Greetings from FIRST YEARS!
by Kathryn Wilson, M.A., CCC-SLP, LSLS Cert. AVT (kathryn_wilson@med.unc.edu)
FIRST YEARS Program Director

"GOOOOOOD MOOOORRRNNIIIINNNG VEEE-ET-NAM! I have been dying to say that to someone so there it is!" (6/30/11)

So began my email to the homebodies minding the FIRST YEARS "store" while I was away in Vietnam. I joined several FIRST YEARS graduates, faculty, and mentors, who responded to last year's call for volunteers to participate in this year's teacher training program at Thuan An Center in Vietnam. 

Here we share some of our memorable moments in our extraordinary "paying it forward" experience. 

We also welcome a new class of students from nine different states and Canada, congratulate another of our students who earned LSLS credentials, feature a wonderful resource just developed by the clinicians at one of our mentor sites, and conclude our series, part 3, on "Learning to Listen; Listening to Learn," by highlighting documents in our Reference Library. 

A Big Welcome to the Class of 2013!

Alexander, Monica - NJ Bleidt, Marti - CO Bray, Laura - MN Hearing, Jan - OR Jenkins, Barbara - NC Moore, Barbara - NC

Nalley, Karen - CA Pond,  Kent - Prince Edward Island, Canada Santoro, Melissa - PA Sidiropoulou, Maria - CA Stefanelli, Mariette - NY Venhuizen, Karen - TX

Congratulations to Shana Smith Lucius! 
We congratulate Shana Smith Lucius (M.A., CCC-SLP, LSLS Cert. AVT, class of 2011) who just received the Listening and Spoken Language Specialist (LSLS) credential. Shana will soon be relocating to Columbus, Ohio, where she'll be the lead Speech-Pathologist, LSLS Cert. AVT, on the Cochlear Implant Team at Nationwide Children's Hospital. As Shana said (8/29/11): "Best preparation program in the country for the LSLS examination. Very practical, hands on, instructors live and breathe AVT." We certainly agree!

FYI: AG Bell has a new free, 30-minute online course on the requirements for LSLS certification. Its completion awards 0.5 Academy-approved CEUs. Register/learn more here. 

As our summer program draws to a close [June 27 - July 22, 2011], it is quite remarkable to reflect on all that was accomplished. In the course of four weeks, we trained 90 teachers who represented 35 schools and early intervention centers throughout South Vietnam, provided training and consultative support to 55 families, fit 30 hearing aids on young children, trained 18 participants in our new audiology program, hosted four webinars between families in the US and Vietnam ... presented to approximately 80 people at the US Consulate in HCMC [Ho Chi Minh City] about pediatric hearing loss ... visited two pediatric hospital audiology clinics ... translated over 600 pages of material and produced four handbooks for our program participants. Eight interpreters worked tirelessly to ensure the content was understood across culture and language differences. We collected data on each child and family that we met with so we can follow their progress over time. It was quite a month for sure! (Stringer, 7/23/2011)

Paige created a video of the training program and her blog documents the team's accomplishments.
Vietnam Teaching Training 2011
Global Foundation For Children With Hearing Loss: Vietnam Blog
Below, we provide some recollections of our own from the FIRST YEARS participants. As Ellen Thomas concluded (8/31/11): "My time with the Global Foundation for Children with Hearing Loss was actually a continuous memorable moment."

Ann Baumann (class of 2007)
Kim Hamren and I were working together on the first day when Hanh came to her appointment. She was a teacher, a high school history teacher! But she was in class because she had a 3 ½ year old son with a profound hearing loss. When she was pregnant she contracted rubella and saw her physician. Despite the recommendation to terminate the pregnancy, her son was born and she quickly determined he did have a hearing loss. He received hearing aids at 8 months of age. A success, right? But the hearing aids "were not good" (as she described them) and it wasn't until he was 3 years old before he received Phonak Naida hearing aids. She came to the consultation to ask if she should get him new hearing aids or an FM system. 

We didn't have any records and we knew that often the children that were being seen needed significant adjustments to their hearing aids. We asked if she had an appointment with the audiology clinic that was running concurrently this year with the Deaf Education Program. She did not, so Kim ran next door to see if an appointment was available. Miraculously someone had just cancelled and Hanh was able to get the last available appointment the next Monday morning! She was from Nha Trang, about 400 km north and had taken the train for about 7 hours to the Thuan An Center. She was able to arrange for her mother to bring her son to the Center. He was tested and performed like a pro. His hearing aids were adjusted so that he was more appropriately amplified and Hanh was able to speak with Christi Sperry, one of the audiologists, who confirmed the hearing aids he had were appropriate and that the best use of her limited money would be to get him the FM system … Later we were able to participate in a Teacher Consultation with the little boy's teacher (who was also in the Program)! It was truly a privilege to be so involved in this little one's life half way around the world!

