Ellen Rhodes and Jill Duncan have written an excellent new book:  AUDITORY-VERBAL PRACTICE: Family-Centered Early Intervention, 2nd Edition; published by Thomas, 2017. It will be appreciated by all clinicians in auditory-verbal practice, and others working with families. Even clinicians with many years of practice will find useful information in this book. The book is different than other books that deal with auditory-verbal practice in that it does not deal with specific therapy activities to build skills but presents in detail the issues we need to review to have a true family centered practice.

 

Diverse cultures

There is a good chapter on the available research about AV practice and suggestions for what needs to be done to improve data collection in this field as well as a good discussion reviewing published data on results of AV practice. The chapter on servicing families from diverse cultures is wonderful. We are all good at serving families like ourselves but serving those with different culture, language or values is more difficult. Families from different cultures bring different perspectives on parenting and disability. As clinicians, we need to understand and accept parenting differences and work with them. If we cannot do that, we are not providing families with the support they need to help their child succeed.

 

Family focused vs family-centered

I believe the most valuable parts of the book are those related to really developing a family centered practice. Auditory-verbal practitioners are family focused, but we are not all family centered, at least not all the time. While I thought I understood the difference, I certainly understand it better now that I have read the book. There is good discussion about developing a positive framework for families. There is a good discussion about giving families hope. As a clinician, I think giving families hope may be the most important thing we do. By giving hope we enable them to move forward. Once families develop hope there are no limits. Rhodes talks about how the family center practitioner is not directly responsible for a child’s progress. This is an important thing for us all to understand and remember. We can help families build the skills but, unless we take the child for our own, (not an option), we are not directly responsible. There is a good discussion about the different family based models, how they differ, and how we need to use that information in our own practice.

 

Facilitating parent decision making

There is a good discussion about facilitating parent decision making and our role as clinicians in this process. For example, when families are deciding whether or not to have their child receive a cochlear implant, what is our role? Certainly to provide information and to be sure that families understand their choices and the consequences of selecting to implant or not, but it is not our decision to make. Any clinician who has been in this field for a number of years has had the experience of having families make decisions that we did not agree with. It is not easy to sit silently when a family chooses against an implant when our experience tells us that an implant would be appropriate. But, as we all know, it is not our decision.

 

Family relationships

There is good discussion about family relations: mother-father, parent-grandparents, siblings etc. and a very good discussion about parent-child interaction and how we, as clinicians, can provide assistance. The third section of the book discusses the family centered early intervention AV practice. There is a good discussion about home therapy, and a very good discussion about evaluating families characteristics and looking at their needs, and another about supporting and engaging families. The book ends with a chapter from Mary McGinnis with specific clinical examples about becoming more family centered which I think will be valuable for students and new clinicians, and even for some of us older clinicians

 

I strongly recommend this book. It is long and will require some thinking when reading it, but it will improve our practice.

 

 

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