I have just returned from spending 3 weeks in Vietnam working with the Global Foundation for Children with Hearing Loss (www.childrenwithhearingloss.org). This was my second visit with this group. We went to a teacher training university, a children’s hospital and an early intervention center. Let me start by saying that things are very different in Vietnam. Please go to the Global Foundation website for more information about the program and about how to support the effort.)
We spoke to a group of student teachers and parents of children with hearing loss at Hanoi Teacher Training University. Teachers have been trained there for some time, but there is limited training for special needs. In Hanoi, where the university is, there is a special education teacher training program. The University has an audiology test booth and works hard to train students to understand about working with children with hearing loss. There are no audiologists, so a big part of the training is missing. Everyone was fascinated by what we had to say and wanted to know more. For two full days we talked about how to identify hearing loss, things to consider when fitting hearing aids, deciding when to move to cochlear implants, and how to teach kids to talk. Everyone loved hearing from us and wanted all the information they could get.
Teacher training near Ho Chi Minh City
On this trip we also got to speak to a special education teacher training at a university outside of Ho Chi Minh City (formerly Saigon, and still cslled that by many). These were undergrad students in special education, many of whom have an interest in deaf education. Our group was very impressed with these students. From our previous experience, we expected them to know little about hearing loss, but were very happily surprised. We had two hours to teach them and we decided that we would talk about how to test hearing and how to read audiograms.
We started with testing hearing. They had heard about how to do it but had never seen it done. I used the video from my text book (Madell and Flexer, Pediatric Audiology: Diagnosis, Technology, and Management, Thieme, NY) and showed testing. They were so excited to see the testing and to get a first hand look at how it is done. When we showed them the audiograms we were really impressed that they could accurately read them. They could identify degree and type of hearing loss and knew when masking was needed. These lucky students have been trained in part by Ms. Thuy at the Thuan An Center, who has helped organize the program, and the students are getting to observe and practice in the pre-school at this center. (More about her later.)
In Vietnam, speech-language pathology is part of a combined therapy degree which includes training in occupational therapy, physical therapy and speech-language pathology. Most clinicians work in all areas. A few can specialize in one area. There is no specific training in teaching oral language to children who are deaf and hard of hearing.
Schools for the Deaf
Our experience in schools for the deaf (at least in the south of Vietnam) was varied. In some, the teachers had no training in deafness, and many had no training in education. Most schools taught sign language, which may be a necessity since very few of the children had hearing aids. However, there has not, until recently, been a universal sign language so each school has its own sign language.
On my last visit, I asked the principal of the school for the deaf in Dal Lat how the teachers learned sign language, and he told me they learned it from the kids. If that is the case, it is pretty clear that the language level will be low – and it is. Schools are primarily residential and begin at age 6. In many places there are no services for kids under 6 years of age. Most schools do not have anyone to test hearing and do not have audiometers, so even when we tried to teach people how to test there was no way for them to follow up. Most kids do not have hearing aids and if they do, there is no one to check that they work. While everyone wants to have kids learn to listen and speak, they do not have the resources. That’s terrifying for those of us who have worked in an auditory verbal environment for all of our careers.
Schools train kids to do a variety of manual tasks. They learn sewing and use sewing machines, they learn some carpentry skills, and in one school they were learning art, which would be sold to tourists and locals. It seemed that each school had its own vocational services. Not all schools taught the same skills.
Early intervention starts at age 3 years. However, in many places in Vietnam there are no services for children under the age of 6. There are a few early-intervention centers where services begin at age 3 years. In some places, therapists or teachers work with children at earlier ages. The Thuan An Center is one such a place where children identified before age three can get services, and teachers trained at the local university with practicum at this center are providing therapy and parent counseling in different cities and towns in south Vietnam.
The Thuan An Center has three classrooms for pre-schoolers. The auditory-verbal educators working with the Global Foundation for Children with Hearing loss have been working with these teachers for several years and the results are clear. Teachers understand about auditory work and they work on listening activities. They are very short of equipment, only two classrooms had FMs until recently when they received a gift of a third system. Not all the kids have FM receivers.
The Early Intervention supervisor, Sr. Sang, is terrific. I showed her how to check FMs, and she now spends the first hour of every day checking the system in all the classrooms. On an earlier trip I visited another Early Intervention program in Ho Chi Minh City which was doing a great job of teaching spoken language to the kids. However, both programs really needed audiology help. As we all know, kids cannot learn to listen and talk well when they do not hear well. So, fixing the audiology problems in Vietnam is urgent.
What is the future?
The enthusiasm for improving services in Vietnam is awe inspiring. University programs are expanding training to work with deaf children. Schools and hospitals are recognizing the necessity for technology. There is still an enormous need for technology. Everyone there is working on building services and things are moving onto an upward path.
Anyone interested in learning more and possibly helping please visit www.childrenwithhearingloss.org.