A thumbnail summary of an interactive colloquy session with the renowned and professed ENT specialist and Cochlear Implant Surgeon Dr. Shomeshwar Singh :

1          WHEN TO CONTACT YOUR CI SURGEON?

If there are any signs of inflammation at the implant site i.e. Redness, Swelling, and Pain. In general falls or bumps won’t affect either the external processor or internal implants. Rush to the doctor if there is any bruising or bleeding.

2          WHICH SPORTS TO AVOID?

As general advisory only contact sports with direct impact on implant sites and implants are restricted like Boxing, Wrestling, Kabaddi. Other games like football, basketball, cricket can be played with necessary preventive measures and the adjunct help of advanced accessories.

3          HOW TO TACKLE SWEAT RELATED IRRITATIONS?

Normal powders can be applied for the same after taking out the processors at night time. In general ointments or medicines can be applied on the implant site too if required if there are no signs of cuts or bruise.

4          IN SITUATIONS OF COMMON COLD AND COUGH?

Not only in cochlear implant recipients but in persons with typical hearing too, there is a dip in hearing due to cold, cough and related congestion. Parents of implant recipients need to take aggressive preventive and curative measures though and especially look for any fluid collection or infection. There is no need to panic just being vigilant is the key.

5          IN CASE THE CHILD NEEDS MRI?

All the Implant companies have stipulated well-versed document on MRI- do’s and don’ts and is provided to implant centres clinics and surgeons. MRI, if required, one needs to take a written or printed advisory from concerned surgeon or audiologist and the radiologist can decide accordingly, how to proceed the scan procedure.

6          WHAT IF THE INTERNAL IMPLANT FAILS?

If there is an internal implant failure then a revision surgery is required with ex-plantation and reimplantation of a new Cochlear Implant. As these are happening on the inner ear level it won’t affect the therapy or speech and language development as it occurs on the CNS(Central Nervous System ) level and the brain is already trained. Though any new step has its own start and will take some time to adjust and adapt to normalcy.

7          WHEN AND HOW TO DECIDE FOR UPGRADES?

It is a point to ponder upon as there are many decisive factors like age of the implantee(both chronological and hearing), the requirement of advanced technology and the new features, availability of ongoing processors and accessories on the shelf. Though it’s always good to go hand in hand with the technology but don’t be swayed away by marketing gimmicks.

8          WHAT IS THE RELIABILITY RATE OF A COCHLEAR IMPLANT DEVICE?

Every Implant company have published their own reliability report and is easily available. Nowadays with advanced and enhanced medical technology implants are expected to have a very high-reliability rate over a longer span of time.

 

The recipients and caregivers need to have a confidence in technology with the acceptance of err making human made technology. Problems do come but there are measures to tackle with. Be Argus eyed and patient.

Have A Happy Hearing!

ACKNOWLEDGEMENT:

Host of the event: Chetana Misra

Session compiled by Nayela Ahmed

Course Coordinator: Ritu Nakra

 

 

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Advocating Self Advocacy

 

 

Parents having children with hearing impairment are extra cautious around them. The need to be around their children and ensure that no harm comes to them is but natural. However an important fact to keep in mind is that children with any kind of impairment need to be taught to lead normal lives. The fundamental reason behind going for hearing aids or cochlear implants is to enable such children to live fairly independent, normal and regular lives.

This fundamental reasoning is lost if the parents are forever hovering around the child and helping them do basic things. The child needs space to grow and to handle situations by himself. This is possible only if we teach them self advocacy right from the beginning.

What is self advocacy? Self advocacy literally means ‘the action of representing oneself or one’s views or interests.’ Being able to do things independently will give your child a sense of purpose and worthiness.

Self advocacy helps them gain awareness of personal preferences, likes, dislikes, strengths, interests, potential and limitations. It helps them differentiate between wants and needs. It helps them make choices and consider multiple options after calculating the consequences of their actions.

The following points will help you understand the importance of self advocacy and how it will help your child gain confidence to face any situation head on.

Teach them the basics:

Children can be taught the basic workings of their hearing aids or Cochlear Implants and should also be able to recognise when the battery runs out or gets disconnected. Children going to play school (age 2.5yrs-3yrs) can be taught to inform if their device is not working. This differentiation will help them reach out and report to adults as soon as they sense something wrong.

Start Early:

There is no such thing as ‘too early’. Start developing self-advocacy skills in your child as early as possible.

As they grow older children (age 4yrs to 5yrs) should be taught to be more expressive if they fail to hear or understand something. They should be able to judge the distance required to hear better. They should be able to clearly communicate that they require the speaker to talk softer, louder or slowly. Teach them to ask for repetitions if they have not understood something.

