Inclusion of children with Hearing Loss into the classroom Sheeba Khan 821745502 Lisa McCaie Centennial College – Progress
Lily Lily is a 4-year old child with severe hearing impairment who has just joined my preschool room. Till this point in her life, she has always been cared for by her maternal grandparents, so this is her first time in a child care setting. Lily’s parents are new to Toronto and ask about the services in the area. They speak some English but primarily Cantonese. Lily has 2 siblings –> a 6-year old brother and a 6-month old sister.
Lily’s needs and the needs of herfamily: Lily has a severe hearing Lily’s parents primarily speak impairment. Cantonese, and very little Lily has previously only been English. looked after by her Lily’s family has just recently grandparents, so she will need to moved to Toronto. adjust to the child care Lily has 2 other siblings so her environment. parents have their hands full. Lily may experience some The family may have to teach trouble communicating with Lily sign language, and may other children in her class. need to learn it themselves too. The family may fear that their other children may or may not have hearing loss also, and may or may not have been diagnosed yet.
Hearing Impairment Hearing Impairment is a broad term that includes both deaf and hard of hearing. The term “deaf” is used to describe a person who has an intense hearing loss which cannot benefit from any intensification of sounds. “Hard of hearing” is the term used for people who may experience mild to severe hearing loss; these are people who may benefit from amplification. The International Symbol of Access for Hearing Impairment.
Main Types of Hearing Loss1. Conductive Hearing Loss: caused by diseases or obstructions in the outer or middle ear that usually affect all frequencies of hearing. A hearing aid generally helps a person with a conductive hearing loss.2. Sensorineural Hearing Loss: results from damage to the inner ear. This loss can range from mild to profound and often affects certain frequencies more than others. Sounds are often distorted, even with a hearing aid.
Statistics According to the Hearing Foundation of Canada website, “A study in the Journal of the American Medical Association reported that nearly 15% of school-aged children had hearing deficits at low and high frequencies (Niskar et al, 2004)”. The VOICE for Hearing Impaired Children website also states that many children continue suffering hearing loss through their school years. “More than 2,000 children are born with a hearing loss in Canada every year, making it one of our country’s most common birth defects for which screening is available. Approximately six in every thousand babies born in Canada have some degree of hearing loss, including profound deafness” (The Hearing Foundation of Canada).
CausesSome known causes of Hearing Impairment are: A family history of hearing loss. Frequent and/or recurring ear infections as an infant or toddler. Some antibiotics and chemotherapy treatments that may have hearing loss as one of the side effects. Meningitis, Measles and CMV (Cytomegalovirus) Infection. Some syndromes and disabilities have also been associated with causing hearing loss, such as Down Syndrome, Pervasive Develeopment Disorder, Autism, Alport Syndrome and Crouzon syndrome.
Other Risk FactorsChildren may also be tested for a hearing impairment if they experienced any of the following: If the child was born premature and/or weighed less than 2 lbs at birth. Required ventilation assistance for more than 10 days right after birth. Scored very low on the Apgar Test at birth. Experienced severe jaundice after birth. If the mother had experienced certain illnesses like German Measles(Rubella) during pregnancy
Not all children with Hearing Loss look and act the same;some children may look and behave just as any othernormal child. One of the most common myths about Hearing Impairment is that individuals who are hearing impaired are easily identifiable, either by their use of sign language, clearly visible hearing aids or by their inability to hear speech and sounds. However, not all children and adults experiencing severe hearing loss look the same. Especially with early intervention and the right adaptations, they may be just like any other person out there. The following video demonstrates just how normal children with even a severe hearing loss may look and act like: Is This Child Really Deaf?
Infant Screening in Hospitals Infant Screening – The Hearing Association of Canada has been working since 2002 to provide free hearing screening for babies born in all the Canadian provinces. “Without screening, the average age of identification of hearing loss has historically been between 2 ½ to 3 years of age, making it difficult for many children to catch up with communication and social skills” (The Hearing Association of Canada). Early detection is the most beneficial, so this program allows for immediate identification of hearing loss soon after delivery of the baby, the test is fairly simple and non-invasive.
Signs & Symptoms of a HearingImpairment in Children The child may experience frequent ear infections. The child may be delayed in their language development. The child may find it difficult to identify or locate certain sounds. The child may watch TV at a really high volume. The child may have behavioural issues, displaying inattentiveness and disruptive behaviour. The child’s speech may sound different or not speak clearly. The child’s vocabulary may consist many words that are often missing endings.
Impact on ChildHearing Impairment can cause 4 major impacts on the child: It may cause a delay in communication skills (speech and language development). As a result, this language deficit would cause learning problems and poor academic achievement. Social isolation and poor self-concept may also be caused by a lack of communication skills and poor social.
Impact on Family When a family receives news of a child’s disability or special need, the parents sometimes feel denial, guilt, anger or shock initially. As they start to slowly accept the news and work towards aiding and assisting their child in any way possible by making adaptations in their home, securing resources and financial assistance, etc. they may feel stress, fatigue and possibly even helplessness. Slowly, they will need to make the necessary changes in their home environment and in their lifestyle to accommodate the child with the special need. In the case of Hearing Impairment, ongoing hearing tests and screening, meeting with doctors, specialists and resource aids, speech therapy, etc. is something the family can expect in their long-term future.
