Services & Support
by Michaela Coon

Interview with the author: Video-Based Aural Rehabilitation Guide: Enhancing Listening and Spoken Language in Children and Adults

October 28, 2019
Share
Research updates

Introducing the new Video-Based Aural Rehabilitation Guide: Enhancing Listening and Spoken Language in Children and Adults

Interview with Linda Daniel, Author, MS, MA, ABA/CCC-A
LSLS Cert. Auditory-Verbal Therapist, Director of HEAR In Dallas

October 2019

Cochlear: What can you tell us about your new book, Video-Based Aural Rehabilitation Guide: Enhancing Listening and Spoken Language in Children and Adults?

Linda Daniel: This is the first textbook of its kind because it includes over 200 captioned videos that illustrate important concepts and clinical practices pertaining to aural rehabilitation for individuals with hearing loss ranging from infants to older adults. This video-based textbook contains a vast amount of current information that is relevant to the education of undergraduate and graduate students; practicing professionals in audiology, speech-language pathology and education of children who are deaf or hard of hearing; and families who have a person with hearing loss.

Due to the multifaceted aspects aural rehabilitation and the diverse professionals involved in the field, disciplines covered in the book and videos include medicine, human development, audiology, speech-language pathology, cognition, psychology, counseling and education. Current theories and research in best practices in audiology, speech pathology, medicine, and counseling are integrated throughout every chapter.  The framework of the book highlights interprofessional collaboration for fostering optimal communication skills and enhanced quality of life for persons with hearing loss.

Cochlear: How do the 200 videos enhance the learning experience? Can you tell us about their creation?

Linda Daniel: Just as in the presentations I gave over my 45-year career, the videos make the information in the textbook immediately applicable to the practice of aural rehabilitation with persons of all ages. The videos feature diverse professionals such as otologists, audiologists, speech-language pathologists, Listening and Spoken Language Specialists, educators, administrators, communication partners and even family members as well. They provide the viewer a host of perspectives from professionals and family members from the time of diagnosis of hearing loss through the process of aural rehabilitation in multiple settings. With captions, the videos are accessible to people with all levels of hearing.  In this age of multimedia instruction and learning, those who use this book will gain both academic knowledge and clinical management information simultaneously.

Cochlear: How does this book advocate for aural rehabilitation requirements across the hearing and speech professions?

Linda Daniel: Chapter 1 brings to light the bodies of knowledge that are requisite for the AR practitioner to acquire and integrate into practice. Chapters 2-4 focus on the function of and candidacy for hearing aids, cochlear implants and the auditory brainstem implant to assist person’s with hearing loss access the acoustic signal of spoken language. Chapters 5-10 present practical perspectives for facilitating listening and spoken language for young children, options for children with complex factors, fundamentals of assessment, educational supports, pre and post-linguistically deafened adults, counseling, quality of life and advocacy.

Cochlear: Who can benefit from this book?

Linda Daniel: By thoughtful design, this book is highly applicable and useful for otologists, audiologists, speech-language pathologists, teachers in regular education and education of the deaf and hard of hearing and families that have a loved one with hearing loss. We intended for it to be valuable for students, professionals and families who want to improve the lives of children and adults with hearing loss.

Cochlear: What topics are covered?

Linda Daniel: Due to the complexity of the field of aural rehabilitation and the heterogeneous population of children and adults with hearing loss, the topics and concepts illustrated in the videos are vast. In addition to information applicable to persons with hearing loss, the topics are presented within the context of family members and communication partners. Chapter titles include:

  1. Overview of Aural Rehabilitation
  2. Hearing Aids and Hearing Assistive Technology Systems
  3. Cochlear Implants for Children and Adults with Hearing Loss
  4. Auditory Brainstem Implants for Children and Adults with Hearing Loss
  5. Intervention After Early Identification of Hearing loss: Listening and Spoken Language Approach
  6. Factors Affecting Intervention and Outcomes of Children with Hearing Loss
  7. Educational Supports for Students with Hearing Loss: Primary through Post-Secondary Settings
  8. Aural Rehabilitation for Adults with Hearing Loss
  9. Fundamentals of Assessing Communication Skills in Children and Adults with Hearing Loss
  10. Quality of Life, Counseling, and Advocacy for Children and Adults with Hearing Loss

Cochlear: What inspired the creation of your book? Did your background play a role?

