Written by: Pedro Brás da Silva
My name is Pedro Brás da Silva and I have worked as a Speech and Language Therapist (SLT) in Portugal for about 20 years, almost all of them working with babies, children and adolescents who are deaf and hard of hearing (DHH). I am married to a SLT, father of two beautiful daughters (already teenagers!), I live by the beach, and I love listening to and playing music (drums!).
Ever since I started working with DHH children and their families, I have slowly witnessed a paradigm shift. In the early days as a professional, I had the opportunity to join in a Specialized Support Unit for DHH children in a mainstream school, where I was the first therapist to work at that institution. It was difficult at first, because a lot of parents and special education professionals did not know what my job was and had a very limited idea of the SLT’s role with DHH children. I started to include parents in my sessions at school, which at the time was an uncommon situation in that context. I was even asked by colleagues and the school principal why I was doing that. Rapidly, most parents were participating actively in therapy sessions and gradually, teachers and the board members realized the importance and relevance of this family-centered support.
Alongside the technological revolution that we have witnessed in the last decade, coupled with my desire to improve my professional performance on behalf of families that want their children who are DHH to enhance hearing and have spoken language as a means of communication, I decided to pursue certification as a Listening and Spoken Language Specialist Certified Auditory-Verbal Therapist (LSLS Cert. AVT). I achieved my certification in December 2018 (I am forever grateful to my mentors Lise Henderson and Maria Emília (Mila) de Melo), thus becoming the first professional certified by the AG Bell Academy in my country.
During this certification period, I witnessed parents gradually become more aware of the typical developmental stages, their child’s level of development and more confident in the application of auditory-verbal strategies. I want to highlight some points that, in my opinion, are crucial for the involvement of families and that this certification allowed me to value even more in the therapeutic process.
The Presence of Parents in Sessions
It is not an option to be left out! In the beginning, I had parents arguing in advance that they wanted the hour to do things for their work, like read and forward some emails, to be able to read a magazine or even to take a walk. For the best interest of the child and his/her development (while having lots of fun like in the photo), I’ve learned that the active presence and participation of parents is crucial so they can continue at home the objectives and strategies learned and discussed during the session.
The Number of Sessions
One to two sessions (at most) per week is usually adequate to ensure that relevant and diagnostic information is obtained from the parents (although some still argue that more sessions are better therapy!). In the sessions, we dedicate enough time to discuss the developments recorded during the week, the session goals, and activities and strategies to be used followed by doing activities with the child. In the end, the most relevant information from the session is highlighted collaboratively, so that the weekly goals and carryover activities can be planned together with the parents as primary facilitators. We should always keep in mind that a LSL certified therapist will be in face-to-face contact with the child only between 4-8 hours per month, compared to the hundreds of hours that families are with the child.
Keep Everything Registered
All the information parents observe and record at home is highly valued by the LSL certified therapist. A Parent’s Book should be encouraged, so that the child’s session objectives, strategies and observed skills are recorded for discussion in every session (as well we want to preserve the parents’ memory skills to remember how to make that grandma’s chocolate cake to offer to the therapist!).
Understand the Needs and Expectations of Each Family
To be able to make a therapeutic plan and adjust the activities to the child’s development level, as well as to their preferences, it is very important that each family has an individual plan, just like a tailor makes a tailored suit. As a professional, I recognize that families have a tiring journey, jammed with professional, personal and household tasks that often prevent availability for children. Yet, there is good news: the development of language skills can be guaranteed in the daily routines (every day, the child must eat, dress to go to school, shower, play, etc.). If parents can spend time together, talking about what both are doing and what is happening, that is transformed into a rich communicative and linguistic experience through listening!
The Caregivers’ Learning Style
The way we learn is different, with styles that vary from person to person. Caregivers, as adults, are more motivated to learn when the information received is relevant and practical in their lives. In auditory-verbal practice, we intend for parents to build goals together with us, suggest activities and use specific strategies daily, which support the objectives outlined. For example, in the first sessions I usually discuss and negotiate with parents the amount of information to be given and how they prefer to receive it (via online coaching) by asking: “At some point in the session I will need to interrupt and give directions, how do you think I can do it? How would you like to receive the information and tips I have to give you?”
In conclusion, the LSLS Cert. AVT process allowed me access to the most recent scientific knowledge, access to the most demanding training in the field of audition and to develop my clinical skills, which allows me to be more prepared to welcome the families of children with DHH, users of hearing technology and those who consciously choose a development (and life) path based on spoken language! And I always share with the parents that we are together in this journey, here and now, to observe the phrase on the horizon: “The best is yet to come!”
Pedro Brás da Silva, MSc, SLP, LSLS Cert. AVT, wrote this from the exquisite city of Porto (Portugal).