Trying to capture in words the warmth of the people we served, the energy and good humor of the team members, the beauty of the children, the faces of parents who struggled to get to appointments and, with apprehension, sought help for their precious children – putting this into words ... that has stumped me! The looks of relief or dread as parents and teachers learned more about hearing loss and technology. The worst was the nuns who wanted to know how long a hearing aid would last for a child. When we said 3 to 5 years typically and maybe less in the humidity, one sister almost cried. For some children they have one and only one chance to get a hand-me-down hearing aid and when it dies, there will not be another chance to get a replacement. She mourned for her students.

The smells of the foods being prepared next to the open window classroom while I lectured, the honking of so many motorbikes in the never-before-seen-traffic patterns, the way the participants in the program sang when we went out to dinner – without any alcohol! They just loved to sing, laugh and gently tease each other and us! The heat and humidity was memorable for this girl from the Pacific Northwest! (8/31/11)

Kim Hamren, FIRST YEARS mentor
This year was the first year for individual teacher consults. Teachers could sign up for hour-long sessions to ask any questions they had. Nearly every hour was filled, and the questions ranged across topics of audiology, behavior concerns, lesson plans ... There were 2 separate teachers who came to their sessions with the hope of finding out "How to start their own early intervention program."  Both had attended the first year [2010] and both had returned this year with the goal of starting early intervention services the following school year. It was amazing to see how quickly such programs were growing, changing, and investing in expanding their services for young children and their families as a result of attending the Teacher Program! (9/13/11)

Ellen Thomas, faculty
Hillary Zanek and I were facilitating a discussion on goals and developmental stages.  Hillary told the group, "You have a child who is 12 months old and a toy duck – that's your only toy. How will you make it work?"  Good discussion followed leading us to the next level where the child is now 18 months … and you have a duck.   Again good discussion. Then the child is 30 months old … and you have a duck.  By the time the child was 4 years old, the teachers were running low on ideas, but one enterprising teacher announced, "Now we will cook the duck."   In all seriousness, she proceeded with a lesson on duck-cooking! (8/31/11)

Helen Zuganelis (class of 2005) 
I have a story that spans both summers in Vietnam, 2010 and this summer. During the consultant sessions, behavior concerns are often addressed among the families. One young boy I first met in 2010 was a definite challenge. The boy had multiple health issues and had undergone several surgeries that had been donated by other organizations, including one for his eyes and one for his heart.  The little guy came into the therapy room and tore it apart.  If he didn't get whatever he wanted, he was instantly throwing himself on the concrete floor and banging his head.  Mom and grandma were so exasperated and embarrassed they couldn't figure out what he wanted fast enough to avoid these horrible, scary tantrums, which occurred several times a day. Over the course of several sessions we mostly practiced managing behavior, and I was never fully confident I had actually done anything for this child.  We barely had the chance to address issues surrounding his hearing aids and hearing loss.

Upon returning to Vietnam in 2011, by chance, every child that had been assigned to me was new to the program and I did not see any families or kids I recognized.  I felt twinges of sadness about this fact since I had been so excited to reconnect.  My last night, I finished up with a family and walked into the next room to see if a colleague needed help.  There was my little guy from the previous summer!  Mom and grandma jumped up to hug me, which to my understanding is not a common Vietnamese custom.   Through the interpreter, they could not stop thanking me for everything I had done for them last summer.  They reminded me about the head banging.   They described how they had worked on his behavior after I left.  Since then, he has replaced the head banging behavior with crossing his arms and making a "pout face."  Mom and grandma were so thrilled with this change and so excited to see me they wanted to show it off!  It did not take much time for him to get upset about not getting what he wanted.  Almost on cue, he turned around, squatted down, crossed his arms and made a pout face!  I thought to myself… "That experience is the reason I was meant to come back to Vietnam this summer and that experience is the reason I hope to come back again." (9/16/11)

Helen Woolard, photographer
Joining the group as photographer was another person with a FIRST YEARS connection - Helen Woolard. Helen is a current UNC student who got her first CI at age 7.  That is when Kathryn Wilson met her while working on the CI team. 