Doctors In Lily’s case, if her hearing impairment hadn’t been diagnosed at birth, then the doctor would have been the first professional to be contacted when a hearing loss was suspected. The signs and symptoms have been discussed earlier that would raise concern and require a hearing test to be performed. At the family’s request, a family doctor or a paediatrician would send the child to an audiologist for the hearing test or screening. The primary care physician may also provide a referral to a doctor who specializes in medical genetics, to find out if your child’s hearing loss may be hereditary. That may help you determine if a similar hearing loss could occur in your other children
Doctors Because Lily’s parents have recently moved to Toronto, they would need to find a family doctor or a paediatrician in the area. According to an article in The Huffington Post, the doctor shortage that we had experienced a few years ago in Toronto has been resolved. Presently, we may have an influx of doctors in Canada, some of whom may remain jobless for a while due to the saturation in that field over the past 5 years. When looking to find a new doctor, here are some tips that are beneficial to use: 1. Ask your last doctor for recommendations. 2. Ask your family and friends for referrals or recommendations. 3. Search locally for Medical Centres in the area. 4. Go to a Walk-In Clinic. 5. Use the CPSO (College of Physicians and Surgeons of Ontario) Doctor Search online.
Audiologists Once a Doctor feels it necessary, he will refer the patient to an Audiologist for Hearing Screening. The audiologist is the health professional that would run the necessary tests in order to determine if there is a partial hearing loss, mild to severe hearing impairment or profound hearing loss and also the type of hearing loss. This is done by performing a series of behavioural and objective tests. The audiologist also is trained to fit hearing aids and to help you gradually adjust to the aids. This usually requires periodic followups to observe changes and progress in hearing abilities. The audiologist may also refer you to an ENT (Ear Nose Throat) doctor for futher screening. Because Lily has already been identified as having a severe case of Hearing Impairment, she would have seen an audiologist already and will need to find a new audiologist in Toronto for future follow-ups to monitor her hearing.
Some hearing tests performed byAudiologists: Auditory Brainstem Response (ABR) Test - a test that checks the brains response to sound; the person being tested can be sound asleep during the test, they do not need to be awake and active. Otoacoustic Emissions (OAE) - a test that checks the inner ear’s responses to sound. The person does not need to be awake during this test. Behavioral Audiometry Evaluation – this test allows the audiologist to assess how a person responds to sound overall by testing the functions of all parts of the ear. The person being tested must be awake and actively responding to sounds heard during the test in order to have accurate results.
ENT (Ear Nose Throat) Doctor orOtolaryngologist After the initial screening is performed by an audiologist, the child will be referred to an otolaryngologist, who will then determine if there are any underlying issues that may be (atleast partially)causing the hearing loss. The ENT Doctor will also be the one to verify if the problem can be treated medically or surgically and then will provide such treatment. X-Rays, CT-Scans, MRI scans, etc. may be required in order to further assess what type of hearing loss is present. After the assessment, simple treatments could be suggested ( like placing eardrum ventilation tubes) or other surgical procedures may be required (Cochlear Implants). The doctor also provides clearance for hearing aid fitting, after determining if no other intervention is indicated. “If it is determined that your child needs a cochlear implant, the otolaryngologist, along with the audiologist, will carry out further tests and examinations, and will carry out the implant surgery” (Role of ENT Doctor).
Early Intervention Specialist A professional with an education backgroud, the Early Intervention Specialist would assist in finding community resources, defining family members’ roles through the management of the hearing impairment and addressing concerns about future educational placement.
Speech and Language Pathologist The Speech and Language Pathologist (SLP) is a professional who predicts what kind of an impact the child’s hearing loss will have on his language development. She will also monitor his progress and determine if the child needs to be referred back to the audiologist or otolaryngologist. It is also the SLP’s job to assist the child to learn proper speech production. If the parents pursue oral communication for the child, the an Auditory-Verbal Therapist may need to step in to direct the family towards additional medical or audiological treatments. The AVP also teaches the family “appropriate speech/language, auditory, and cognitive developmental milestones you may expect for a child with hearing loss” (Role of Speech and Language Pathologist).
Youtube Video Early Intervention for Hearing Loss in Children This YouTube Video allows us to see how successful Early Intervention would be for children who experience hearing loss.
Technologies that can help Most children with mild or severe hearing impairment have some hearing; this is called “residual hearing”. Based the parents’ preference, certain technological options can be used to utilize this residual hearing to the best of its ability. Technology options are: Hearing aids – these assist in amplifying the sounds a child can hear so they sound louder. These come in many styles, but usually for young children, behind-the-ear styles are recommended for their growing ears. Hearing aids help babies hear sounds better so they have a greater chance of developing their language skills. Cochlear implants – a cochlear implant is recommended when hearing aid is not enough, mostly in children with severe to profound hearing loss. Cochlear implants do not make sounds larger; instead, they send sound signals directly to the hearing nerve. A surgery is required to place some part of a cochlear implant inside the ear, while the other parts are worn outside of the ear post-surgery. The sound signal is carried from the outer parts to the inner parts of the cochlear implant. Bone-anchored hearing aids – used when children have either a conductive, mixed or unilateral hearing loss, these aids are also recommended for children who cannot otherwise wear “in the ear” and “behind the ear” hearing aids.
Other Assistive Devices FM System – a Frequency Modulation device that allows a person with hearing loss to hear in background noise. It is sometimes used with a hearing aid. Closed Captioning – usually displayed at the bottom of a TV screen, captioning shows conversation spoken within a program (TV show, Movie, etc.) Text messaging – using Text messaging on the phone instead of an audio phone call.
