JTC Days 3 and 4

We are starting to get into the meat of the material in the classes - today we covered audiological testing and receptive and expressive language evaluations (in lectures), met with Skylar's Audio Verbal Therapist, Charissa, and met with Paige and a Family Therapist to talk about being a sibling to a child with hear betters. The Sibling Program is designed for kids age 6-11, and is described as being for siblings of deaf children. We don't use the word deaf to describe Skylar, but need not be afraid of it - there are degrees of hearing loss and deafness from mild hearing loss to profound deafness. Paige was pretty quiet during the session, but she was listening and absorbing the words we were saying. I won't be surprised if she brings up one of the topics we were discussing, like how siblings sometimes feel like they don't get as much attention as their deaf brother or sister, or how they might worry about or feel the need to protect their sibling.

The experience of the families here varies quite widely - from their child's diagnosis, to their technology, to their access to and success with therapists and specialists. Take Audio Verbal Therapy. This is a type of educational approach that focuses on making the most of the child's residual hearing, with the goal of learning and producing full, complex spoken language. At John Tracy, sign language is not taught and is vaguely disparaged as a method to use "if the child doesn't have or can't develop verbal language." We use sign as a supplemental mode of communication- in the bath, at bed time, and across long distances or in loud environments - anywhere it is hard to hear due to environmental factors or Skylar not having her hearing aids in. Audio Verbal Therapy stresses amplification and verbal strategies without the help of visual cues so the kids learn to use their hearing to the greatest possible extent. There are only 50-100 AVT's in the US and Canada, so it's doubtful we will have access to one in Eugene, but we can share the methods with Skylar's Speech Language Pathologist (who has never worked with a hard of hearing or deaf child before) when we get home.

When learning about expressive language assessments, we learned how to collect and evaluate a language sample. Basically, you write down everything a child says for an hour, and then determine the average length and complexity of each utterance to get a sense of the child's language skills in relation to their hearing peers. Average utterances are supposed to contain at least as many morphemes (the smallest units of meaning in a word) as the child's age in years. The word 'wait' has one morpheme, while 'waited' has two, because the -ed changes the meaning of the word.

Skylar's language sample today included:

• Paige, which one is mine?
• Okay, are you ready for your name tag?
• I'm gonna wash this off when I take a bath, but I'm gonna not take a bath today because we're not dirty. OK, daddy?
• (to papa on facetime video) Why you have a pie?
• I wanna be the monster now!
• Gramma Mary, this is your name tag. It has your name on it.
• But can you put it on top of the fridge so she won't eat all the choc...chocolae chips and raisins?

We will get a complete report from Charissa when she is done evaluating Skylar's language over the course of the three weeks we are here - she sees her every day. Based on the sample above, Skylar's length of sentences and number of morphemes per utterance is above average for her age! It's certain forms of words, like the past tense -ed, that we need to work on with her, and some sounds that she drops or doesn't pronounce correctly.

Each night she is talking herself to sleep for about 45 minutes, repeating things that happened or were said during her day at preschool. "Isaure! We need you! Mommies and Daddies, come in! Stir the cupcakes. I sit next to Rebekah. Wash, wash, wash your hands..." It's pretty awesome how she is processing her experience each night before bed; and I'm sure it continues throughout the night in her dreams.