Meeting the Needs of Children & Families

By: Kyla Donnelly

Case Study: Maria

Maria is a 16-year old girl who is deaf. She is also a single mother with a 4-month old baby. She lost her family when their home was attacked a month ago, and she escaped to another region in the country, leaving everything behind. She is now living alone with the baby. Most nights she makes herself stay awake all night long, because otherwise she will not hear when the baby is crying to be fed. In addition to that, she has a problem when she takes the baby to the local clinic for a check-up. She cannot hear when her name is called by the receptionist, so she missed her turn and has to wait hours and hours in the unheated waiting room. She gave the receptionist a note asking her to put her name up on a piece of paper when it was her turn, or to come and get her, but the receptionist says she is too busy to do this. Maria was told that her baby was also deaf.

The Needs of the Child & Family

Maria is a first time teenage parent with no family help or support. She is also new in the city and probably hasnt met anyone yet. It is important that she has people she can turn to for guidance. Maria and her 4-month old baby are deaf. They cannot hear anything which makes it difficult and stressful for Maria to live her day to day life. When Maria brings her baby to the doctors office the receptionist doesnt notify her when it is her turn; therefore she misses her appointment and has to wait hours longer in the cold waiting room. It would be helpful to Maria if she had someone that could assist her to the doctors office and hear when the receptionist calls for her. On top of that Maria is lacking sleep because she worries that she wont hear her baby when she is crying at night. It would be valuable if Maria could connect with other parents who are deaf and find out what they did in that situation.

Hearing Impairments & Deafness

There are 4 types of hearing loss (plus conductive and sensory mixed which classifies as a 5th type), some more severe than others. Conductive: In most cases this type of hearing loss is usually quite mild and brief. There are complications in the middle and outer of the ear that cause this. Sensory: This type of hearing loss ranges from mild (hears muffled sounds) to severe (no sound at all). The hair cells on the cochlea are either damaged or destroyed making this a permanent hearing impairment. Neural: Neural hearing loss is when the nerve that carries messages to the brain from the cochlea is damaged. Central: This hearing loss is the least common and very hard to treat compared to the others. It has to do with parts of the brain working incorrectly.

Child Care: The Physical Environment

Marias baby is only 4-months old so theres not many physical changes in the environment that would need to be made, but there are modifications that can be made to increase the use of the babies other senses specifically their eyesight and touch:
Attempt to create a more visually appealing room. This can be done by hanging pictures and decorations on the walls and ceiling that are bright and colourful. Create more natural light in the room. Add different toys and materials to the environment that consist of distinctive fabrics and textures. Mirrors are a great item to add to a classroom because it helps the children to become more aware of themselves.

Child Care: Teaching Strategies

At 4-months old Marias baby is still early in development. Teaching strategies are limited because the baby is still so young but there are things that can be done to modify how we interact and teach him/her:

When planning activities for Marias baby do a lot of sensory activities with different textures and materials. Practice basic sign language with the baby so they can learn it and have a way to communicate with the ECE when they want something. (this is definitely important as he/she gets older) Do visual activities with the baby such as hide and seek.

Child Care: Including Other Children

Marias baby is still really young and probably doesnt get too much play time with the other children so including other children at this age is quite difficult but as he/she gets older it will be really important. Strategies to teach the other children would be: Teach them basic sign language so as they get older they have a way to communicate with Marias baby without him/her being excluded because of his/her disability. Include them in the sensory activities to expand the use of their other senses.

Child Care: Supporting The Family

Supporting Maria is really important because she doesnt have any family in Toronto. She is a young, first time parent and needs the support from the daycare staff to make life a little easier and less stressful. Things that can help are: Hiring someone that knows sign language or a staff member(s) learning sign language so communication is easier for her. Providing her with resources that could be helpful and useful. Assuring her that we are doing everything we can to create an inclusive environment for her child.

Agencies & Resources

Cochlear Implants or Hearing Aids Depending on the type of hearing loss that Maria suffers she has the option of getting a hearing aid if she chooses to. (At 4 months Marias baby is a little too young but as he/she gets a little bit older there is the option. The youngest child Sick Kids Hospital has done a cochlear implant on was only 8 months old.) At the moment only two hospitals in Ontario do cochlear implants: 1. Sunnybrook Hospital 2. Sick Kids Hospital Sunnybrook Hospital only does cochlear implants on adults 18 and up but fortunately Sick Kids Hospital does implants on children 18 and under.

