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| Another photo slideshow by Smilebox |
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Merry Christmas From Our Family
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TIPS FOR COMMUNICATING WITH PEOPLE WITH HEARING LOSS
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| Source While conversation comes easily to most people, for those with hearing loss it can be a frustrating, confusing and ultimately alienating experience. |
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| Source For the person with hearing loss even those that wears hearing aids or cochlear implants, it is important that other participants in the conversation employ helpful communication strategies like the ones listed below. This will ensure that the person with hearing loss can understand and contribute to the conversation. TIPS FOR COMMUNICATING WITH PEOPLE WITH HEARING LOSS • Position yourself to accommodate the person with hearing loss. Face them directly, in good light and on the same level. If they hear better in one ear, position yourself on that side. • Do not attempt to talk to the person from another room. Those who are hard of hearing often need to see the talker to better understand what is being said. • Speak clearly, slowly and naturally. Make sure to enunciate your words! • Keep your hands and other obstructions away from your face. Hands, chewing gum and food can all make it harder to understand what you are saying. • Be aware of background noise levels that might lead to difficulty for the listener with hearing loss. If possible, conduct the conversation in a quiet space. • Pay attention to the listener’s facial expressions. Do they look lost or puzzled? • In a group conversation, take turns speaking. Talking over others might confuse the listener. • Get the listener’s attention before addressing them. This can be done with a wave or a polite tap on the arm. • Do not simply repeat yourself over and over again if the listener does not understand something. Try phrasing the sentence differently, or write it down if necessary. • Lastly, do not shout or over-exaggerate facial expressions and mouth movements. This can appear aggressive and rude, and will only lead to confusion. |
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Winter Pinterest Board for Auditory Verbal Therapy
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JANUARY : Listening and Spoken Language Calendar
“Children learn language best through enjoyable, natural, meaningful one-to-one interactions with people who are special to them – their parents!”
Judith Simser, O.Ont., B.Ed., Dip Ed. Deaf, LSLS Cert. AVT
Here is a month's worth of language suggestions that you can incorporate into
LISTENING and spoken language activities with your child.
Click HERE to download your own printable copy.
Today, due to advances in hearing aids and cochlear implant technology, early diagnosis, and support from Auditory Verbal therapists, children who are deaf or hard of hearing can develop listening and spoken language.
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TJ’s Story: Hearing Challenges & Self-Advocacy
TJ's tells his story of struggling to hear, communicate, and fit in socially.
TJ's Story is a tool to promote self advocacy for kids
and to better educate parents, peers and teachers.
TJ’s Story booklet with examples of IEP goals written to Common Core Standards can be purchased at:
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The Ear Book: An interactive guide to the various parts of the ear.
This interactive guide leads you through the process of hearing
from the outer ear to the cochlea and inner ear bones,
and finally to the auditory nerve that sends impulses to the brain for interpretation.
Just click on each stage to reveal the process and respective conditions in deeper detail.
at the ADVANCE Healthcare Network for Speech-Language and Audiology.
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Disney's Access Program
Click HERE for a bloggers post regarding the new Disney's Access Program.
If you are planning a visit can call Guest Information:
(714) 781-4636 for Disneyland and (407) 824-4321 for Disney World.
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Role Model in the Spotlight - Seahawks Fullback Derrick Coleman
This week I shared this video with some of the children and their parents in my practice. They related to Derrick Coleman's story because of the positive modeling and years of high expectations in our Auditory Verbal Therapy.
https://www.youtube.com/watch?v=u2HD57z4F8E#t=11
What's your vision for your child?
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| The Power of Positive Thinking by Norman Vincent Peale |
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Games that Target Auditory Processing or Related Skills
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Today, Children Can Share Their Own Stories
SEEMS LIKE YESTERDAY THIS WAS MY MANTRA.
DREAMS DO COME TRUE.
