Lily is a 4-year-old girl with severe hearing impairment who is new to the preschool. Her family speaks Cantonese and some English. The educator needs to ensure Lily feels safe and comfortable. Adaptations may include using sign language, visual aids, and a buddy system. Services in the area can help Lily's family learn English and access support for her hearing. An audiologist can assess Lily and recommend devices or therapy to enhance her hearing.

1. SEVERE HEARING IMPAIRMENT
B Y : E L I Z A B E T H B A B O O R A M
E C E P 2 3 3 - 0 6
L I S A M C C A I E - W A T T E R S
Meeting the Needs of Children
and Families: Lily

2. Who is Lily and her Family?
 Lily is four year old girl with a severe hearing
impairment
 She has two siblings; a six year old brother and six
month old baby sister
 Her family consist of her parents, her siblings, and
her maternal grandparents
 They speak mostly Cantonese and a bit of English
 Her family is new to Toronto
 She’s brand new in my preschool room and had
never been in a childcare centre before

3. Needs of the family?
Lily:
 Ensures Lily feels safe, comfortable, and enjoys her new
experience at my childcare centre
 Enhance the preschool room to ensure Lily can be fully
engaged in the program
 Incorporate phrases in Cantonese into some activities
and in communication
For the family:
 Learn English
 Services in Toronto for newcomers
 Services to help enhance Lily’s hearing

4. What Does It Mean: Hearing Impairment
 It falls under physical challenges, children may have difficulty
communicating, interpreting social cues (feelings and emotions) but
other senses may be increased (week 3)
 There are different degrees of hearing loss; mild, moderate, severe/
profound
 Depending on the age of the individual with a hearing impairment,
hearing can be restored or enhanced
 An individual can have normal hearing in one ear but can be impaired
in the other (Siemens Hearing Aids, 2015)
 BUT CAN LIVE NORMALLY!!

5. What It Looks Like: Mild Hearing Impairment
 It’s difficult to understand
soft speech, even more so
with some background noise
 Rely on visual cues
 Misses 25 – 40% of speech
(CAA, 2010 – 2015)
 Hearing loss range in
decibels (dB HL) 26 - 40
(CAA, 2010 – 2015)

6. What It Looks Like: Moderate Hearing Impairment
 “Misses 50-100% of the speech signal, depending on the
listening situation” (CAA, 2010 – 2015)
 May need a hearing aid
 May be difficult to have a conversation
 Difficult to understand speech with a loud background
 Hearing loss range in decibels (dB HL) 40 – 60 (CAA, 2010 –
2015)

7. What It Looks Like: Severe Hearing Impairment
 Can be difficult to hear loud speech but can hear if it
is amplified
 Rely on lip reading/ sign language
 Hearing loss range in decibels (dB HL) 71– 90 (CAA,
2010 – 2015)

8. What It Looks Like: Profound Hearing Impairment
 “Rely heavily on visual information for learning and
communication” (CAA, 2010 – 2015)
 Cannot hear at all, rely on lip reading and/or sign
language
 Will still have difficulties in hearing even with a
hearing aid, however most people may have
a cochlear implant
 Hearing loss range in decibels (dB HL) 91+ (CAA, 2010
– 2015)

9. Take A Step Into Their World
 The following is a video that helps you get a sense of
what it means to fall under either normal, mild, or
severe hearing impairment
 Before starting the video, please adjust the volume at
your comfort
https://www.youtube.com/watch?v=TD5E88fFnxE&f
eature=youtu.be
Can you imagine what Lily is feeling after this?

10. More On Severe Hearing Impairment
 Along with the actual impairment
of hearing, there can be pain that
can happen
 Pains such as; ringing in the
ear(s), pressure/ fullness in the
ear(s), and dizziness (Isaacson, 2014)
 Also depending on the individual,
knowing the right amplification is
crucial to meeting the needs of
that person

11. Hearing Impairment Effects Development
 “The earlier hearing loss occurs in a child's life, the more
serious the effects on the child's development.” (ASHA, 2015)
 This works in reverse as well, the sooner the impairment is
indentified the easier it’s going to be for that child when it
comes to his/her development
 Hearing impairment can effect children’s vocabulary; with
difficulty learning abstract words
 Sentence structure becomes challenging as well because it
may be difficult to hear word ending with “s” or “ed”

12. Hearing Impairment Effects Development Cont.
 “Children with hearing loss often cannot
hear quiet speech sounds such as "s,"
"sh," "f," "t," and "k" and therefore do not
include them in their speech. Thus,
speech may be difficult to understand.
Children with hearing loss may not hear
their own voices when they speak. They
may speak too loudly or not loud enough.
They may have a speaking pitch that is
too high. They may sound like they are
mumbling because of poor stress, poor
inflection, or poor rate of speaking.”
(ASHA, 2015)

13. Physical Adaptations
 To ensure Lily is comfortable and can engage in my
program at my childcare centre I would make sure that
songs we sing have words and actions so that she can
participate along with the other children
 With these song I will make sure they are not too
complicated so that Lily can learn them, I can even fade out
the ones she had learned and add in some that enhance her
learning

