delivering FM system for summer servicing, so be sure to check with your contact at each school so that you understand the expectations. Additionally, some audiological contracts include summer servicing; for others, this is an additional cost. Be sure to communicate with your team and your student’s managing audiologist so no surprise bills arrive at the school.

Comprehensive summer servicing should include:

·      Replacement of rechargeable batteries

·      Replacement of any frayed cords

·      Repair or replacement of any pieces with loose or worn connections

·      Cleaning of all of the components

·      Full testing of the FM system to ensure all components work properly together

·      *An appointment for your student for FM verification (transparency) and a functional listening test with and without their equipment should occur before the start of the new school year

     An appointment for FM verification is an aspect of equipment management that I find is too often overlooked by school systems and their contracted audiologists. Just as it is important for an audiologist to verify and program the FM and fit it to each child when it is ordered, it is an essential step in annual service. While some audiologists verify the equipment according to the American Academy of Audiology pediatric guidelines as part of their protocol, many skip this step. They imply take the pieces from the box and put them on the student, which I unfortunately see too often in the field. When this happens, the student may not be getting optimal auditory input through the FM system and their specific hearing aid and/or cochlear implant settings. This means that the FM signal may be too soft preventing optimal access, or too loud, which decreases their access to peers.  In either case, when the FM is not transparent, the student may reject the equipment as it either does not seem beneficial or negatively impacts their ability to hear and learn from other students in the classroom. I remember seeing a student for the first time a few years ago at the start of the school year. Her teachers reported that she used her FM consistently and never reported any trouble with it. While meeting with the student, I asked her how she felt about her FM. She commented that it was fine but didn’t really know what it did for her or why she had to use it. When I listened through her hearing aid, the signal from the FM was so soft I could barely hear it! No wonder she didn’t see the benefit! After speaking with her audiologist and getting her parent involved, the FM system was verified, the volume of the FM was increased appropriately, and the student then had access through her FM.

If you are unsure if your student’s FM system has been verified, speak with the managing audiologist and ensure that this is part of the student’s management plan. As verification often requires the student to go to the audiologist for an appointment (unless the audiologist has portable verification equipment), work with families to set that appointment now before it gets forgotten in the hustle of the fall and the start of a new school year. Part of the planning will be knowing for sure who will be designated to pick up the FM in the fall and return it to the school. Sometimes families bring the FM after the verification appointment, sometimes it’s me (the teacher of the deaf/hard of hearing), and sometimes it’s a designated school staff member.  It is also a good idea to start planning for next year in terms of trainings. If possible, schedule the in-service for the fall where relevant staff can be trained in how to use the FM in order to maximize access for the student with hearing loss. With some advanced planning, students, families and schools will not have to worry about the functioning of amplification next fall. J