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UNDERSTANDING INSURANCE PLANS
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| Source |
This article is adapted from © Jennifer Getch, MA CCC-SLP
www.nwspeechtherapy.com/blog
First, talk to your Audiologist or Auditory-Verbal Therapist to determine which specific codes will be used for billing. You will need to know both the:
• The CPT procedure code(s)
• ICD-9 diagnosis code(s)
When calling your insurance company to check on benefits for Auditory Rehabilitation, Auditory Verbal Therapy or Auditory Processing Therapy utilize the "cheat sheet" below.
Insurance Terminology
It can be daunting when dealing with insurance companies regarding the health coverage of auditory rehabilitation or auditory-verbal therapy sessions for you or your child. Below are some insurance terms you may come across when dealing with insurance.
Co-pay: People are most familiar with a co-pay. This is the specific amount of money that you pay for certain services. It may be $15 co-pay for a doctors visit, a $25 co-pay for a prescription but either way you know exactly how much you will need to pay and it DOES NOT change based on the cost of the service. You will pay your $15 co-pay whether the doctor charges $300 or $3000 for that service.
Co-insurance: This is the amount you will pay for each service and it is based on a ratio that is set by your plan. If your visit costs $100 and your plans co-insurance ratio is 80/20 then your insurance company will pay $80 and you will pay $20. If the same visit was $1000 then your insurance will pay $800 where you would pay $200. Therefore it DOES NOT stay the same as it is based on what the services cost. (NOTE: It is extremely rare for a health plan to have both a co-pay and a co-insurance that would be due for a particular service, it is usually one or the other.)
Deductible: This is the specified amount of money that you will pay out of pocket BEFORE insurance begins to cover any portion of the charges. It is important to specifically ask if a patients deductible has to be met prior to insurance kicking in as there are many plans that have a deductible, however, the patient does not have to meet the deductible for speech therapy services prior to insurance kicking in.
Maximum out-of-pocket: This is the maximum you will have to pay in a year. It is an accumulation of your deductible, co-pays and co- insurance. After the maximum out-of-pocket has been met then insurance will pay 100% for the remainder of charges.
Prior authorization: Prior authorization is pre-approval from your health insurance plan that the specified service WILL be covered. If your health plan requires prior authorization for a service then it is required for you to obtain this approval BEFORE you have the service done. Otherwise Insurance can deny it even though they may have otherwise covered it. Most health plans have forms on their websites to download, fill out and fax in to get this approval. You will need to send the evaluation report, if available.
CPT code: This is a 5 digit numerical code that is used to describe medical procedures. Common ones for Auditory Rehabilitation are:
CPT code 92626, Evaluation of Auditory Rehabilitation Status, first hour
CPT code 92630, auditory rehabilitation, prelingual hearing lossCPT code 92633, auditory rehabilitation, postlingual hearing loss
ICD-9 code: This is a coding system used to describe signs, symptoms, conditions, injuries or diseases. (NOTE: ICD-10 will begin in October 2013).
Exclusions: These are specific conditions (ICD-9 codes) not covered by an insurance plan.
Appeal: This is the course of action you can take when coverage of a service has been denied and you would like the insurance company to re-assess in the hopes that they may change their decision and cover the service previously denied.
Appeal: This is the course of action you can take when coverage of a service has been denied and you would like the insurance company to re-assess in the hopes that they may change their decision and cover the service previously denied.
Allowed amount: This is the amount that an insurance company bases their payment on. It is not necessarily the amount that the provider billed. For instance, the provider may bill $130 for a service however; the insurance company only allows $100 for that service so the co-insurance amount is based on that allowed amount and not the billed amount from the provider.
In-Network: Most insurance plans have different coverage based on whether the provider is "in-network or out-of-network". Co-pays, Co-insurance and deductibles are often lower for in-network providers. To be considered in-network, the provider has to have a contract signed with the insurance company. The downside to this, for a provider, is that this contract often limits the amounts that the provider can charge the insurance company for a particular service and the insurance company does not allow a provider to bill the patient for the amount over what insurance allows.
Out-of-network: Patients will often pay more for co-pays, co-insurance and deductibles when utilizing an out-of-network provider. They will also often incur the additional cost above what the insurances allowed amount is. Let’s say that your insurance allows a
provider to bill $250 for a particular service but that provider normally charges $300 for this service. If your co-pay is $25.00 then you will pay $25.00 in addition to the $50 not allowed by insurance. Especially with the big changes happening with health insurance, many providers choose to be out-of-network providers so that they do not have to take such a big deduction in their reimbursement rates.