Other Assistive Devices (continued...) Flashing and vibrating Audio loop systems alarms – these alarm clocks – this is an audio come with a vibrator that is Telephone amplifiers – these frequency loop placed under a mattress or are portable plug-in devices Infrared listening that amplify the volume of system that allows pillow; it vibrates when the devices - an infrared incoming calls up to 100% on hearing aid wearers alarm goes off on the clock. listening device is a corded home or business to hear more clearly Flashing lights also alert the small, plastic object phones. Price ranges from $35- by converting person that the alarm is going (shaped like a allows a $110, depending on the type of electromagnetic field off. Price ranges from $50- person to listen to the device and capabilities. signals into sound. $140. audio description in the theater. It works by converting an invisible beam of infrared light into sound that plays into headphones or ear buds.
Medical Treatments The Hearing Loss Clinic states that Only about 10% of hearing losses are helped by surgery or other medical treatment 90% of hearing losses can be treated with the use of hearing instruments
Medical/Surgical Procedures In most cases of conductive hearing loss (occurring in the outer or middle ear), medications or surgery can assist with improving a child’s hearing. Hearing loss caused by a chronic ear infection occurs when fluid builds up behind the ear drum in the middle ear. If this doesn’t clear up with medication, a simple surgery can be performed to place a tiny tube in the eardrum to drain the fluid out. Conductive hearing loss due to a part of the ear forming incorrectly while the baby was growing in the womb can be improved or corrected with surgery. An Otolaryngologist will usually determine the steps to take in correcting this issue. Surgery is required for cochlear implants and bone-anchored hearing aid as well!
Physical environment Labelling System1. Signs for Direction (names and pictures on- shelves for toys, cubbies, writing and art material holders, etc.)1. Allergy Board – pictures of children with pictures of items they are allergic to.2. Bigger, darker labels than normal so everything is clear and simple for Lily to understand and refer to.3. DAISY – a Digital Accessible Information System, these books contain both sound and text.4. Closed Captioning – When showing the children an informative video, whether it is part of my own planned curriculum or whether we have a guest visitor showing a video to the children, we make make sure to have closed captioning so that it’s easier for Lily to follow along.
Physical Environment Promote more learning through a variety of materials incorporated into many different curriculum areas.ASL Number Puzzle ASL Alphabet Peg Puzzle First Signs Match Up Signs Flash Cards Keep Quiet Sign Language Cubes GameI love you Floor Puzzle Sign Language Vocabulary Cards Fingerspelling Blocks Sign Language Bingo
Changes in Teaching StrategiesRoutines/Transitions I will make sure that routines should be clearly defined with same expectations as for other children, but allow more time for Lily. I will have to make sure I follow through on expectations from Lily. I will create a labelled chart of daily routines (pictures and words) I will allow a little more time for transitions from one activity to another, especially when going from high activity to low activity & vice versa, and from indoor to outdoor & vice versa. I will learn sign language by signing up for classes, so that I can communicate with Lily a little better. While I wait for my classes to start, I will search for some basic ASL training videos on YouTube to teach myself and Lily some simple gestures for common terms and words. Since Lily has never been in a child care setting (she was looked after by her grandparents), I will have to give her some time to adjust to our routines and adapt to the set schedules.
Changes in Teaching StrategiesAdaptive Play Materials “Adaptations help children to develop independence, interact with their peers and manipulate materials”(ConnectABILITY) The 4 strategies used in making these adaptations are: 1. Stabilize – secure materials onto a surface underneath 2. Enlarge – add small pieces or materials to make a toy accessible 3. Enhance – when parts of a toy are used differently to make it more accessible 4. Simplify – reduce the number of steps, remove the number of pieces or replace the number of materials In Lily’s case, I would especially use the enhancing technique to add bright/bold colours, add pictures to any toys that have just words on them and make writing appear larger. I would also use the simplifying technique in the beginning, when she is just starting to use certain new toys or play certain new games with us, that she might be experiencing for the first time at our centre.
American Sign Language “American Sign Language (ASL) is a complete, complex language that employs signs made by moving the hands combined with facial expressions and postures of the body. It is the primary language of many North Americans who are deaf and is one of several communication options used by people who are deaf or hard-of-hearing” (National Institute on Deafness and Other Communication Disorders). Although not all forms of sign language from different parts of the world is exactly the same, many words and terms are similar and correspond with each other, making it easier for people who are deaf or hearing impaired to communicate with others. I will encourage Lily to learn some sign language (if she doesn’t already know it) and I will use this form of communication in class regularly.
Teaching New Skills and Routines Because Lily has a severe hearing impairment, it will be very important for me to modify my strategies in the classroom with her, especially when trying to teach a new skill. One of the things I plan on teaching her if she doesn’t already know it, is sign language. I would use the technique of Prompting and Fading to accomplish this. Types of Prompts are – Physical, Modeling, Gestural, Visual, and Positional Prompts. Normally, with any child who has a special need, I would use all the types of prompts in that specific order, with full and partial prompting at each step. But with Lily, if she does not have any hearing at all, then the verbal instructions that are a part of the Modeling and Gestural Prompts will have to be modified so that I’m either using only gestures with her, or if she has already learned to read well, then I can write down the words that I would have used while Modeling or Gesturing.
Using Visuals With Lily, I would use some other tools besides classroom labels, to help her learn routines. First/Then Board – I would use a First/Then Board with Lily to teach her the sequence of events in our routines. It will also assist with skill-building when I need Lily to do an activity she doesn’t enjoy very much by showing her that a more-preferred activity will follow. Choice Board – During some parts of the day (eg: free play, outdoor playtime, etc.), an individual choice board can allow Lily to make her own choices of what materials/toys she wants to play with. In the beginning, I will include a non-preferred activity choice on the board to teach her to make choices, then I will only include the activities she enjoys.