14. Physical Adaptations Cont
Toys
 I also have to make sure the toys I have in my centre are not
too loud or noisy
 There is a misconception that parents that have children
with a hearing impairment do not need to worry about toys
that emit loud sounds, however they do, with any child with
or without a hearing impairment

15. Physical Adaptations Cont
 The danger with noisy toys is greater
than the 90-dB level implies especially
when hold it directly to the ear, as
children often do, because a noisy toy
actually exposes the ear to as much as
120 dB of sound, the equivalent of a jet
plane taking off, which noise at this
level is painful and can result in
permanent hearing loss. (ASHA, 2015)
 Use heavy duty duck tape and place
over speaks to reduce volume of the toy

16. Physical Adaptations Cont
Toys
 I would also have small white boards or white boards that are mounted
so that communication and learning may be easier between Lily, other
children , and myself

17. Physical Adaptations Cont
Labelling System:
• Bins are both labelled with words and pictures
• Words are in different languages
• Use real pictures and post it at the side of the bins
• Use an actual object and glue it do the bin (glue a piece of
Lego to the Lego bin)
(week 4)

18. Physical Adaptations Cont
Adaptive Devices
 Lily is a child with a severe hearing impairment, that means
she could have a possible hearing aid, if that’s what her doctor
and/or audiologist suggest
 There are many different kinds of hearing aids

19. Hearing Aids
 The following is an interactive picture, please place
your curser over the blue dot to view the message
http://www.thinglink.com/scene/6388869936101457
94
The picture was created by Elizabeth Babooram
Individual pictures used are cited

20. Physical Adaptations Cont
Cochlear Implants
 They are a surgically implanted device
 It works in partnership with its external
parts
 It works by sending electrical simulation
to the auditory nerve in the inner ear
 This device can help adults and children
with serve to profound hearing
impairment
 “The cochlear implant does not result in
“restored” or “cured” hearing. It does,
however, allow for the perception of the
sensation of sound” (ASHA, 2015)

21. Physical Adaptations Cont
Sign Language
 It is another form of communication, but done without speaking
 Sometimes people do speak while signing to another, which can be a
form of prompting and fading sign language (for Lily this may help
staff, children and myself to communicate with her easier)
 “This can involve simultaneously combining hand shapes, orientation
and movement of then hands, arms or body, and facial expressions to
fluidly express a speaker’s thoughts” (week 8)

22. Physical Adaptations Cont
 When it comes to my flexibility in routines, schedules and
activities I can:
 Add in different ways to do activities so that Lily can also
participate
 It never hurts to be more flexible in time, and to give more
warnings
 Have pictorial schedules posted
(Week 4)

23. Physical Adaptations Cont
Stability and Predictability
 Warnings of change
 Consistent staff
 Communication with staff and parents
 Predetermined roles
(Week 4)

24. Teaching Strategies
 As a ECE in my preschool room I have to remember
Lily is very capable of participating in the program
 She doesn’t have the problem, I do
 I need to ensure that I can communicate with Lily
 I need to make sure that she’s happy, comfortable and feels
safe in my care
 Since I don’t know if Lily does have a hearing aid or
cochlear implant, these are my teaching strategies I
would implement if she did and/or didn’t have one

25. Teaching Strategies Cont
Sign Language
 I spoke about what sign language is, however
this is what I would do with it
 I would have flash cards of letters or phrases
that are signed
 I would then show Lily them and practice
them with her while speaking, we can include
other children as well
 Physically using sign language to
communicate with her, can encourage other
children to do as well

26. Teaching Strategies Cont
 “If your child has a speech and language delay, a vision or
hearing impairment, a Speech Language Pathologist or
agency support person can provide you with special
techniques to help your child communicate.” (week 1)
 They would be able to teach me ways that I can effectively
communicate with Lily
 IT’S OKAY TO ASK FOR HELP!

27. Teaching Strategies Cont
Modelling
 This would help me tell Lily what to do but without verbal
saying it, for example putting books on the book shelf
Actively Listening
 I need to make sure that I am looking at Lily’s verbal and
non verbal cues to ensure that I can respond, interact and
communicate effectively
(week 7)

28. Teaching Strategies Cont
Picture Exchange
Communication System
(PECS)
 “Using PECS, a child learns to
exchange a picture of a desired
object in return for that object.”
(week 1)
 This would be great for Lily
because she is still learning
English along with her family
 This way if she’s shy or isn’t ready
to verbally request something she
can do it this way

29. Teaching Strategies Cont
Using Visual
 Having a personal flash card keychain or clip is another way to
help me communicate with Lily, vise versa
 There can be ones to teach to English words, or actions, for
example clean up
Communicating Effectively
 Ensure that I am at eye level, face to face when communicating
with Lily
 “Provide context and repetition, which is helpful not only to
students with hearing loss, but to other students as well:
announce what’s about to happen and recap what’s just taken
place.” (Teaching a Child with Hearing Loss, 2015)

30. Teaching Strategies Cont
Have Transcriptions of Audio Information
 Providing Lily with written material can ensure her of what
is going on
 This can be in Cantonese and/or English
*This strategy varies on her reading comprehension and the amount of
English she knows*