Linda Daniel: I’ve always been intrigued by how a person could have an idea, produce sound with their mouth, then another person could hear the talker’s idea. I knew my calling was to “teach deaf children to talk,” as I had announced to my mom when I was 4 years old. My path led me to study with founders of the LSL field (called Acoupedics and Auditory-Oral in the 1970’s)–Doreen Pollack, Marian Ernst, and Daniel Ling. After having a life-changing experience observing these masters, I began giving presentations and showing the videos of the children from my practice at professional conferences. I learned so much by observing my mentors as they worked with children with hearing loss, I knew that videos would be an incredible supplement to a book.

I wanted to disseminate much of what I’ve learned in my 45-year career. When I met Sneha Bhardwaj, Ph.D., at my poster session at the 2009 American Academy of Audiology (AAA) convention in Dallas, the seeds for this book began to germinate. Knowing her position as a university instructor and her interest in aural rehabilitation, I invited her to observe sessions of Auditory-Verbal Therapy in my practice. After she heard the children speak and demonstrate their listening, language, and cognitive skills, we were convinced that we had to produce a video-based textbook for university students, practicing professionals and families. It took several years to coalesce, and here we are now publishing the first aural rehabilitation textbook with 200 captioned videos.

Cochlear: What excites you the most about this release?

Linda Daniel: The book reflects the personal nature of the aural rehabilitation. While it is a solid academic textbook, it is written with a personal tone, tying the information to practice. This approach weaves the academic information into aural rehabilitation services as the topics unfold through the chapters. There are box-inserts in every chapter to highlight experiences of children, adults, and family members to bring the text to life. Case presentations, with videos, are included at the end of every chapter to give an in-dept look at key concepts of the chapter in a true patient story.

Video-Based Aural Rehabilitation Guide: Enhancing Listening and Spoken Language in Children and Adults, L Daniel and S Bharadwaj, Plural Publishing, San Diego, CA. 2021, release date October 18, 2019.

Related Posts
Dr. Laure Pratesi

Aural rehabilitation in practice with Dr. Pratesi

December 14, 2021

Laura Pratesi, AuD, discusses the importance of aural rehabilitation and how she puts it into practice.

What is the value of aural rehabilitation for your adult patients?

Aural rehabilitation is immensely valuable. I recommend it to patients at just about every stage in their hearing wellness journey. I explain that aural rehab is like “physical therapy for the brain.” Whichever skills the patient wants to strengthen or develop, we create a treatment plan and a goal to work towards. I use certain speech in noise tests (such as the QuickSIN or AzBio), as well as questionnaires such as COSI, APHAB, HHIA, HHIE, as benchmarks, to track their progress. 

Data shows that aural rehab is important for adult patients – how do you implement into practice?

Pre-COVID, we were working on developing a weekly in-person group therapy session. I think that patients can learn so much from each other, knowing there are others in the same boat. Group therapy would also give patients the opportunity to listen to lots of different voices (male and female, accent variations, loud and softer talkers, etc.). COVID-19 certainly changed our plans and brought an additional level of complexity as masks hamper lipreading and distort speech signals while quality degrades over distance. We were not sure how to overcome this. So during this time, I have focused on working with patients individually, and having them complete homework by themselves or with family members. 

At what point in the treatment process do you bring up rehab? For whom?

I bring up aural rehab from just about day one. In private practice, if patients are at my office, it is because they notice they are struggling. They have acknowledged that there is an issue, and they want to get to the bottom of it. I listen carefully to their symptoms and concerns. Even patients whose test results fall into the “normal” range may not be performing as optimally as they would like. For some patients, their challenge may have more to do with auditory processing than anatomy and physiology, but that does not mean that their struggles are not real, and do not need to be addressed. If a patient is in front of me with a complaint, then I will work with them to find a solution to their problem!

How does an aural rehab program impact your practice?