Being vocal will help them develop their vocabulary as well. The more words they use, the more they learn pronunciation, sounds, vocabulary and language.

Communicate:

In a new environment, the child must have the confidence to walk up to an adult and inform them about his or her needs.

They should be able to explain to the teacher and find the right spot to sit in class. A shy child might find it difficult to do so, but make them understand that they need to speak up for themselves if they have to learn in class.

Most importantly the child should be made to understand that the hearing aid or Cochlear Implant is meant to help them function like regular children and should not be taken as a mark or symbol of any disability. It is their friend and should be treated as one.

Seeking Help:

If communication is important, then asking for help is equally important. The child should be made to understand that asking for help is not wrong. Asking for help will not lead to them being mocked or laughed at. They can confide in friends and ask them for notes or updates if they miss out on hearing the instructions or lectures in class. This confiding will strengthen their bonds with these friends and will make for a wonderful foundation to a long lasting friendship too.

Mental Preparation:

In a comfortable, known environment with help from family and friends the child will be able to function normally. However, how will the child cope in a new environment without a known person to help or support? Prepare your child for such unaccounted or unplanned situations. What if the child gets separated from the parents in a mall? What if the child has to go to another school for a project or a submission? How will the child deal with such situations if he is not made aware of them in the first place? Mentally prepare your child to face such challenges. Teach him to approach people and ask for help without feeling insecure. Teach him to be confident and importantly encourage him to go out and experience the world first hand by himself.

Maintenance:

Teach your child to keep the hearing aid or Cochlear Implant in a safe place or in the Dehumidifier when they are not wearing it. They should be taught to automatically include ‘wearing of device’ into their morning rituals once they wake up. It should be as natural as brushing teeth.

Final word:

Do understand that children with hearing impairment are like normal children but hear differently. They need to lead normal lives and enjoy all the things that regular children do. They only need a little help in hearing and that is possible with the collective cooperation and support of everyone the child comes across.

Hearing should not be a privilege, it should be a right.

Ritu Nakra

LSLS Cert.AVT

Tips for fathers and professionals to help facilitate spoken language skills in young children with hearing loss

Father_s_day [1490963]

Dear Dads,

You play a very vital role in the development of your little ones. When you are around your child, the child feels much more secure and protected. As a therapist, I would like to acknowledge all your efforts in helping your child to be a strong individual in his/her life, especially on this Father’s Day.

Tips on how you can contribute in a better manner towards the speech and language development of your child:

  • The male voice is naturally at a lower frequency as compared to a female voice. Hence, your natural low pitch gives an opportunity for children with hearing loss to acquire a good base of suprasegmentals through your voice. Therefore, the golden rule for you is to sing, sing and sing to your child.
  • Since the mother gets tired of all the household chores during the day, you can take the initiative for a bed time story telling session with your child. This gives you a good opportunity to share some special moments with your little one and foster a stronger bond between you both.
  • One of the principles of Auditory Verbal Therapy (AVT) states that to guide and coach parents so that they can help children to integrate listening and spoken language skills into all aspects of their lives. To make the learning experience more natural, joyful, meaningful and fun at home, you can easily supplement the lessons learnt by your child in the therapy sessions by taking your family out during weekends for picnics, jungle safaris, farmhouse visits or even to beach fronts.
  • If you are unable to visit your child’s therapy centre frequently, do try to go at least once a month to meet the professionals involved with your child and to attend guidance and counselling sessions / workshops organised by the centre.
  • Research done by AVT’s in India has concluded that families where there is a healthy relationship between the husband and wife overcome the grief of knowing the fact that their child has a hearing loss in a better way. So, be very supportive of your spouse.

Tips for Professionals to encourage the father’s involvement :

As per the national survey of over 262 fathers of children with hearing loss conducted by Dr. K. Todd Houston, PhD, CCC-SLP, LSLS Cert. AVT, following are the conclusions:

  • Treat fathers as equal partners in the parenting process.
  • Give flexibility of appointments as per their
  • Don’t ignore fathers during meetings. Make eye contact with them, ask them how they are coping and look for ways to support them in the process.
  • Be unbiased in your recommendations.
  • Be sensitive & empathetic to the father’s situation.
  • Don’t make assumptions about the father’s role or level of interest.
  • Provide father-specific information / materials like websites, books or support materials which can help them.
  • Help them to connect with other families with hearing impaired children, especially their fathers and also advocates.
  • Discuss and explain latest technology.
  • Be sensitive to religious and cultural differences.

Wishing all fathers a Happy Father’s Day and hope you have a wonderful journey full of beautiful surprises with your children.

With Warm Regards,

Ritu Nakra

LSLS Cert. AVT