31. Teaching Strategies Cont
Buddy System
 Having this will ensure Lily that she can also rely on
peers and build relationships with them
 It also takes off the added stress of making sure that
I’M making sure she’s comfortable
 Helps to teach her the schedule
 Can also help other children understand Lily’s
needs and have her join in their play
 “This helps the student with hearing loss know
where the class is in the lesson; it can also help a
busy teacher.” (Teaching a Child with Hearing Loss, 2015)

32. Meeting the Needs of the Family
Lily’s parents had asked me about services in the
area, the following are some services that I believe
can benefit Lily’s family:
 YMCAGTA http://www.ymcagta.org/en/newcomers/
 Enhance English
 Help with employment
 Information centre

33. Meeting the Needs of the Family Cont
 The TDSB website has a section for newcomers, and has three locations
that you can visit, I will also put them down below
http://www.tdsb.on.ca/newcomers/adults/settlementservices/newcom
erservices.aspx
Newcomer Services - Centerpoint
6464 Yonge Street, 2nd Floor
(Centerpoint Mall, at Steeles)
North York, Ontario M2M 3X4
Tel: (416) 395-2045
Fax: (416) 395-2031
Email: nscenterpoint@tdsb.on.ca
Hours of Operation:
Monday to Friday,
8:30 a.m. - 4:30 p.m.

34. Meeting the Needs of the Family Cont
Newcomer Services - Malvern
31 Tapscott Road, Unit T-81
(Malvern Town Centre, at Neilson)
Scarborough, Ontario M1B 4Y7
Tel:(416) 396-4631
Fax:(416) 396-4780
Email: nsmalvern@tdsb.on.ca
Hours of Operation:
September to June
Monday to Friday,
10a.m. - 8 p.m.
July and August
Monday to Friday,
10a.m. - 6 p.m.

35. Meeting the Needs of the Family Cont
Newcomer Services - Morningside*
2870 Ellesmere Road
(Ellesmere and Morningside)
Scarborough, Ontario M1E 4B8
Tel:(416) 393-0285
Fax:(416) 393-0376
Email: nsmorningside@tdsb.on.ca
* On-site Child Care available
Hours of Operation:
Monday to Friday,
10a.m. - 6 p.m.
This location is inside of Military Trail Public School

36. Meeting the Needs of the Family Cont
Canadian Academy of Audiology (CAA)
https://canadianaudiology.ca/consumer.html
Vision:
We will be the national association for audiology in Canada.
Mission statement:
The Canadian Academy of Audiology is a professional organization
dedicated to enhancing the profession of Audiology, the provision of quality
hearing health care and education to those with, or at risk for, hearing
and/or vestibular disorders. The Academy further strives to represent the
audiological community on relevant national issues in a timely, organized
manner.
The Academy is committed to maintaining and advancing ethical standards
of practice. The Academy promotes the continuous improvement in the
abilities of its members by facilitating and encouraging Conferences &
Events and research, thereby enhancing the role of audiologists as primary
hearing health care providers.

37. Meeting the Needs of the Family Cont
 How can CAA help Lily’s family?
 Find and explain what an audiologist is
 Provide more information about what it means to have a
hearing impairment
 Ways to enhance the child’s hearing through different devices
 Possible options/ next step you can do regarding Lily’s hearing
impairment

38. Meeting the
Needs of
the Family
Finding an
audiologist can be
very simply for the
family
Just by typing in
their postal code
would bring up local
Audiologist
However these are
some places for Lily’s
family to take into
consideration near
my childcare centre

39. Meeting the Needs of the Family Cont
Other professionals Lily’s family could benefit from:
 A resource teacher/ consultant = provide information,
other resources, and professionals in the community
regarding Lily’s needs
 Lily’s family doctor = ensure that Lily is professionally
diagnosis, then refer help/ support
 A Speech and Language Therapist = can help develop
communication skills with Lily and the family, verbally and
non verbally
(Week 9)

40. NEVER GIVE UP!
 From everything I learned, through this assignment and the
Early Childhood Education program is to never give up on
children, regardless if they have a special need or not.
https://www.youtube.com/watch?v=JIcffodRvL4

41. Bibliography for Content
 Internet
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http://www.asha.org/public/hearing/Cochlear-Implant/
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loss/degrees-of-hearing-loss/
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http://www.asha.org/public/hearing/Effects-of-Hearing-Loss-on-Development/
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42. Bibliography for Content
 Newcomer Services. (n.d.). Retrieved March 30, 2015, from
http://www.tdsb.on.ca/newcomers/adults/settlementservices/newcomerservic
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http://www.medicalnewstoday.com/articles/249285.php
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43. Bibliography for Content
 Class notes
• Inclusion of Children with Special Needs, week 1
• Inclusion of Children with Special Needs, week 3
• Inclusion of Children with Special Needs, week 4
• Inclusion of Children with Special Needs, week 7
• Inclusion of Children with Special Needs, week 8
• Inclusion of Children with Special Needs, week 9

44. Bibliography for Pictures
 Pictures
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45. Bibliography for Pictures
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