I believe focusing on aural rehabilitation means that our clinic is working to treat the whole person. We cannot just fit a set hearing aids or a cochlear implant and call it a day. When the brain has been deprived of certain sounds (sometimes for decades), it’s going to take time to learn how to hear and process again. I was born with hearing loss myself, and I did not hear much in my left ear for the first 20+ years of my life, until I got a hearing aid. I remember the time it took to get adjusted to hearing my refrigerator humming and my clock ticking. I was about two years into wearing my own hearing aids until I could tolerate them at the full volume recommended for my hearing loss.

Even now, if I switch between old and new technology, or change between hearing aid brands, it takes about 2-3 weeks for my brain to adjust to the differences. It only makes sense that it will take time for others to adjust as well. Factors to consider include the patient’s duration of deafness, pre- or post-lingual on-set of hearing loss (i.e. before or after speech development) and interventions used to date. As a provider, and as someone with hearing loss, I think it’s important we address the person as a whole. Many are seeking better access to sound and greater ease with communication. Why would we not want to try to address those concerns?

How has Cochlear™ CoPilot been integrated into your program?

Cochlear CoPilot has been an effective addition to my aural rehab tool box. It has previously been a challenge to find quality, affordable solutions for my patients. There have been programs that have been discontinued, others that are not cost effective, some that are cumbersome or not intuitive. I love how the lessons build off of each other, and the tasks gradually become more complex. If the beginning tasks are too easy, you can jump ahead. If the exercise is too hard, you can go back and work on the skill set that builds up to it. You can focus on names or numbers or street addresses or whatever. I found the exercises to be applicable to real conversations and real interactions.

How have your patients used and benefited from Cochlear CoPilot?

I think that any kind of listening exercise can be beneficial, but I love that patients can stream directly to their processor/hearing aid, or can turn one side off and work an individual ear at a time. It’s been very easy to get the app downloaded and installed for my patients. I set aside a few minutes of their appointment time to go over and practice some of the first lessons. Everyone has found it very simple and easy to use, and not intimidating at all. My patients like the streaming aspect the most – and that they can do the exercises anywhere at any time. I try to get patients to commit to at least one hour a day of dedicated aural rehab time. Snagging 10-15 minutes here or there, they can accomplish that easily! 

Download Cochlear CoPilot for free from the Apple® App Store®.

About the author:

Laura Pratesi, Au.D. is owner of Citrus Hearing Clinic LLC in Clermont, Florida. Dr. Laura received her Bachelor of Science in Communication and Sciences Disorders with a concentration in Human Development from Auburn University in 2008, and her Doctor of Audiology degree from Auburn University in 2012. During her time at Auburn, she had the opportunity to work in a variety of clinical settings including in a school system, hospital system, VA facility, ENT practice, private practice, and assisted living facilities. She has extensive experience in working with both pediatric and geriatric populations, as well as veterans.

Audiology is not just a profession for Dr. Laura, but also a calling. Diagnosed with a progressive hearing loss at age 5 years, she was first fit with amplification by her classmates while at Auburn University. Having struggled with untreated hearing loss for years while falling into care gaps, Dr. Laura is passionate about proper identification, diagnosis and intervention of hearing and balance disorders for patients of all ages. 

Dr. Laura has been featured as a Woman of the Year for 2020 by Orlando Magazine, a HearStrong Champion, was a part of the Docs with Disabilities campaign by the University of Michigan, and was featured on multiple podcasts, including Orlando Lady Boss. She is a Fellow of the American Academy of Audiology, has her CCC-A from ASHA, is a member of the Academy of Doctors of Audiology, and is a member of the Florida Academy of Audiology. Since April 2021, she has been a member of a FLAA Task Force charged with updating Audiology Statutes in the state of Florida. At her practice, she does contract work for the Veteran’s Administration, the Department of Vocational Rehabilitation, the Lake County School System, and the Social Security Administration. She resides in Central Florida with her husband, their five year old son, four cats, and two hermit crabs. In her free time, she is a volunteer at Clermont First United Methodist Church, and the former Publicity Chair board member of the Moonlight Players community theater (on hiatus due to Covid-19).

For compatibility information visit www.cochlear.com/compatibility

Apple, the Apple logo, Apple Watch, FaceTime, Made for iPad logo, Made for iPhone logo, Made for iPod logo, iPhone, iPad Pro, iPad Air, iPad mini, iPad and iPod touch are trademarks of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple Inc., registered in the U.S. and other countries.

