On the Road to Ho Chi Minh City

This week’s Blog is written by my friend and colleague Lillian Henderson.  She earned a master’s degree from the University of South Carolina in speech pathology and is an LSLS Certified Auditory Verbal Therapist.  Lillian is the lead speech pathologist for the University of North Carolina School of Medicine’s Pediatric Cochlear Implant team.  She has worked with cochlear implant recipients for the past 15 years, providing therapy and diagnostics to deaf or hard of hearing children who are learning spoken language.  Lillian has also provided training to professionals throughout the United States and graduate students from various universities.  She is a consultant with the Global Foundation for Children with Hearing Loss in Vietnam and worked with me this past January on my latest visit to Vietnam.

 

This past January I had the privilege to return to Vietnam for my second trip with Global Foundation For Children With Hearing Loss.  This time, my colleague and good friend Hannah Eskridge went with me.  Hannah and I work for CASTLE (The Center for the Acquisition of Spoken language Through Listening Enrichment).  CASTLE is part of the pediatric cochlear implant team at the University of North Carolina and the Otolaryngology/Head and Neck Surgery Department.  CASTLE’S mission is to provide a quality Listening and Spoken Language program for children with hearing loss; empower parents as primary teachers and advocates; and train specialists in Listening and Spoken Language. Since our primary goal is to coach professionals on how to teach spoken language through listening, traveling to another country to provide training was a perfect fit for us.

Working in Vietnam

I paid my first visit to Vietnam last summer.  On that trip, one of the Vietnamese professionals asked if there was one document that could cover all of the goals for Listening and Spoken Language. There is currently no such resource available for the education of children with hearing loss in Vietnam. This request made it my mission to have something in place for Global Foundation’s next visit to Vietnam.

Developing a curriculum

Along with Hannah and our mentor, Kathryn Wilson, we devised a curriculum for Global Foundation to use in Vietnam.  From the research that had been done on developing English, we adapted a four-year curriculum that incorporates audition, language, speech, cognition and literacy skills.  The only problem was that this curriculum was based on English.  Therefore, on our first day in Ho Chi Minh City, Paige Stringer, Global Foundation’s founder and executive director, set up a meeting with Trinh Thi Kim Ngoc, dean of Ho Chi Minh College’s Department of Exceptional Children.  With her help and some of her own research on the Vietnamese language, we were able to have a working draft for the participants to work with on Monday morning.

Late Diagnoses and Supporting Spoken Language

Most children in Vietnam are not diagnosed with a hearing loss until two or three years of age.  However, this trend is shifting as awareness grows about the potential that exists when earlier identification is in place.  The Vietnamese have requested more training so they are prepared to support the listening and spoken language development of younger children.  This has been one of the Global Foundation’s top priorities.

When Hannah and I started practicing in the United States, we too had children whose hearing loss was identified late. In North Carolina, we use a systematic approach developed by Thomas Fields for teaching vocabulary to children with a language delay.

The curriculum that we developed for Vietnamese professionals covers audition, speech, language, literacy, and cognition/play.  We focused on the vocabulary development and auditory memory aspects in our week-long training so as to give the Vietnamese professionals some tools they could immediately apply to their own work.  Hannah and I spent the first two days teaching them how to input new words, check to see if a child understands the word, practice the word through imitation and ultimately see if the child can use the word independently.   This approach was new to the Vietnam professionals, but after practicing with a child and the child’s parent, the hierarchy was familiar to them.

Teaching in a foreign language

Using Judy Simser’s work, we also taught auditory memory skills, how to teach Learning to Listen Sounds, and how to systematically pick targets based on the child’s audibility and language.  Auditory strategies were introduced, modeled by us and then practiced by the Vietnamese while they conducted a session with a child and parent.

All week, we were constantly learning new things about the Vietnamese language and making adjustments to the curriculum.  The group made a list of their own Learning to Listen Sounds that reflect what the Vietnamese would use for onomatopoeias according to all the frequencies needed for speech.

The Global Foundation’s team will continue teaching the curriculum in Vietnam in its summer training and Mobile Mission training programs. Select Vietnamese professionals will also further their development through the Global Foundation’s video analysis program.

What we learn when we do this kind of work

Working in Vietnam is a humbling experience.  The professionals and families in Vietnam are so open to new ideas and strive so hard to improve their skills to help the children under very difficult circumstances.  Both Hannah and I have had the luxury of practicing in the United States where pediatric cochlear implants have long been an option. Neither of us has ever worked with a child deafened by rubella.  These are new experiences for us that harken back to days gone by in the United States.  There are options for our families in North Carolina that are not available to the Vietnamese.

The Global Foundation is working to increase awareness in Vietnam about the importance of newborn hearing screening, inoculations for diseases such as rubella, the need for adequate hearing technology, and the support that is needed to help  children with hearing loss learn to communicate through spoken language.  Since the majority of children with hearing loss live in developing countries, it is my hope that cochlear implant and hearing aid companies will continue to explore ways to make their technology more accessible.  Without such hearing technology, it will be very difficult for these children to achieve their potential for spoken language.

Strangely, I find that reflecting on my time in Vietnam fills me with feelings of gratitude.  My gratitude is to all of the professionals who came before me in the U.S., which makes practicing here in 2013 relatively easy.  Without newborn hearing screenings, inoculations for rubella, access to current hearing technology and research on the normal development of speech, language and audition skills, my practice would be very different.

Now it is my turn to share what others have shared with me.

About Jane Madell

Jane Madell has a consulting practice in pediatric audiology. She is an audiologist, speech-language pathologist, and LSLS auditory verbal therapist, with a BA from Emerson College and an MA and PhD from the University of Wisconsin. Her 45+ years experience ranges from Deaf Nursery programs to positions at the League for the Hard of Hearing (Director), Long Island College Hospital, Downstate Medical Center, Beth Israel Medical Center/New York Eye and Ear Infirmary as director of the Hearing and Learning Center and Cochlear Implant Center. Jane has taught at the University of Tennessee, Columbia University, Downstate Medical School, and Albert Einstein Medical School, published 5 books, and written numerous books chapters and journal articles, and is a well known international lecturer.