Medical Necessity: Many insurance plans will only pay for services that they feel are "medically necessary", this often means that they will require reports from therapists, physicians, etc. and will utilize their own professionals to conduct an evaluation of these reports in determining if there is a medical necessity for the patient to receive the services in question.
Explanation of Benefits (EOB): This is a summary of the billed service where you are able to see what portion was applied to deductible/co-pay/co-insurance, etc. It will also tell you when services are denied and why.
Check Reimbursement Resource Guides such as:
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| http://apps.advancedbionics.com/cismart/CPTSummary.aspx |
FOR MORE INFORMATION
Insurance Guide for Parents:
http://www.listeningandspokenlanguage.org/Document.aspx?id=228
Reimbursement and coding:
http://www.audrehab.org/6%20Reimbursement%20Panel%20_Abel%20&%20White.pdf
http://www.audiologyonline.com/articles/audiology-cpt-code-changes-for-1001
http://www.asha.org/practice/reimbursement/coding/ar_reimbursement/
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Ling's Voice
After about two years of her son’s d/hh of hearing journey began,
including Auditory Verbal Therapy, Bethany Horn has published,
Ling’s Voicea tool for families and AVTs to provide the children
with opportunity for sound or word imitation, to test speech detection and
encourage spontaneous vocalization with use of auditory memory.
Bethany says, “It’s to assist the kids working so hard to listen and use spoken language!”
You can order your copy at:
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"I ATE MY OWNER'S HEARING AID." barked Fluffy.
You want to know why your dog perks up
long before you hear someone walking up to the door?
Dogs hear up to 50,000 to 65,000 cycles per second – humans, just 20,000.
Dogs have 18 or more muscles in their ears allowing them to be mobile.
Dogs hear about 4 times the distance of a humans.
Dogs hear ultrasonic frequencies like
dog whistles
a squeaking mouse or
whistling hearing aids!
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| Source |
So, remember to open the battery door whenever your hearing aids are not in use,
so your dog isn't attracted to the high frequency feedback.
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| Source |
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FEBRUARY: Listening and Spoken Language Calendar
“Children learn language best through enjoyable, natural, meaningful one-to-one interactions with people who are special to them – their parents!”
Judith Simser, O.Ont., B.Ed., Dip Ed. Deaf, LSLS Cert. AVT
Here is a month's worth of language suggestions that you can incorporate into
AUDITORY VERBAL THERAPY activities with your child.
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Get on the Brain Train (Repost from Cochlearimplantonline.com)
"Whenever people ask me what I do, I tell them that I help families of children with hearing loss teach their children to listen and speak without the use of sign language."
Get on the Brain Train
Repost from http://cochlearimplantonline.com/site/get-on-the-brain-train/
January 5th, 2014
"Whenever people ask me what I do, I tell them that I help families of children with hearing loss teach their children to listen and speak without the use of sign language. Inevitably, the next question I hear is, “HOW?!?” Those poor people. Little do they know that they’ve opened up the door for me to talk them to death about my one of my favorite subjects: The Auditory Brain.
Most people think that hearing loss is an ear problem. Makes sense, right? But that answer fails to look into the complicated, incredible processes that help us communicate. It’s important for the general public to understand, but it’s even more important for the families of children with hearing loss and those who work with them.
Ears are incredible. Even those weird-looking folds on the outside of your ear (the pinna) are specially formed to capture sound and send it down your ear canal. The bones in your middle ear — the tiniest bones in your body — work together to send the sound through the system. The snail-shaped cochlea is filled with many, many tiny hair cells that move when sound waves pass through the fluid that surrounds them, stimulating the auditory nerve and sending impulses to the brain. All of those steps are important, but here’s the thing: if we could get those electrical impulses to the brain without needing any of those intermediary structures, a person could still experience sound. That’s what happens with the electrical signals of a cochlear implant (or an auditory brain stem implant). Those electrical signals travel up the auditory nerve to the auditory centers of the brain.