Offer support for Self-esteem andMotivation I will make sure Lily has many opportunities to work with me one-on-one or in small groups with other children in order to learn through a variety of interactions and social situations. I will offer her a variety of open ended materials and developmentally appropriate experiences so she can be challenged and create her own learning. Some other things I will constantly check and implement as strategies for successful integration are: 1. Philosophy – children are more or less the same, and we should all work together as a team. 2. Observation – look longer and deeper at what Lily can and can’t do, and especially remain observant of her non-verbal behaviour and interactions with others. 3. Physical Presence – even if I’m not standing right beside Lily, I should position myself in such a way at all times that I can see her and get to her quickly should the circumstance arise that she needs me. 4. Modeling – I will learn to use sign language and use it consistently so I can effectively model to her the behaviour I want her to learn. 5. Choices - since Lily has a hearing impairment, she will need a little more time to understand what needs to be done (rather than just being able to hear instructions and follow them quickly); I will have to be patient in allowing her time to follow instructions and also in making her own choices. 6. Praise and Encouragement – because of Lily’s situation, I would use more non-verbal gestures like a pat on the back, high-5, wink and nod. I will also have to use precise facial expressions a bit more than I would with other children in the room. 7. Active Listening – I would have to be extra attentive to Lily when she approaches me for help or needs something. During times of high activity (playing outdoors, getting ready to head home, etc.) I would need to keep my eye on Lily and the children around her to read her non-verbal behaviour and react appropriately.
The child as a part of the largergroup of children I will create awareness of Lily’s Hearing Impairment by talking to the children about this. I will use storybooks, a short video or two about Hearing Loss, and other resources to teach the children about this special need. Then I will allow them time to formulate and ask any questions they have so I can provide them a complete understanding of Lily’s situation and ensure empathy from them. I will, of course, go to the library to research appropriate books on hearing loss, search for youtube videos and look for any other resources to use with the children. Then I will also use Social Stories to teach the children about accepting others, sharing and caring, etc. so they can learn what is appropriate and not when they are interacting with Lily every day. A social story is a tool for teaching social skills to children. In this case, the social story will be used to prepare the children for the new event of having a child with a hearing impairment in our classroom; it will teach them positive behaviour.
Collaborative Planning, Staff Training and Communicating withParents of Child with Special Needs I will research many different sources in order to learn more about Hearing Impairments and what more I can do for Lily in my classroom. I will also research resources to help Lily’s parents in their situation. I will set aside some time on a weekly basis, and as required by Lily’s parents, to connect with them about Lily’s learning and development progress. We will collaborate and plan towards her future. Regular charts and a Home/School Communication Book will be created in order to track issues, concerns, accomplishments and overall progress. I will also try to learn some Chinese, or initially have an interpreter present for my weekly meetings with Lily’s parents, since they don’t speak English too well. I will also refer to them some ESL classes if they wish to find out how to learn more English or get fluent in the language. Materials will be added to our classroom to promote diversity and add to Lily’s sense of belonging while she is in our classroom (Books on Chinese culture, Dolls to match her looks a little more, Photographs of Chinese Traditions, Paintings, etc.) Using our “Identifying Skills to Teach” handout from Week 6, I will follow the steps closely to first choose a single area or skill I want to teach, break it down into smaller steps, build Lily’s confidence and motivate her through reinforcement, keep track of the progress and invite other teachers and Lily’s parents to join in teaching the skill as well.
Communicating with Lily’s Parents The first thing I will do is to speak with Lily’s parents and identify what her situation is like, in detail. If this requires an interpreter, I will contact one through the Agency Supervisor, so that we can communicate properly without any obstructions. I will find out what type of Hearing Loss Lily has and at what her history has been like. Of most concern will be whether or not Lily has been fitted with any hearing aids or implants or if she’s undergone any surgery to correct her impairment. I will also check with her parents whether or not Lily uses any technology or assistive devices to help her in everyday activities and communications. Then I will ask if they use sign language to communicate with her. The answers to these questions will help me get a holistic idea of Lily’s situation and will help me in planning for her more effeciently. Then, together, we will decide on a joint approach to assist Lily in her learning and development at home and at daycare.
Providing Support/Resources Family Support Services For Lily’s parents, whether they have just recently found out about Lily’s hearing loss or have been aware of this for a long time, they would still need a lot of support. “Parents of children with recently identified hearing loss can seek different kinds of support. Support is anything that helps a family and may include advice, information, having the chance to get to know other parents that have a child with hearing loss, locating a deaf mentor, finding childcare or transportation, giving parents time for personal relaxation or just a supportive listener”(Family Support Services).
Doctor The doctor is who makes the initial diagnosis and then makes the referral for diagnosis and links the parents to other resources for support. Lily has already been diagnosed as hearing impaired so in this case, the doctor would be needed for the other assistance rather than the diagnosis. Because Lily’s parents have just recently moved to Toronto, they would need to find a doctor for her. This can be done using an online database of doctors, called The College of Physicians and Surgeons of Ontario. This online search is free of charge, serves all residents of the province of Ontario and does not require a referral. Any person can go online and search the database by plugging in some key information about what type of doctor you want, whether you would like to request a female or male doctor specifically, what language is primarily spoken, what area you prefer the doctor’s office to be located in, etc.