Q&A with Meredith Klingshirn, AuD: Integration of Cochlear’s candidate and recipient education programs into clinical protocol

May 8, 2023

With Meredith Klingshirn, AuD, Audiology Manager, Hillcrest Hearing and Balance Center (A division of Southwest Ohio ENT Specialists)

This Q&A delves into the impact of Cochlear’s Engagement Managers (EM) and Recipient Solutions Managers (RSM) on Southwest ENT’s clinical processes. Read on to see how these relationships can bolster clinic efficiency and further increase your recipients’ confidence with their new devices and to achieve hearing goals.

The EM service allows candidates to gain the necessary information pre-surgery and also connects them to Cochlear Volunteers. The RSM Program provides a best-in-class virtual learning experience for new hearing implant recipients. Recipients who attend these educational sessions, offered in English and Spanish, learn how to use and care for equipment, real-world aural rehabilitation tips, how to pair accessories, how to use smart apps and how to utilize the many resources available at Cochlear.

First, tell us a little bit about yourself. What’s your favorite part about being an audiologist?

I have been with Southwest Ohio ENT for six years and have been an implant audiologist for five. My favorite part of being an audiologist is seeing a patient get their life back. Family members often tell us that their loved one has withdrawn from family gatherings or social situations due to their hearing loss. Being able to help that person hear and understand again, is truly a gift. I love being able to create relationships with my patients and following them for several years. When they come into the office for appointments, I love to hear about the new activities they are doing or the places they are going because they now have the confidence and hearing to do so.

Your center has had great success integrating Cochlear’s Engagement Managers (EM) and Recipient Solutions Managers (RSM) into your clinical protocol. How has this partnership benefited you in terms of clinical efficiency?

We initially integrated the use of our EM and RSM into our clinic protocols due to being short- staffed. We were incredibly backlogged with cochlear implant evaluation referrals to the point where our own patients were being referred out to other practices in the area affiliated with the Cochlear Provider Network. To keep our own patients, we knew we needed to make a change and added our EM to our cochlear implant evaluation protocol and RSM to the follow up care.

Every patient that is seen by our office for a cochlear implant evaluation first has a conversation with our EM for cochlear implant counseling and information. They are then seen by our audiologists for the evaluation portion and follow up with the EM to pick out their devices and accessories. Once the patient is implanted and seen for activation, we schedule them for an appointment with our RSM for assistance with navigating Cochlear tools, accessories and aural rehabilitation options.

We have absolutely seen clinic growth since we’ve changed our protocols. We have almost doubled the number of surgeries in the past six months. Although we have seen significant growth, we still have enough time in our schedules for appropriate follow up of those being implanted as well as those patients who we need to see for routine appointments or problems.  The time that we have saved by having our patients see our EM and RSM have not only allowed us to keep our own patients and catch up on our backlog of cochlear implant evaluations, but we have created more time in our schedules that has allowed us to see patients for their activations and spend time with those that need extra attention or programming.

What is the value of these EM/RSM relationships for your patients? What do they like most about the programs?

We have found that patients have been very receptive to these relationships. They truly appreciate having another touch point to ask questions or discuss their options along their cochlear implant journey. Not only do our patients have their audiologist or surgeon to discuss questions or concerns, they can reach out to the EM or RSM who can also help answer non-troubleshooting questions. Our patients also appreciate that our EM is able connect them to a recipient who has already been through the process.  

Cochlear America’s July 2022 Volume 3 Connected Care Report

Patients who meet with our RSM following their activation have increased confidence in their equipment and their ability to use it. Once a patient has met with the RSM regarding their accessories, we rarely need to spend time reviewing it again. When patients know what their accessories do and how to maintain their devices, we see an increased confidence and ownership of the devices. They feel comfortable cleaning their devices, creating repair requests and reaching out to Cochlear for any assistance they may need. They have an understanding of what they can do on their own and when they need to schedule an appointment with us.

What would you recommend to another clinician to get started in integrating EMs and RSMs into their clinical protocols?

Most audiologists want to see and help as many patients as they possibly can. One of the best and easiest ways to do this is to integrate the use of Cochlear’s EMs and RSMs into their clinic protocols.