That’s when the real magic starts to happen. You see, no matter how good your hearing aids or how well programmed your cochlear implants, those sound waves or electrical impulses are meaningless until they are processed by the auditory cortex in the brain and become linked to sounds, words, or music. The brain has fantastic capacity to grow and change, and it is one of the crucial components to success with a cochlear implant. The brain has what we call experience dependent plasticity — a fancy way of saying “what happens to you shapes your brain.” For a child whose parents have chosen a listening and spoken language outcome, the more words that go in, the more listening experiences that child has, the more that center of their brain will grow. Conversely, if a person has gone through a long period of auditory deprivation (relying primarily on visual communication and/or not using hearing technology), that part of the brain gets pirated away to be used for different purposes (use it or lose it).
The brain is also all about connection. All of the cells in your brain (called neurons) connect to one another to form complex webs. These connections are called synapses. When a child hears the sound of a word and then puts it together with its meaning, a synapse is formed. Over time, those connections build stronger and stronger webs that enable us, for example, to hear the word “dog” and know not only what that means but also to connect it to a web of other information we know and have experienced (names of our family pets, different types of dogs, the sound a dog makes, stories we’ve read about dogs, etc.). If a child’s access to input is limited, either because they are not in a listening, talking environment, do not have appropriate hearing technology, or are not wearing their technology all waking hours, these synapses can be weaker, disorganized or even disconnected. The richer, fuller input a child receives going IN, the better speech, language, comprehension, and cognition they are going to have coming OUT. Remember: the quality of the INPUT determines the quality of the OUTPUT.
The importance of the brain is why many leaders in the field have called hearing loss a “neurodevelopmental emergency.” If children with hearing loss do not receive access to sound and appropriate intervention as soon as possible, the auditory centers of their brain may never regain the infinite potential they have at birth to become fully functioning members of a world full of speech and sound. It is also one reason why we see varied results among cochlear implant users. If we — people with hearing loss, parents, professionals, and the public at large — could stop thinking “ears” when we think about hearing loss and start thinking BRAIN, we would be one step closer to achieving optimal outcomes!
For more information on this topic, I recommend anything written by Dr. Carol Flexer, the queen of the auditory brain! You can visit her website or listen to this wonderful free recorded webinar."
Dr. Carol Flexer was Lynn's (HearSayLW) professor, her AV Mentor and a dear friend.
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Humor, Listening and Language
Telling jokes is a fun way for children to listen carefully, learn higher level language such as multiple meanings, puns and improve their social skills.
For some kids it is very natural to tell jokes, but for others it is the delivery that they may have to practice. Using their clear speech and appropriate pausing is essential. Listening and playing off their partner makes a joke work or flop.
Practice makes perfect and here are Valentine Day jokes that you child can practice telling to your friends and family.
Giggle, laugh and have fun!
Telling jokes is good for kids!
It increases their confidence, helps them to remember a story in order,
and stimulate their thinking!
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The Cochlear Implant Is 10% Hardware And 90% Software
A cochlear implant is a small, electronic device that can help provide a sense of sound to a person who is profoundly deaf or severely hard of hearing. The implant is surgically placed under the skin behind the ear. A cochlear implant does not restore or create normal hearing. Instead, it can give a deaf person a useful auditory understanding of the environment and help him or her to understand speech. Since 1990, thousands of children and adults have received cochlear implants. Cochlear implants were designed for persons with severe to profound hearing losses that obtain little benefit from hearing aids.
Cochlear implants are the only medical technology able to functionally restore one of the five senses. Unlike hearing aids, which amplify sound, cochlear implants are electronic devices that bypass the damaged part of your inner ear so that you can hear your best.
Here is a clear video that briefly demonstrates hearing, hearing loss and how a CI functions.
“It’s been said that the cochlear implant is 10% hardware and 90% software. And the software is what you do with the device and involves the family and the Auditory Verbal program that emphasizes listening and speaking skills. Cochlear implants are tools, not miracles. But the results can be miraculous with the right software in place.