Audiology at Rouge Valley Health System(Centenary Site) Audiologists screen patients for hearing loss by running tests and assessments. They also provide intervention supports for children who have hearing loss.Audiology at Rouge Valley Health System –Centenaryhttp://www.rougevalley.ca/rehabilitation2867 Ellesmere RdScarborough, OntarioM1E 4B9416-281-7266Fax: firstname.lastname@example.orgThe Audiology department at the Centenary Hospital in Toronto provides all audiology services: audiological evaluation, hearing aid prescription, aural rehabilitation, central auditory screening, auditory brainstem response assessments and infant auditory brainstem response. Their children screening services are top notch- all tests are play based. One test utilizes peg boards (the child should add a peg to the board each time a short sound is played in his ear. The results are recorded to see, on average, how many times he was successful in hearing the sound and placing the peg on the board). Another test requires the child to sit on a chair in the middle of the sound room, and then a short sound is played at short intervals to see if the child acknowledges the sound. These sounds vary in pitch, allowing the audiologist to assess and record the range of hearing for the child in both ears individually. These are some of the tests used on preschoolers and school age children. Services are available in French, Cantonese and Mandarin, which is benefical to Lily’s parents who speak Cantonese primarily and only a little English. The clinic is child-friendly, welcoming the patient’s siblings to also play with other toys provided for the purpose of keeping them occupied and happy so parents are less stressed.Fee – Covered by OHIPReferral – usually referred by a doctor, but services can also be arranged independently.Availability – some waiting period, usually 6 months to a year, depending on the diagnosis and age of child.
Octolaryngology at Sunnybrook Hospital Otolaryngology is a “medical specialty concerned with illness or injury of the ear, nose, and throat (ENT), as well as medical and surgical treatments for diseases of the ear and skull base” (Octolaryngology at Sunnybrook).Octolaryngology at Sunnybrook Hospitalhttp://sunnybrook.ca/content/?page=Dept_ENT_HomeSunnybrook Health Sciences Centre 2075 Bayview Avenue, Suite M1 102 Toronto, ON M4N 3M5 Tel: (416) 480-4138 Fax: (416) 480-5761 The Octolaryngology department is located in the Sunnybrook Health Sciences Centre building and provides many medical and surgical treatments sought by people suffering from a hearing loss. Services provided are – Audiology, Cochlear Implant Program, Dizziness Clinic and Vestibular Lab, Head and Neck Oncology Clinic, and the Hearing Aid Centre. A referral is required from a doctor or audiologist; forms are provided online.Fee – covered by OHIP partially/Insurance or Full payment of costs and servicesReferral – made through a doctor or an audiologist. Forms are provided on the website.Availability – usally about 6-9 months for an appointment
InterpreterMCIS Language Services An Interpreter translates the message from one language to another after each person speaks in a conversation.MCIS Language Serviceshttp://mcislanguages.com/789 Don Mills RdSuite 608North York, OntarioM3C 1T5 MCIS Language Services is an online website providing Oral Interpretation Services, Translation and Transcription, and Social Intitiatives in over 200 languages. Requests can be made online 24/7 for an in-person interpreter, or for a scheduled phone/video interpreter.Fee – unable to find accurate fee unless a form for interpreter services is filled out and submitted.Referral – no referral requiredAvailability – phone and Video interpretation services are available immediately upon request, but if an in-person interpreter is reqired, it takes about 24 hours is the suggested waiting period.
Speech and Language TherapistToronto Preschool Speech and Language Services Speech and Language Therapists work with a child to assist in the development of the child’s verbal and non-verbal communication, language and also their swallowing and feeding skills.Toronto Preschool Speech and Language Services Preschool Speech and Language Program Toronto Public Health 416-338-8255 (voice) 416-338-0025 (TTY) email@example.comToronto Preschool Speech and Language Services provides an excellent program for children who may require a wide range of services or assessments due to delays in language or speech development. Services are free, do not require OHIP coverage, and are provided for all ages from birth till entry into senior kindergarten. Services provided include – assessment of children’s language development, speech and language workshops for children and their families, therapy in groups or individually if needed, and a transitional plan for the child when he is ready to start kindergarten.Fee – No cost to the family.Referral – No referral required. Parents, Caregivers, Nurseries, etc. can call the agency directly.Availability – Appointments are given in a timely manner; at the most, 1 month wait.
Bibliography1. Definition of Hearing Impairment. Industry Canada Website. Retrieved on March 10, 2013 from http://www.apt.gc.ca/wat/wb14200e.asp?did=5.2. Image. International Symbol of Access for Hearing Impairment. Deafness Forum of Australia. Retrieved on March 3, 2013 from http://www.deafnessforum.org.au/index.php?q=accessible-accomodation.3. Image. Girl Doing Sign Language. Retrieved on March 29, 2013 from http://www.google.ca/imgres?q=hearing+impairment&hl=en&biw=1365&bih=596&tbm=isch&tbnid=5Yd2sDS2TVbr1 M:&imgrefurl=http://www.cdc.gov/ncbddd/kids/hearing.html&docid=iZgcoiPBcA_H9M&imgurl=http://www.cdc.gov /ncbddd/kids/images/sign-language-kid- kq.jpg&w=298&h=243&ei=35NVUcfvLcX5qwHYooC4DQ&zoom=1&iact=hc&vpx=310&vpy=264&dur=328&hovh=194&h ovw=238&tx=146&ty=125&page=1&tbnh=140&tbnw=172&start=0&ndsp=21&ved=1t:429,r:9,s:0,i:133.4. Main Types of Hearing Loss. Kentuckys Office for the Americans with Disabilities Act. Retrieved on March 2, 2013 from http://ada.ky.gov/hearing_imp_def.htm.5. Image. Main Types of Hearing Loss. Green Business and Lifestyle Blog. Conductive Hearing Loss in Newborn. http://www.google.ca/imgres?q=conductive+hearing+loss&hl=en&sa=X&biw=1365&bih=596&tbm=isch&tbnid=EC3m mj5CFSfc0M:&imgrefurl=http://www.greenbizletter.com/conductive-hearing-loss-in- newborn/&docid=eirbIxE7zD59DM&imgurl=http://greenbizletter.com/wp- content/uploads/2012/03/hearing_types.jpg&w=375&h=285&ei=YJZVUbv9BMfyqQHi2oGYCg&zoom=1&iact=hc&vpx= 291&vpy=110&dur=3073&hovh=196&hovw=258&tx=150&ty=131&page=1&tbnh=142&tbnw=187&start=0&ndsp=21&ved=1t: 429,r:2,s:0,i:102 .