As a clinic or audiologist, think about where you are spending most of your time with a cochlear implant candidate or recipient. Are you spending a lot of time counseling these patients? Is it paperwork or answering emails from patients? Are you spending a lot of time reviewing different aural rehabilitation options and programs or spending time reviewing and teaching the patient how to use their accessories? I know as a clinic, we were spending a lot of time doing all of these things before we integrated the use of our EM and RSM. If the resources are available and it allows us to see and help another patient, why not consider it?

Consider how you’d want to involve the EM or RSM. We have been most successful with follow through attendance scheduling the patient with the EM or RSM ourselves while they are sitting in our office for mapping appointments after activation. Cochlear has made it so easy to schedule these appointments through their scheduling link and it takes less than five minutes! Although these appointments are virtual, we have found that a good number of our older population now feels comfortable with these types of appointments, especially after COVID. The initial appointment with the RSM helps the patient navigate the resources that Cochlear has to offer.

Following an appointment with their physician, each candidate referred for a cochlear implant evaluation receives a folder with information to review before they are seen for their appointment with the audiologist. Each folder contains information regarding the implant process, device, surgery, etc. Prior to their cochlear implant evaluation, each person has a conversation with our EM discussing the same things that we would have talked about during the first part of the implant evaluation. This allows us to move smoothly and promptly into the testing portion of the appointment with little to no need for additional counseling.

What can you predict for your clinic in the future as the collaboration of services continues to grow and flourish?

I think that Cochlear has done an excellent job providing resources for clinics to use that allow us to cut down the amount of time we are spending with patients in our offices. Using these resources allows us audiologists to reach a higher number of people with hearing loss and continue to change and improve lives. I foresee our office continuing to grow our implant program and the number of people reached in the Dayton, OH area. I look forward to continuing to collaborate with Cochlear and am excited to add the remote services to our protocol allowing us to reach even more patients.  

Get an inside look on the RSM Program here! Talk to your local Cochlear representative to get started.

About the author:

Dr. Meredith Klingshirn received her Bachelor of Arts in Speech and Hearing Science from The Ohio State University. She received her Doctorate of Audiology from Northeast Ohio AuD Consortium. Dr Klingshirn services cochlear implant, bone conduction devices, and hearing aid patients at Hillcrest Hearing and Balance. She lives in the Dayton, Ohio area with her husband, Derek, their (almost) one year old son, Mack, and sheepadoodle, Remi. She enjoys exploring new cities and our national parks with her family. When she’s not at work you can find her at the gym.

Cochlear logo - white

©Cochlear Limited 2024. All rights reserved. ACE, Advance Off-Stylet, AOS, Ardium, AutoNRT, Autosensitivity, Baha, Baha SoftWear, BCDrive, Beam, Bring Back the Beat, Button, Carina, Cochlear, 科利耳, コクレア, 코클리어, Cochlear SoftWear, Contour, コントゥア, Contour Advance, Custom Sound, DermaLock, Freedom, Hear now. And always, Hugfit, Human Design, Hybrid, Invisible Hearing, Kanso, LowPro, MET, MP3000, myCochlear, mySmartSound, NRT, Nucleus, Osia, Outcome Focused Fitting, Off-Stylet, Piezo Power, Profile, Slimline, SmartSound, Softip, SoundArc, True Wireless, the elliptical logo, Vistafix, Whisper, WindShield and Xidium are either trademarks or registered trademarks of the Cochlear group of companies. The names of actual companies and products mentioned herein may be the trademarks of their respective owners.

 

This material is intended for health professionals. If you are a consumer, please seek advice from your health professional about treatments for hearing loss. Outcomes may vary, and your health professional will advise you about the factors which could affect your outcome. Always read the instructions for use. Not all products are available in all countries. Please contact your local Cochlear representative for product information.

 

Cochlear ProNews is monitored Monday through Friday, excluding some holidays. Questions and inquiries submitted over the weekends or holidays may see a delay in response. For immediate assistance please contact us directly. You are solely responsible for your interactions with other members of our Websites. Cochlear reserves the right, but has no obligation, to monitor disputes or communications between you and other members of our Websites. For a full list of Cochlear’s terms of use, click here.