The journey starts with knowledge steps whether you are an adult with hearing loss or helping your child be successful with learning to listen and use spoken language.
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Time or Money? A Christmas and Year Long Reminder
I saw this posted this morning @Time-Warp Wife and it made me think of Auditory Verbal families.
I would say…
If you want your child to learn through listening and speaking, spend twice as much time with them and half as much money.
Some of the most successful children I've had experience with in Auditory Verbal Therapy often aren't the ones who have the most toys, the latest video games, the most clothes or are in every activity, sport, running here and there rather the ones who loved ones spend time with in extended conversations, listening to stories and just doing life.
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I would say…
If you want your child to learn through listening and speaking, spend twice as much time with them and half as much money.
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| Source: @Time-Warp Wife |
Some of the most successful children I've had experience with in Auditory Verbal Therapy often aren't the ones who have the most toys, the latest video games, the most clothes or are in every activity, sport, running here and there rather the ones who loved ones spend time with in extended conversations, listening to stories and just doing life.
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KJ - Champion Listener and Gymnist
Sports and Making Wise Auditory Choices For Our Kids
KJ started Auditory Verbal Therapy at 12 weeks. He is now a first grader with bilateral cochlear implants and age appropriate language, clear speech, and confidence - thanks to his parents! Yesterday, he took 1st place in all 6 events – which is typical for this little athlete.
KJ started Auditory Verbal Therapy at 12 weeks. He is now a first grader with bilateral cochlear implants and age appropriate language, clear speech, and confidence - thanks to his parents! Yesterday, he took 1st place in all 6 events – which is typical for this little athlete.
Of course, the sky is the limit today for kids that are d/hh but KJ’s parents wisely guided him to a sport that he enjoys, while able to wear his FM, has 1:1 coach training and also being part of a team.
Over the years, I’ve been sad to watch some of my little listeners on a basketball court – only using their EYES because they can’t understand speech due to the gym acoustics, squeaking shoes, shouting fans… As parents you can encourage you child to try different activates but can also guide them towards better hearing opportunities. Tennis anyone? Of course, one of my AV grads is playing soccer in college now and look at Derrick Coleman – but life is hard enough.
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| Life is hard enough! |
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Listening and Spoken Language in Vietnam
I accepted an invitation to join the Global Foundation For Children with Hearing Loss in Vietnam this summer. It will be a privilege to be part of this network of audiologists, speech pathologists and auditory-verbal therapists that share my compassion and enthusiasm for empowering professionals and families with the expertise and tools they need to help their children with hearing loss achieve their full potential in our hearing world.
The Foundation aims to make a direct and lasting impact on the future of thousands of children that are deaf and hard of hearing around the world by providing them with access to the technology, education, and resources they need to become contributing members
of society.
Take a few minutes to view these two videos below.
This first video showcases the Global Foundation For Children With Hearing Loss,
the vision, and the multi-faceted program that is changing lives for children
who are deaf or hard of hearing in Vietnam.
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| http://animoto.com/play/ORBSY4JqUk3SCh7rJY9khw |
The second video features the teacher training program.
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| http://www.childrenwithhearingloss.org/projects-video2.shtml |
The Summer Training component features curricula covering topics in audiology, speech-pathology, early intervention, and auditory-verbal practice. Teachers, medical teams, therapists, audiology technicians, and families from the participating schools, clinics, and hospitals travel to Thuan An Center each summer to board and to attend the training. Those who pass the final test at the conclusion of each summer workshop progress to the next level the following year and build on their knowledge over time.
The curricula include lectures and practicum for Vietnamese professionals and evening sessions for families - all designed to help children with hearing loss develop their listening and spoken language skills. We also fit hearing aids on children from low-income families as part of our audiology training course.
The Global Foundation and Thuan An Center held the first training event in Summer, 2010. Subsequent programs were held in 2011, 2012, and 2013 with the next one scheduled for Summer, 2014.
If you want to find out more go to:
Thanks in advance for your interest in this opportunity for us to make a difference in the lives of so many children in Vietnam. I would appreciate your prayers in this adventure.
Many thanks,
Lynn
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