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Noel, Auditory Verbal Therapist

Photo: An auditory verbal therapist supports parents in developing the skills and knowledge to develop their child’s listening, talking, thinking and social skills.

Our regular lifestyle may be on hold for the time being, but we all know how important it is to continue developing language and communication skills for deaf children. We are all adapting to considerable changes in our work and home lives and providing services and support in different ways.   

I work for a national charity and support families of deaf babies and preschool children across the UK in one-to-one appointments. We began working from home four weeks ago, but wanted to ensure our family programme could continue without interruption and could be adapted to respond to circumstances which were changing on a daily basis.  We began to deliver our services through a range of online platforms.

Fortunately, I have had previous experience of telepractice (using technology to deliver therapy over the phone or video chat, rather than in person). Working with families in the North of England, Scotland and Northern Ireland has meant that I was delivering sessions from my London base via online platforms such as Skype or Zoom for a few years before the COVID-19 reality kicked in.

I want to share with you some tips for making the most of language development through online therapy, whether you’re a family considering online sessions or a practitioner who is considering starting sessions.

How does therapy via telepractice work?

Telepractice in the world of healthcare has been around for quite some time. Ten years ago, studies had already been published on the benefits of using telepractice to provide therapy for children.¹ The evolution of video conferencing technology, and its availability to most of the UK population, means that virtual therapy sessions have become much easier.

As an auditory verbal therapist, my main aim is to coach parents and carers in using different strategies to support their deaf child’s listening and spoken language, rather than coaching the child themselves. This makes using telepractice much more straightforward. This is true of any communication coaching where the parent is the main service user, be it Auditory Verbal, oral, British Sign Language (BSL) or Total Communication.

Doing three or four appointments online a week is very different to doing all of your appointments via your laptop, so it can be hard to adjust. Likewise for parents, I completely appreciate some of you may have more than one child at home who needs attention, or you may be aiming for less screen time rather than adding more!

For parents

Here are some of the concerns that families have had before trying telepractice:

My child won’t be able to focus for long enough.

The magic of telepractice is that the child is at home, so they can wander off and come back. This is absolutely fine. Remember, the main person getting support is the parent or carer, and the practitioner is there to coach the parents in using these strategies. If the child does wander off, you can work on using a good auditory hook to get your child to come back. Any situation can be good for language-learning!

I don't have the same pictures and toys that the practitioner has

Teachers of the Deaf and speech therapists are renowned for having great toys and pictures. However, language development does not depend on toys and pictures, but on social interaction between a parent or carer and the child. The aim of therapy is to support the family in using strategies in their daily routines at home. Having a session online from the comfort of your own home is a good way to apply strategies there and then. Instead of using pictures, why not ask your practitioner for a session based around something that you do with your child on a daily basis? It could be preparing toast or playing with your child’s own toys. Sessions can work using lots of things that you have at home.

My child won't be able to hear over the computer

The sound coming from a computer or a tablet may not be good quality, which is why we need to make sure that any other background noise is kept to a minimum. If your child has a radio aid, there are ways of connecting it to your computer for improved sound signal.

Speak to your Teacher of the Deaf or audiologist about setting this up or get in touch with us for more information. As the practitioner will be guiding you in the strategies to use, the most important thing is that the child can hear your voice clearly. If the practitioner does speak directly to the child, you can repeat what was said if you notice that your child hasn't understood.

For practitioners

Here are some tips for practitioners who are about to start online sessions:

Make sure you both have good internet connection

For effective coaching, the practitioner must be able to provide in-the-moment feedback. You may also be working with very young children who won’t wait around while the connection buffers! Choose a place in your house that can provide a strong internet signal so that the conversation can run smoothly. Check the technology works for your families by doing a test run.

Plan the session with parents or carers in advance

This way, parents or carers know what the focus will be and can choose the most suitable location for the session to take place. You might need to exchange a couple of emails before the session to set goals together. It might also be useful to have a phone call or even dedicate the first 5-10 minutes of the telepractice session to planning the rest of the session. This all depends on what will work best for each individual parent or carer.

If you're planning to play a particular game or activity, have a chat about what resources they'll need, you can make use of what the family already has in their home. The key here is to make sure that the resources are kept out of reach of the child to start with as otherwise the child will already have had an opportunity to play with those object or toys and, by the time the session starts, they may already be over the novelty of the game.

Find the best place to hold the session

You'll need to find a room with minimal distractions. Find somewhere quiet and with a plain background so that messages can be delivered clearly. For the families joining the session, talk about what will work best for them. Discuss with them how to create the best possible listening environment for their child, for example, by closing windows or switching off appliances. Soft furnishings like tablecloths can help reduce noise from reverberation.

I hope that we can continue to support deaf children throughout this period, so that listening, language and communication do not take a backseat. If anyone has any questions about the content of this blog I will be happy to respond via email, or even as a virtual chat!

Stay safe, stay at home and keep talking!

[email protected]

¹Romanow, K. et. al., 2010