Sick Kids Hospital

If Maria decides she wants a cochlear implant there is a process she needs to follow:
1. She needs to Apply to the program by filling out a questionnaire and sending it to Sick Kids. When they receive it they will contact her to book an appointment. 2. At her appointment she will meet with an audiologist who will test her hearing. She will also have to meet with other doctors and surgeons over the course of a few months. When all appointments are done an assessment will be made by the Cochlear Implant Program team to decide if Maria is a good candidate for the implant. 3. If Maria has been approved for the cochlear implant she will then get the surgery which take between 2-3 hours and she will stay in the hospital for one night.

Sick Kids Hospital

After the Surgery:

4. Three weeks for her next appointment where she meets with an audiologist to get the external device of her implant. 5. One week after the equipment appointment she will have another appointment to turn the cochlear implant on. This process is called MAPping and is the first time since the surgery that she will hear sound. 6. After that appointment she will have many more throughout the first year to assess how shes doing and following that year she will have a MAP appointment every 6 months and an evaluation every year.
Sick Kids Hospital Cochlear Implant Program (click the link)

Sick Kids Hospital

Cost of the implant:

Cochlear Implants are very expensive and cost about $24,000 just for the equipment and excluding the surgery. Fortunately there are ways that Maria could afford an implant: 1. OHIP- there is a program called ADP (Assistive Devices Program) that pays up to 75% of the cochlear implant and all Maria needs is an Ontario Health Card. (To be eligible for an Ontario Health Card she needs to be in Ontario for 3 months so she will need to wait another 2 months.)
Ministry of Health Assistive Devices Program (click the link)

2. Fundraising - There is an amazing online website called YouCaring that allows people to create a fundraiser to raise money for anything (ie. Medical expenses, adoptions, tuition for school etc.) and the website is free.
YouCaring (click the link)

Parenting Programs Maria could benefit from some parenting programs because it offers her the chance to meet other parents and get advice and support that she may need. There are a few agencies that I found that offer parenting programs for deaf individuals:

1. Silent Voice (click the link)

This is an organization that overs many programs and services. They help families who have deaf members learn to communicate with each other as well as hearing individuals learn sign language. 2. The Bob Rumball Centre for the Deaf
(click the link)

This centre offers many programs and services for deaf individuals as well as deaf individuals with developmental disabilities.

Silent Voice Silent Voice offers many parenting programs that Maria could attend that relate to her needs and all of them are in sign language. The Macaulay Child Development Centre: This is an 8-week program for deaf parents with deaf and hearing children. Throughout the program they cover topics about discipline, communication, nutrition and more. Parent-Child Mother Goose Program: This is a 6-week program is for deaf and hearing families who use sign language. They cover bonding and communicating with your child, using sign language to tell stories, as well as facial and body language.

Silent Voice (continued)

Make the Connection: Birth to One: This program is for deaf parents with children aged 0 to 12 months. Its a 9 week group that talks about secure attachments, communication, infant learning, the early years and your relationship with your infant. This is a free program offered by the Toronto public health. Living and Learning with Baby: This is a 5-week program for new parents who are deaf with children aged 6 weeks to 6 months. They teach parents how to progress through parenthood and how to build support systems. This is a free program offered by the Toronto public health.

Bob Rumball The Bob Rumball Centre offers more interactive programs for deaf families and a better chance for Maria to get acquainted with other parents. They only have a few that fit her needs but they are offered in sign language. Ontario Early Years Centre: This is a free drop-in playgroup offered at the Bob Rumball Centre for parents who are deaf or hearing with children aged birth to 6 years can connect with each other and give advice and tips on raising and caring for young children. This group is offered on Tuesdays and Thursdays from 9:30am-11:30am. Parent/Infant Program:

This is another playgroup for deaf children aged birth to 6 years. Staff provide individual support to families about making important decisions for their child and implementing goals. This group is offered on Wednesdays and Fridays from 9:30am-1pm.