6 Statistic About Hearing Deficits. Hearing Foundation of Canada Retrieved on March 29, 2013 from http://www.thfc.ca/cms/en/KeyStatistics/KeyStatistics.aspx?menuid=877 Statistic about Hearing Impairment in Children. VOICE for Hearing Impaired Children. Retrieved on March 3, 2013 from http://www.voicefordeafkids.com/education.asp8 YouTube Video. Early Intervention for Hearing Loss in Children. Retrieved on March 2, 2013 from http://www.youtube.com/watch?v=-3jmo14zZDoOnline Website. Causes. MedicineNet.com. Retrieved on March 9, 2013 from http://www.medicinenet.com/detecting_hearing_loss_in_children/page2.htm10 Image. Antibiotics. Retrieved on March 29, 2013 from http://www.google.ca/imgres?q=antibiotics&hl=en&biw=1365&bih=596&tbm=isch&tbnid=ojPSlZnsDTPleM:&imgrefu rl=http://www.nlm.nih.gov/medlineplus/antibiotics.html&docid=Nv4T5g13CXIgHM&imgurl=http://www.nlm.nih.go v/medlineplus/images/pills.jpg&w=230&h=181&ei=IC1WUcObPOaFywGg2YHgDQ&zoom=1&iact=hc&vpx=209&vpy=1 88&dur=1950&hovh=144&hovw=184&tx=118&ty=100&page=1&tbnh=142&tbnw=181&start=0&ndsp=21&ved=1t:429,r:1,s:0, i:15113 Image. Ear Infection. Retrieved on March 29, 2013 from http://averastorycenter.org/wp-content/uploads/2012/11/Eich- ear-infections-photo.jpg14 Image. Autism Awareness. Retrieved on March 29, 2013 from http://www.topnews.in/health/diseases/autism15 Image. Apgar Test Score. Retrieved on March 12, 2013 from http://www.umm.edu/pregnancy/000129.htm9 Youtube Video. Is This Child Really Deaf? Retrieved on March 28, 2013 from http://www.youtube.com/watch?v=P5xVJJU2Bgo10 Image. Sign Language and Child. Retrieved on March 3, 2013 from http://www.google.ca/imgres?q=deaf+children&hl=en&sa=X&biw=1365&bih=596&tbm=isch&tbnid=uZniB2EvqZaSJM: &imgrefurl=http://kidsbookclub.tescomagazine.com/parents-zone/helping-your-deaf-child-learn-to- read.html&docid=_uj4Z997mXNBhM&imgurl=http://kidsbookclub.tescomagazine.com/Media/images/deaf-child- blog-hero-47314aa6-3b48-454e-ba64-9e53f9a13e4a-0- 580x295.jpg&w=580&h=295&ei=Cq9VUZfFMoq6qgGtrYHwAw&zoom=1&iact=hc&vpx=872&vpy=142&dur=3198&hovh =160&hovw=315&tx=135&ty=99&page=1&tbnh=138&tbnw=269&start=0&ndsp=20&ved=1t:429,r:5,s:0,i:97
10 Infant Screening in Hospitals. The Hearing Association of Canada. Retrieved on March 12, 2013 from http://www.thfc.ca/cms/en/NewbornHearingScreening.aspx11 Image. Infant Hearing Test. Retrieved on March 12, 2013 from http://health.allrefer.com/health/hearing-loss-infants- hearing-test.html12 Online Website. The Hearing Foundation of Canada. Retrieved on March 12, 2013 from http://www.thfc.ca/cms/en/NewbornHearingScreening.aspx13 Signs & Symptoms of a Hearing Impairment in Children. Retrieved on March 12, 2013 from http://www.thfc.ca/cms/en/NewbornHearingScreening.aspx14 Image. Child Ear Infection. Retrieved on March 12, 2013 from http://frenchtribune.com/teneur/1316436-ear- infections-linked-high-number-hearing-loss-cases15 Online Website. Impacts of Hearing Loss on the Child. The American Speech Language Hearing Association. Retrieved on March 12, 2013 from http://www.asha.org/public/hearing/disorders/effects.htm16 Online Website. Impact of Hearing Impairment on the family. American Academy of Otolarygology. Retrieved on March 15, 2013 from http://www.entnet.org/HealthInformation/childHearingLoss.cfm17 Online Web Article. Web MD. Help for Parents of Children with Hearing Loss. Retrieved on March 30, 2013 from http://www.webmd.com/parenting/help-for-parents-hearing-impaired-children18 Image. Doctor with Child. Retrieved on March 30, 2013 from http://www.cbc.ca/news/pointofview/2011/01/doctor- shortage-have-you-had-trouble-accessing-a-doctor.html.19 Online News Report. The Huffington Post. Number of Doctors at an All Time High in Canada. Retrieved on March 30, 2013 from http://toronto.about.com/od/health/ht/findadoctor.htm20 Online Article. About.Com Toronto. Retrieved on March 30, 2013 from http://toronto.about.com/od/health/ht/findadoctor.htm