Helen documented the trip with a blog, full of photographs, and memories. Seen at right, Helen captioned the shot with: "A few of these women gave me a 'feel-ski' today when they reached inside my dress to see my old implant that sits in my bra, and rubbed my hair to find my magnets to my cochlear implants.² They were so curious that I laughed so hard resulting in extreme importance to take a photo with these women. They are definitely not what you would define as shy. What another great day." (6/29/11)

Enjoy her pictorial journey here: helenwoolardphotography.blogspot.com (scroll to begin at July 15, 2011)

Notes:
¹The first Vietnam Mobile Mission was conducted in January 2011. The mobile teams coach teachers in their own classrooms to reinforce learning gained in the summer. They also provide audiology training and support to children. VIDEO montage of this event. 
²The device Helen is talking about is her old one that is body worn.  She got her newest one just after exams in May 2011.

In the last issue we shared a discovery about the Ling Sounds: Not all sounds mean the same thing in all cultures! Specifically, as Ann Baumann (class of 2007) wrote in an email: "I don't think the Ling sounds are the same ... or at least, the /s/ for instance, isn't one they'd use in 'polite company' because it is the sound they make to indicate someone is going to the bathroom!" (3/25/11). Subsequent research uncovered that the same problem existed in Cantonese (but not Mandarin). 

Elizabeth Cole, author of our Basic Speech Acoustics course, suggested some alternative sounds to use to explain the principle behind the Ling sounds ... which seemed a logical resolution until ... Kathryn Wilson emailed (6/4/11): "All very timely ... I just finished watching a video of one of the Vietnamese teachers sent in for the training.  She started the session with the Ling Sounds and she did do the /s/!!!"

What was used? Kathryn solves the mystery:

Having traveled in several countries and working with people from various cultures, I have learned the importance of not doing or saying anything that could be perceived as offensive. The old saying "When in Rome do as the Romans do" is useful advice!  As you might imagine, it was a bit of a relief when I watched that video back in June and observed the teacher using all six of the Ling sounds. I began to think that a discussion of the Ling Sounds, how and why we use them would be okay afterall.  This proved to be the case. In Vietnamese, there are vowels, consonants, consonant clusters, and then there are "tones."  One of the consonants is the "s."  The teachers administer ALL the Ling Sounds at the beginning of their sessions and they have learned how to interpret a child's responses. Everyone seemed completely at ease with their understanding and use of the six sound test. Mystery solved!!! 

In part 1 of this series, we shared the Auditory Learning Guide/ALG, examined in the unit on facilitating auditory learning.  In part 2 we featured our compilation of Tests & Measurements: Auditory, Speech, Language and General Developmental, covered in the language units. 

In the last course unit, on speech development, assessment and intervention, we feature Ling's "PLEs," i.e. the Ling Evaluations for Phonetic and Phonologic³ Levels. Want to learn how to use the PLEs? Come take our course! 

Here, in part 3, the conclusion of our series, we highlight the Infant / Toddler Speech Inventory, recommended for children who are not yet able to respond to the tasks required for the PLEs. 

FIRST YEARS. (2009). Infant / Toddler Speech Inventory
The Inventory is useful for keeping track of segmental and nonsegmental speech features in both imitation and spontaneous productions.  During weekly sessions with the child, the professional can update the chart with new developments by listening to the child and recording sounds the parents have heard.

And a bit of fun ...
In the course, we also give Brading's Developmental Ages for Sound Mastery and suggest creating phrases, for mnemonic devices, to help in remembering the ages at which various consonant sounds are mastered. For example, "Poor Mary Never Has Water" gives the consonant sounds typically mastered by age 3. 

Brading, T. (2006). Developmental Ages for Sound Mastery
In last year's group, this inspired some creative "competition" in our forums. We share a few of the creations to end with a smile.

6 years old (t, r, l, ing) 
— "Tracy Really Likes Swinging"
— "Teachers Really Like teaching!"

7 years old (ch, sh, j, th) 
— "All boys love to ...Chase Shout Jump Throw"
— "Jumpy Sheep Chew Things"

8 years old (s, v, z) 
— "Very Sweet Zookeeper!"
— "Very Stinky Zebra" 

... and the all-around favorite ... 

8 years old (s, v, z)
— "Steven Van Zandt" (I couldn't help it ... I'm a Jersey Girl still in my heart!) 

When questioned about her phrase - Who is Steven Van Zandt? - Dara Breitkopf (class of 2011) responded (11/27/10): "He plays with Bruce Springsteen & the E Street Band (which is why I had to include him and get back to my NJ roots!). He's also known as Little Steven ... Little Stevie ... and seen often wearing a bandana. Maybe that will strike your memory. Or maybe not!"