Financial Assistance It is unknown what kind of financial situation Maria is in but she is a young teenage mother with no family support. Having extra financial assistance will benefit her because she can buy any extra things that her and her baby would need. There are two government programs that Maria could apply for: 1. Ontario Child Benefit (click the link) 2. Assistance for Children with Severe Disabilities (click the link)

Ontario Child Benefit

(click the link)

This program is for any family that has a low or medium income. The amount the family receives depends on the total income they make and receive that amount per child. Maria has one child and could receive a maximum of $1,210 per year. (In July 2014 is goes up to $1,310)

Assistance for Children with Severe Disabilities

(click the link)

This program assist families that have children with disabilities. The amount the family receives depends on the total family income and the severity of the disability but they can get anywhere between $25-$440 a month. Because Marias child is deaf and under the age of 18 means that she is eligible for this program.

Canadian Hearing Society

(click the link) This agency offers many programs and services for the deaf and hard of hearing but not many are extremely useful for Maria. There are two things however that I thought would relevant to her situation. The first is their sale of special devices for people who are deaf and hard of hearing. They have a shop (online and in person) that sells alarm clocks, baby monitors, smoke detectors, carbon monoxide detectors, alerting systems for the door and much more. All these things are essential for Maria because she lives alone. In particular the baby monitors would be really useful to her because she loses a lot of sleep staying awake to make sure she is always there when her baby wakes up. These monitors detect the baby crying and translates into vibrating so Maria can feel when her baby is making noise and can wake up. The devices they sell are pricey and start from $100 and up.

Store Location: 271 Spadina Road Toronto, ON M5R2V3

Contact Information: TTY: 1-877-215-9530 Fax: 416-928-2523 Email: tr.frontdesk@chs.ca Hours of Operation: 9am-5pm

Canadian Hearing Society (continued)

The second service that I found extremely important and useful for Maria was their interpreter services. Their services are usually free for deaf and hard of hearing individuals and anyone can book an interpreter. Maria can book an interpreter if she has an appointment or meeting, but they are also available in emergencies. When booking an interpreter for a scheduled meeting they must be requested three business days in advance and are available during business and evening hours, weekends and holidays. Emergency interpreters are available 24 hours a day every day when immediate attention is required. These services would be convenient when she needs to go to the doctors or hospital.

To Book An Interpreter: Monday to Thursday 8am-8pm Friday - 8am to 5pm TTY: 1-877-843-0368 Skype: callois.chs E-mail: requests@oischs.ca Fax: 1-855-656-3750

For An Emergency Interpreter: TTY: 1-866-831-4657 E-mail: ois@answerplus.ca SMS/Text: 905-971-0564 (charges may apply)

Bibliography

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Morlet, Thierry. "What's Hearing Loss?." KidsHealth - the Web's most visited site about children's health. The Nemours Foundation, 1 May 2012. Web. 6 Apr. 2014. <http://kidshealth.org/kid/health_problems/sight/hearing_impairment.html#>.
"Ontario Child Benefit - What is it?." Ontario Child Benefit - What is it?. N.p., n.d. Web. 6 Apr. 2014. <http://www.children.gov.on.ca/htdocs/English/topics/financialhelp/ocb/what.aspx>.

"Public Information." Assistive Devices Program- Public. N.p., n.d. Web. 6 Apr. 2014. <http://www.health.gov.on.ca/en/public/programs/adp/>.
Sheppard, Mary. "Cochlear implants: A world of sound for the deaf." CBCnews. CBC/Radio Canada, 31 Mar. 2011. Web. 6 Apr. 2014. <http://www.cbc.ca/news/health/cochlear-implants-a-world-of-sound-for-the-deaf1.1058362>.

"Silent Voice Canada." Silent Voice Canada RSS. N.p., n.d. Web. 6 Apr. 2014. <http://silentvoice.ca/#>.
"Start Free Online Fundraising." Free Online Fundraising. Raise Money Online.. N.p., n.d. Web. 6 Apr. 2014. <http://www.youcaring.com/>. "The Bob Rumball - About the Centre." The Bob Rumball - About the Centre. N.p., n.d. Web. 6 Apr. 2014. <http://www2.bobrumball.org/content/3/Centre>. Class Notes from Inclusion of Children with Special Needs