By Jane Madell, Au.D.
We are all influenced by words. Some have easy, uncomplicated meanings (book, tree, house) and others carry a lot of emotional baggage (disabled, slow, delayed, etc.). When audiologists talk with families and children we are working with, we need to think carefully about how we describe children and test results. We do not want our words to interfere with our message.
Normal vs. Abnormal
What does it mean to say that a child’s behavior or test results are “abnormal”? Is there another way we can discuss this? Can we talk about what we expect to see and compare it to what we are seeing? We need to be sure we are talking about a specific test or behavior and not making a statement about the whole child. We need to be sure we are not saying, “Your child is abnormal.” We are saying, “Your child’s hearing is abnormal.” In audiology we might say, “Children with typical hearing have responses above this line on the audiogram. Your child’s hearing is below this line.” When describing speech perception testing, we can talk about what typical children can understand and what we may need to do to help this child understand speech better. A speech-language pathologist or listening and spoken language specialist might say, “Children with typical language development have a vocabulary of XX words at this age, your child has a vocabulary of XX words.”
Describing strengths and weaknesses
It is more useful to describe a child’s strength and weaknesses than to describe a child as having a disability (unless you are trying to get a school district to agree to services in an Individualized Education Program (IEP) meeting). Labeling a child as “disabled” does nothing to plan remediation. It is much more useful to make a list of strengths and areas of weakness. The areas of weakness, carefully defined, can result in a treatment plan. If testing identifies a hearing loss, it provides an opportunity to discuss possibilities for remediation such as selecting technology or determining therapy options. If a speech-language evaluation indicates specific areas of weakness (e.g, vocabulary, auditory memory, etc.), the report should discuss how these areas of weakness will affect language and literacy, and the therapy plan should specifically list areas to be worked on to improve skills.
When discussing test results with a child we need to remember that this is likely going to be distressing and we need remind the child that everyone has areas of strength and weakness, and we need to be sure to remind her what her strengths are.
Giving criticism or suggestions
Kids with hearing loss and other disabilities that affect access to academic information find it difficult to deal with the constant need for extra help, etc. They spend hours a week in therapy of one kind or another where they are working on areas of weakness and things that are difficult. They may be receiving preview and review services in school to help them keep up. The very fact that they need to go to see the teacher of the deaf for these services is an indication to the child that he is different than the other kids in his classroom. We need to be sure we are providing positive feedback along with areas needing improvement. If we need to give criticism, sandwich it between positive statements. While we need to give kids honest information, we need to be careful how we explain it. There is no value in telling kids that their work is “bad” or “poor,” or that “if they worked harder they would be able to do better.” We need to encourage them to work hard, but we will accomplish it more easily by being positive.
An important part of success is helping kids advocate for themselves. It is very tempting as parents and professionals to advocate for our children. But we are not always there, so we need to help kids learn to advocate for themselves. They need to understand that they have a disability, and while this is not a statement about who they are as a person, it is a statement about what is needed to help them hear or learn. Talk about how to, recognize when you have missed something, and how to ask for help. If you do not know what page the teacher said to go to, raise your hand and ask for repetition, or look at your neighbor’s book. If you do not hear the answers of other kids to a teacher’s questions, ask the teacher to repeat. If you miss a friend’s comment, ask what was said. Practicing how to ask is very useful with parents or therapists modeling how to ask.
Introducing kids to others with the same disability
Kids need to know that they are not alone. When working with a child with hearing loss, it is useful to introduce them to other kids and to adults who have hearing loss. If there are celebrities who have hearing loss, it will make kids feel terrific to know about them. It helps them to understand that hearing loss is not going to interfere with being who they want to be. When it became public that Derrick Coleman has a hearing loss, it gave a boost to a lot of kids with hearing loss. I personally loved the commercial that Duracell put out with him saying something like, “They told me I couldn’t do this, but I was deaf so I didn’t listen.” What a powerful statement for kids!! Meeting physicians, audiologists, or teachers with hearing loss opens doors for kids. Audiologists, speech-language pathologists, listening and spoken language specialists, teachers of the deaf, and families can seek out adults with hearing loss for kids and parents to meet. It will help everyone feel stronger.
This post originally appeared on Hearing Health @ Hearing Health & Technology Matters’ blog on June 16, 2015. The author, Jane Madell, Au.D., is an audiologist, speech-language pathologist, and auditory verbal therapist with 40-plus years of experience in the greater New York City area.