By Shari S. Beams, Ph.D., CCC-A. FAAA
Children are often underestimated. They can be a challenge to work with but very rewarding.
While I was working on my Ph.D., I worked for the University as a graduate assistant. I remember one day I was supervising and the clinicians that day were seeing a 4-year old boy for the second time. He had very poor speech and they had a hard time testing him the first visit. They were finally able to get him to respond to words by placing picture cards on the ground and having him put a bean bag on the picture that corresponded to the word he had heard. He was able to do that fairly successfully, and at a fairly low volume. When they tried to have him respond to beeps, he just wouldn’t do it. They tried having him raise his hand, say “beep”, throw bean bags, all our typical tricks for testing children his age, but they just couldn’t do it.
We started testing the same way as before. Picture cards on the floor. The student clinician would say a word through the microphone and into the speakers in the booth, and the child would put a bean bag on the picture or the word he heard. Since he was only 4 years old, his father was in the booth with him. I was observing the testing and finally I had to stop the test and asked the dad to leave the room and left the child with just another student clinician. It turns out, that the father would hear the word too, it was coming out of a loudspeaker, and he would look at the picture. The child would see him look at the picture so that was where he would put the bean bag! The dad wasn’t doing it on purpose. It was just instinct. If someone says “where is the toothbrush?” you look at the toothbrush. Once we had the father leave the room, we were able to get a more reliable test of his hearing. It turned out he had a moderate hearing loss in both ears. Once he started wearing hearing aids his speech improved dramatically.
Another time, I was testing a child a little older, probably 10 years old or so. We were about halfway through the test when he announced that he thought it was funny, but every time he heard a beep, he could see a red light reflecting off my glasses. It turns out the machine I was using had a red light that would light up every time I pushed the button to present a beep. So I had to take off my glasses before I could continue the test. I wanted to make sure the child was hearing the beep, not raising his hand because he saw the light and knew the light meant a beep should be heard.
I made the mistake one time of wearing a white blazer over my dress when I went to clinic. The child took one look at me and screamed “No shots!”. She thought my blazer was a lab coat. It’s bad enough that when we have to perform some of our tests we have to put little plastic plugs in their ears, or if we need to make molds of their ears we have a cartridge gun to dispense silicone that is pretty scary looking, but throw in a lab coat and children will think the worst. I had one little girl who I tested for the first time when she was 4 years old. We discovered she had a moderate hearing loss in both ears. We had to make molds of her ears to order her ear molds for her hearing aids. She didn’t like that much. She was one of those kids that covered her ears and said “no shots”. She discovered it wasn’t all that traumatic though. But for the next few years, every time she saw me she would just shake her head and say “no shots” and smile.
Most of my patients are adults and honestly, I prefer working with adults, but kids are really smart and can be really fun too.
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