Independent reviews into some of the cochlear implant programmes in Australia have highlighted the importance of consistent, coordinated wrap around care for children who receive cochlear implants (CI). The review identified problems with the implant programme stretching back many years, following concerns of parents and independent audiologists that implants had been incorrectly programmed (under-mapped), leading to hearing and developmental delays among children.
Unlike adult CI recipients who typically have previous experience with hearing and have a well-developed base for language and listening, children require a higher level of clinical management from providers who see the whole child’s progress and needs. The Hearing House is committed to providing comprehensive and family centered care for our tamariki and their whānau.
Here are the foundational principles of our philosophies and practices at The Hearing House.
The Hearing House’s philosophy on early intervention reflects the evolution of improved hearing technologies and the need to provide effective services to our cultural and developmentally diverse children over a wide geographical region. Our core values and goals for service provision have been guided by the evidence of Family-Centered Practice (FCP). An International Consensus Statement published in 2013 (Moeller et al) continues to be the foundational document that guides us, but we have further supplemented this document by expanding our practices to include co-treating and the addition of whānau support and counselling services at The Hearing House.
Co-treating involves meeting with families as a team, so information shared doesn’t have to be repeated multiple times by the whānau, and everyone can have a part in sharing information, decision making and care planning. It allows for continuity of care and ensures that the child is the focus of the intervention. Each professional - whether it is the audiologist, the speech therapist, or the counsellor - has a unique role in working with the family to seek their input and participation in goal setting. Through co-treating we can stay connected and aware of the child’s needs and progress. We can support each other in our roles while working collaboratively within our main scopes of practice.
Our Hearing House counsellor uses Te Whare Tapa Wha as a health model in her counselling, which describes health and wellbeing as a wharenui/meeting house with four walls. These walls represent taha wairua/spiritual wellbeing, taha hinengaro/mental and emotional wellbeing, taha tinana/physical wellbeing and taha whānau/family and social wellbeing. Our connection with the whenua/land forms the foundation.
In addition, we supervise a social work trainee on placement in our counselling suite, and are looking to integrate more aspects of social work support into the services we offer our clients.
The following is a summary of the principles of family-centred care relevant to The Hearing House:
Comprehensive services are offered and available regardless of a family’s socio-economic status, income or geographic location.
Families are encouraged and supported in participating in decision making, goal setting and intervention planning. Intervention is tailored to meet the specific needs, circumstances and preferences of the child/adult and family, recognising that each person’s hearing journey and family experience is unique.
Our processes are flexible, individualised, and responsive to changing needs, preferences and the family’s learning styles.
We respond in a sensitive and empathetic manner and assume all families are trustworthy and treat them as such.
Decision making authority rests with the family and we support them to create a vision and plan for their child’s future. We are open and flexible to a range of communication possibilities.
We recognise the key role of parent-to-parent and peer/mentor support and facilitate opportunities for these to occur. We are aware of social emotional support that families need and refer to mental health services and support when needed.
We promote linguistic accessibility respecting the importance of first language development and provide functional learning opportunities, based on routines, interests and enjoyment.
Our technical knowledge and support for families facilitate language and communication abilities (remote microphones, streaming technology and accessories, visual technologies, AAC, educational technology).
We routinely and authentically evaluate an individual child’s development and family satisfaction and modify interventions if needed to promote optimal outcomes.
We use continuous assessment data and validate programme practices through continual evaluation.
Reference
Moeller, M. P., Carr, G., Seaver, L., Stredler-Brown, A., & Holzinger, D. (2013). Best practices in family-centered early intervention for children who are deaf or hard of hearing: An international consensus statement. Journal of Deaf Studies and Deaf Education, 18(4), 429–445).
Principles of therapy offered for children at The Hearing House
With a family or whānau-centered focus on the family, parents are essential to each child’s success, and we partner with them to understand their values and goals for their child’s future.
We recognise that children are unique – we offer a variety of flexible and creative approaches to learn what a child responds to and how to turn that into success.
We focus on meaningful communication. We offer Listening and Spoken Language therapy, listening support for alternative communication modes and welcome New Zealand Sign Language (NZSL) and bilingual/bicultural approaches when needed or requested by whānau.
For babies with early intervention, we offer guidance on nurturing the foundations of emerging language and encourage incidental natural language learning.
For children who have had auditory deprivation, we offer a systematic and intensive training programme for them to reach their full auditory and oral language potential. We partner with Deaf Aotearoa to support children who are developing NZSL alongside or as an alternative to spoken language.
For children who require/use alternative forms of communication, we offer guidance on how listening skill development can complement their main mode of communication.
We use a combination of formal and informal assessments to guide our focus and consider a holistic view of the child’s communication, including auditory milestones, language development and the subtle higher-level skills of inference, problem solving, and social nuances in real world conversations.
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