what does a TOD do exactly?

June 15, 2006

OK, here is the latest in our saga. Elias saw the audiologist on Tuesday,

and she gave me a letter

to send to the school district. To recap, Elias is in preschool, and has an

IEP through our school

district. He gets PT, OT, a " special education itinerant teacher " and speech

therapy. He has a

bilateral moderate-to-severe loss in the middle and high frequencies.

At the last IEP meeting, the district refused to put his FM system on the

IEP, saying that

we could just work it out with the teacher. I think they did this because he

is in preschool and

they figure that kids don't really learn things in preschool.

The audiologist was not happy about this, so her letter is a long

explanation of why he needs

the FM system now. She also requests that his school have " consultation

services with

a Teacher of the Hearing Impaired " . I think this is so that his preschool

teacher can learn

how to appropriately work with him and his FM system.

I asked the speech therapist about this yesterday. Generally, I have a good

relationship

with her. But she seemed really offended by this request, and said that she

didn't think

we needed services of a TOD until kindergarten. She said it would just be

frustrating

for the TOD, because preschools aren't equipped to work with hearing

impaired kids.

She also said that there is nothing that a TOD could teach us to do that we

wouldn't

already know. I asked her about preliteracy skills, and she said that the

things we

do already (we read to our kids constantly) are enough. She mentioned some

strategies,

such as pointing out rhymes, and having Elias identify words by sight, that

we

could start working on. But we already do all those things!

The preschool teacher, meanwhile, is enthused about this idea. But she has

two

teachers under her who tend to not be as on board as she is.

So what does a TOD do exactly, besides advise the preschool teacher about

sound-dampening

strategies, and visual cues? Is such a teacher appropriate for a preschooler

or should we wait until next year with kindergarten? How do I know if my kid

needs these services?

--

Bonnie

June 15, 2006

Teachers of the deaf do a lot of things. They work with kids from

birth through high school. But someone who knows about hearing loss,

knows what needs to be done to build the brain (auditory, language

and speech) needs to be involved at the very least in a consulting

capacity. I'm assuming your son is oral. So correct me if this is

wrong. Has the speech teacher ever been in charge of teaching

audition, language and speech to a child with a hearing loss

before?? If not, she could use the help whether she realizes it or

not. In an ideal world, he would be in a preschool that specialized

in his communication mode and the teacher would be a TOD. So he's not

in the ideal world, he has a special ed itinerant who may be useless

as far as the hearing loss is concerned. And a teacher who is not

used to hearing impaired kids. We used an audiologist rather than a

TOD to help our teachers understand the effect of the hearing loss -

and this was after we got Maggie to age appropriate auditory skills,

language and speech. So it is definitely a GREAT thing to have a TOD

come in and work with the teachers. Our AVT happened to have the

background of being a TOD so we had a TOD for our late " early

intervention) at age 4 and 5 prior to real kindergarten. She is in

the business of teaching deaf and hard of heairng kids how to listen,

understand language and talk and get them ready for school, most of

her clients are in the infant and preschool age.

I will say that any old TOD will not necessarily help. If they

aren't familiar with kids who are oral, or sign depending on which

you are using they aren't much help. If they only work with an older

age group, they might not be much help. If they aren't of the era

where they have high expectations, they might not be much help. So

try to figure out a way to make the SLP less defensive. An SLP can

do all those things mentioned about the TOD but only IF they have had

special training beyond their masters (or a masters with an emphasis

on oral language devel.!) and have experience with the early

intervention of numerous kids with hearing loss, not just Elias. Hope

this helps.

June 16, 2006

> >

> What is the relationship of AVT to a TOD? The acronyms are making my

> head spin! How do I find these people? How do I know what Elias

> really needs? Could I just find someone privately and try to get my

> insurance to cover it, or just pay for the services? I worry that

if I go

> through the school district, we will just end up with whoever they

pick,

> which might not be the right thing.

>

> Hi Bonnie, Sorry about all the acronyms! An auditory verbal

therapist is trained to teach a child to use their residual hearing

to learn language and speech and to function in the mainstream. They

don't use sign or lip reading, only listening. They actually train

the child's brain - to create and fortify the auditory pathways that

don't get built automatically when a child has a hearing loss.

Auditory verbal is one of the 5 modes of communication that people

use with kids with hearing loss. There's a lot more to it, but a

great entre to understanding AV is Dr. Carol Flexer's book

Facilitating Hearing and Listening in Young Children. You can get it

at the library through interlibrary loan.

In order to become an AVT you must first be an audiologist, SLP

(speech language pathologist) or a Teacher of the Deaf. Then you have

further training in the auditory verbal methodology. We decided we

wanted AVT for Maggie and as it worked out, our school system paid

for it. But that was after a nasty and protracted due process battle

which I wouldn't recommend to anyone! You can just find an AVT and

work with them privately and often your insurance will pay. The

school system was going to give us 1 1/2 hours per week total with

someone who didn't believe kids with hearing aids could function

without sign language. So I know what you mean. It is great to see

what the school will offer because sometimes you get exactly what

your child needs, but often they don't have much idea what needs to

happen.

June 16, 2006