With a bit of help from Wikipedia, that phrase proved one not soon forgotten! 

In 2008, Nancy Caleffe-Schenck and Dian Baker developed a wonderful resource – Speech Sounds – on consonant development and teaching. 

Caleffe-Schenck & Baker. (2008). Speech Sounds. A Guide for Parents and Professionals

Separate chapters are devoted to ...

– Plosives and Stops - p/b, t/d, k/g
– Fricatives - h, f/v, TH(voiced) /th(unvoiced), s/z, sh/zh
– Nasals - m, n, ng
– Semivowels - w, y
– Liquids - l, r
– Affricatives - ch, j

When initially published, there was no companion resource for vowel work. Back then, one of the student exercises in our course on Listening & Spoken Language Development & Intervention was to develop similar resources for vowels. 

That assignment is no longer.  A group of clinicians at the University of North Carolina-Chapel Hill CASTLE program, a mentor site for FIRST YEARS, has just developed Speech Sounds: Vowels. Hot off the press, it is included below:

CASTLE. (2011). Speech Sounds: Vowels. A Guide for Parents and Professionals

Jane Madell, Ph.D., CCC-A/SLP, LSLS Cert. AVT, and Carol Flexer, Ph.D., CCC-A, LSLS Cert. AVT, are requesting feedback from parents on whether their children are using FM systems and, if they are using them, at what age and in what conditions. Feedback will be used for future publications and presentations. To participate, direct parents to  http://www.surveymonkey.com/s/FMkids to complete a brief survey. Feedback will be collected until Oct. 1, 2011.

1. Barton, C.A. (class of 2011). (2011). Music and literacy development in young children with hearing loss. A duet! Early Childhood Online Magazine, 2(1), 53-55.
2. Talking Tips - To subscribe to Talking Tips, send an email to: learntotalk@cox.net
1. Rossi, K. Talking Tips, July, 2011. (Theme: "On the go")
2. Rossi, K. Talking Tips, August, 2011.
3. In July, 2011,  The Volta Review released a monograph edition - A Strategic Analysis of State Early Hearing Detection and Intervention Programs - with several articles by faculty member Gayla Hutsell-Guignard. The monograph edition analyzes results from a survey questioning all 50 EHDI state coordinators on the strengths and needs in EHDI programs. 
1. Bradham, T.S., Hoffman, J., Houston, K.T., & Hutsell-Guignard, G. (2011). Fostering Quality Improvement in EHDI Systems.
2. Houston, K.T., Bradham, T.S., Muñoz, K.S., & Hutsell-Guignard, G. (2011). Newborn Hearing Screening:  An Analysis of Current Practice.
3. Bradham, T.S., Houston, K.T., Hutsell-Guignard, G., & Hoffman, J. (2011). Strategic Analysis of Family Support in EHDI Systems.
4. New web page at AG Bell on "Back to School" at http://nc.agbell.org/NetCommunity/Page.aspx?pid=1323

1. Barton, C.A. (class of 2011). (2011, September 15). Constructing meaning in music and text: implications for literacy development in young children with hearing loss. Early Childhood Online Magazine. [podcast, also accessible after 9/15]
2. Heavner, K. & Vernelson, S. Bloom & Lahey II / CASLLS II: Roadmap to Language Development. November 14-15, 2011.. LSLS credit.
3. Henderson, L., Knott, M. & Teagle, H.F.B. Cochlear Implants & Challenging Cases. December 12, 2011. LSLS credit.
4. Stringer, P., Boulse-Archaro, T., Fuller, J., Ganek, H., Zuganelis, H. (class of 2005). Changing Lives in Vietnam: Collaborating for Children with Hearing Loss. ASHA Annual Convention. November 19, 2011. 
5. Vernelson, S. "Roadmaps" Review & Make it, Take it. September 17, 2011.
6. Walker, B. & Wilson, K. Accelerated Growth for the Late Beginnng Listener ... Tools, Teams, and Tactics. NC AG Bell/CCCDP Fall Conference, Asheboro, NC, November 3, 2011. LSLS credit.
7. Wilson, K. Engaging Parents and Family Members in Early Intervention. EDHI Fifth Biennial Pediatric Audiology Symposium. Co-conference sponsors: Southeastern Regional EHDI Conference & NCHAM Investing in Family Support Conference. Raleigh, NC, October 26-28, 2011.

© 2011, The University of North Carolina at Chapel Hill FIRST YEARS Certificate in Auditory Learning for Young Children with Hearing Loss. All rights reserved. May be reproduced in any medium for non-commercial purposes.
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