10 Image. Child Ear Infection. Retrieved on March 12, 2013 from http://frenchtribune.com/teneur/1316436-ear-infections-linked- high-number-hearing-loss-cases11 Online Website. Impacts of Hearing Loss on the Child. The American Speech Language Hearing Association. Retrieved on March 12, 2013 from http://www.asha.org/public/hearing/disorders/effects.htm12 Online Website. Impact of Hearing Impairment on the family. American Academy of Otolarygology. Retrieved on March 15, 2013 from http://www.entnet.org/HealthInformation/childHearingLoss.cfm13 Online Web Article. Web MD. Help for Parents of Children with Hearing Loss. Retrieved on March 30, 2013 from http://www.webmd.com/parenting/help-for-parents-hearing-impaired-children14 Image. Doctor with Child. Retrieved on March 30, 2013 from http://www.cbc.ca/news/pointofview/2011/01/doctor-shortage- have-you-had-trouble-accessing-a-doctor.html.15 Online News Report. The Huffington Post. Number of Doctors at an All Time High in Canada. Retrieved on March 30, 2013 from http://toronto.about.com/od/health/ht/findadoctor.htm16 Online Article. About.Com Toronto. Retrieved on March 30, 2013 from http://toronto.about.com/od/health/ht/findadoctor.htm17 Online Website. Role of Audiologists. Retrieved on March 30, 2013 from http://www.entnet.org/HealthInformation/childHearingLoss.cfm18 Image. Audiologist. Retrieved on March 21, 2013 from http://www.hearingdevicetips.com/tips-to-find-a-good-audiologist..19 Online Website. Centers for Disease Control and Prevention. Retrieved on March 18, 2013 from http://www.cdc.gov/ncbddd/hearingloss/screening.html20 Online Website. American Academy of Otolaryngology. Retrieved on March 30, 2013 from http://www.entnet.org/HealthInformation/childHearingLoss.cfm.21 Image. ENT. Retrieved on March 15, 2013 from https://www.google.ca/search?q=ent+doctor&hl=en&safe=off&source=lnms&tbm=isch&sa=X&ei=yG1XUdj1B4e1qgHKvYDoAQ& ved=0CAcQ_AUoAQ&biw=1280&bih=929#hl=en&safe=off&tbm=isch&sa=1&q=ear+nose+throat&oq=ear+nose+throat&gs_l=img .3..0l6j0i24l4.5054.26379.6.284126.96.36.199.188.8.131.525.2041.8j4j0j1j0j1.14.0...0.0...1c.1.7.img.Nb52LFzXCSw&bav=on.2,or.r_qf.&bvm=bv .44442042,d.aWM&fp=93555186d4e829f5&biw=1280&bih=929&imgrc=WWUQ1ZrZzJQe_M%3A%3BZBZyIVELHA9aMM%3Bhtt p%253A%252F%252Fwww.kudzu.com%252Fcontent%252Fincludes_kudzu%252Fcategory%252Fear-nose-and- throat.jpg%3Bhttp%253A%252F%252Fwww.kudzu.com%252FcategoryMain.jsp%253FN%253D2058%3B574%3B255.22 Online Website. Role of the Early Intervention Specialist. Retrieved on March 13, 2013 from http://www.entnet.org/HealthInformation/childHearingLoss.cfm
10 Image. Early Intervention Specialist. Retrieved on March 13, 2013 from https://carmenwiki.osu.edu/display/hdfs361sp20119489/Early+Intervention+Specialist11 Online Website. Role of Speech and Language Pathologist. American Academy of Otolaryngology. Retrieved on March 15, 2013 from http://www.entnet.org/HealthInformation/childHearingLoss.cfm12 Image. Speech and Language Pathologist. Retrieved on March 15, 2013 from http://www.mysomeday.com/lulu/someday/Career/be-a- Speech-Language-Pathologist13 Online Website. Devices that help with hearing loss. Centers for Disease Control and Prevention. Retrieved on March 18, 2013 from http://www.cdc.gov/ncbddd/hearingloss/treatment.html14 Online Website. Telephone Amplifiers. Harris Communications. Retrieved on March 31, 2013 from http://www.harriscomm.com/catalog/default.php?cPath=47_16715 Image. Hearing Loss Clinic. Retrieved on March 15, 2013 from http://www.hearingloss.ca/testimonials/16 Online Website. Medical/Surgical Procedures. Centers for Disease Control and Prevention. Retrieved on March 18, 2013 from http://www.cdc.gov/ncbddd/hearingloss/treatment.html17 Online Website. Family Support Services. Centers for Disease Control and Prevention. Retrieved on March 18, 2013 from http://www.cdc.gov/ncbddd/hearingloss/treatment.html18 Image. Phone Amplifier. Retrieved on March 31, 2013 from http://www.assistireland.ie/eng/Products_Directory/Deaf_and_Hard_of_Hearing/Telephones/Portable_Amplifiers/Plug- in_Telephone_Amplifier.html19 Online Website. Flashing and Vibrating Alarms. 4 Alarm Clocks. Retrieved on March 31, 2013 from http://www.4alarmclocks.com/vialcl.html20 Image. Flashing & Vibrating Alarm Clock. Retrieved on March 31, 2013 from http://www.ebay.com/itm/Clarity-Wireless-Alarm-Clock- Flashing-Light-Lamp-Visual-Vibrating-Deaf-Alert-Sys-/40043605658221 Online Website. Audio Loop Systems. Ampetronic. Retrieved on March 31, 2013 from http://www.ampetronic.com/Home22 Image. Audio Induction Loop. Suffolk. Retrieved on March 31, 2013 from http://www.shss.org.uk/inductionloopsystem.html
10 Online Article. Infrared Listening Devices. Arts and Visually Impaired Audiences. Retrieved on March 31, 2013 from http://www.artsvia.org/newsArticle.cfm?aId=3911 Image. Infrared Listening Device. Retrieved on March 30, 2013 from http://www.audiolinks.com/tek9/tek9.asp?pg=products&specific=jpdoomrnq12 Online Website. The Hearing Loss Clinic. Retrieved on March 12, 2013 from http://www.hearingloss.ca/hearing-loss-statistics- demographics/13 McCaie, Lisa. Centennial College. Inclusion of Children with Special Needs. Class Handout. Adaptive Learning Environments. Week 414 Image. Labelled Bins for Materials. Retrieved on March 31, 2013 from http://www.kindergartenkindergarten.com/2010/09/my- kindergarten-classroom.html15 Image. Labelled areas. Retrieved on March 29, 2013 from http://crisscrossapplesauce.typepad.com/.a/6a00e55111563088340134872fea70970c-pi16 Image. Manipulatives. Retrieved on March 15, 2013 from http://crisscrossapplesauce.typepad.com/.a/6a00e55111563088340133f40f3251970b-pi17 Image. Math area. Retrieved on March 15, 2013 from http://crisscrossapplesauce.typepad.com/.a/6a00e55111563088340133f40f31bb970b-pi18 Image. Reading area. Retrieved on March 15, 2013 from http://crisscrossapplesauce.typepad.com/.a/6a00e55111563088340134872fea70970c-pi19 Image. Shapes Chart. Retrieved on March 16, 2013 from http://www.guruparents.com/shapes-chart.html#.UVmWCdxzbcs Image. Daily Routine Chart. Retrieved on March 16, 2013 from http://psjhomedaycare.com/2.html Image. Sign Language Charts and Book. Retrieved on March 16, 2013 from http://mommypowers.us/wp- content/uploads/2011/08/DSC06540.jpg Image. ASL Chart. Retrieved on March 16, 2013 from http://my.opera.com/tdjmd1/albums/showpic.dml?album=9277802&picture=128398402
Online WebSite. Assistive Products for Deaf and Hard of Hearing. Harris Communications. Retrieved on March 22, 2013 from http://www.harriscomm.com/ Image. Sign Language Vocabulary Cards. Retrieved on March 22, 2013 from http://www.harriscomm.com/index.php/basic-signing-vocabulary-cards-set-b.html#.Uvmgsdxzbcs Image. I Love You Floor Puzzle. Retrieved on March 22, 2013 from http://www.harriscomm.com/index.php/american-sign-language-ily-8inch-wooden- puzzle.html#.UVmhCtxzbcs Image. Finerspelling Blocks. Retrieved on March 22, 2013 from http://www.harriscomm.com/index.php/fingerspelling-sign-language-blocks.html#.UVmmMNxzbcs Image. ASL ABC Peg Puzzle. Retrieved on March 22, 2013 from http://www.harriscomm.com/index.php/alphabet-sign-language-peg-puzzle.html#.UVmhXNxzbcs Image. ASL Number Puzzle. Retrieved on March 22, 2013 from http://www.harriscomm.com/index.php/asl-sign-language-numbers-puzzle.html#.UVmh0Nxzbcs Image. Signs Flash Cards. Retrieved on March 22, 2013 from http://www.harriscomm.com/index.php/more-signs-sign-language-flashcards.html#.UVmiGNxzbcs Image. Keep Quiet Sign Language Cubes Game. Retrieved on March 22, 2013 from http://www.harriscomm.com/index.php/keep-quiet-sign-language-cubes-game.html#.Uvmistxzbcs Image. Sign Language Bingo. Retrieved on March 22, 2013 from http://www.harriscomm.com/index.php/sign-language-bingo-game.html#.UVmi8txzbcs Image. First Signs Match Up. Retrieved on March 22, 2013 from http://www.harriscomm.com/index.php/match-up-puzzles-first-signs.html#.UVmjPdxzbcs McCaie, Lisa. Centennial College. Inclusion of Children with Special Needs. Class Handout. Identifying Skills to Teach. Week 6
Online Website. Family Support Services. Centers for Disease Control and Prevention. Retrieved on March 18, 2013 from http://www.cdc.gov/ncbddd/hearingloss/treatment.html McCaie, Lisa. Centennial College. Inclusion of Children with Special Needs. Class Powerpoint. Week 9 The College of Physicians and Surgeons of Ontario. Online Database. Retrieved on April 1, 2013 from http://www.cpso.on.ca/docsearch/ McCaie, Lisa. Centennial College. Inclusion of Children with Special Needs. Class Powerpoint. Week 9. slide 9 Rouge Valley Health System Centenary. Learning Disabilities Resource Community. Retrieved on April 1, 2013 from http://www.ldrc.ca/community/directory/?id=131 Audiology at Rouge Valley Centenary. Retrieved on April 1, 2013 from http://www.rougevalley.ca/rehabilitation Patient Services. Octolaryngology at Sunnybrook Hospital. Retrieved on April 1, 2013 from http://sunnybrook.ca/content/?page=Dept_ENT_Prog Octolaryngology at Sunnybrook Hospital. Welcome. Retrieved on April 1, 2013 from http://sunnybrook.ca/content/?page=Dept_ENT_Home Interpreter Services. MCIS Language Services. Retrieved on April 1, 2013 from http://mcislanguages.com/interpretation/ McCaie, Lisa. Centennial College. Inclusion of Children with Special Needs. Class Powerpoint. Week 9. slide 12 Toronto Preschool Speech and Language Services. Preschool Speech and Language Program. Retrieved on April 1, 2013 from http://www.tpsls.on.ca/psl/services.htm