The Ripple Effect

Our Vietnam Deaf Education Program is putting an advanced twist on the old adage -- "give a man a fish and he eats for a day, teach a man to fish and he eats for a lifetime".  We directly teach about 90 teachers across 38 schools in 20 Vietnam provinces in our training program about how to help young children with hearing loss learn to develop spoken language.  But perhaps what is more impactful is the organic ripple effect of knowledge and benefit that our training is creating. 

When these teachers return home from our training programs, they are sharing their knowledge with other teachers and families in their own schools and communities who are then applying the lessons learned.  Furthermore, our program has fostered networking between teachers across the participating schools in our education program and across functions to include professionals in our audiology program.  We teach both audiology and auditory-verbal therapy/education in an integrated fashion at each training program because both fields are equally necessary to help a child with hearing loss  succeed.  Not only are the children being served today directly benefiting from the growing knowledge and expertise of the participants in our training program, but also the children who these teachers and other professionals will work with well into the future. The benefits are exponential and sustainable.

Thuy and I visited three schools in three different provinces over the past few days. All three schools have teachers who have been enrolled in our training programs for at least two years.  There were numerous examples of how our program is making a mark in both subtle and dramatic ways -- from the way teachers are now approaching their work to the changes to facilities and classroom design to the stories they shared with us. 

For example. the Global Foundation's team of educational professionals have been stressing the importance of utilizing everyday listening and language opportunities in the teachers' instruction. Rather than a rote approach of having the children repeat words or sentences after the teacher, teachers are being encouraged to apply interactive activities that foster natural conversation in the learning process. This has been perhaps one of the most difficult concepts for the Vietnamese teachers in our program to grasp because it is a such a different approach from what they are used to.  However, these past few days, we have seen evidence that the teachers are moving in this direction with positive results. 

One teacher built an entire lesson around jackfruit. She brought in a jackfruit for her kindergarten class. They talked about what it looks like and what it tastes like. They had an interactive discussion around a colorful book the teacher created about the jackfruit's lifecycle. They talked about how to cut it open and how to eat it. The conversation was lively and completely conversational throughout.  In the course of learning about a kind of fruit, the class of eight children with hearing loss were also practicing listening and speaking.

In another example, a teacher told of how a parent came to their school with a child newly identified with hearing loss. The educational staff directed the family to a hearing aid distributor in Ho Chi Minh City that they now have a relationship because of our training program. After securing the hearing aids her child needed, the mother attended our parent program during our summer training to learn how she could help her child at home. She started applying the strategies she learned from our course. Meanwhile, the school started early intervention therapy instruction as a result of our training program and was able to offer early intervention therapy services to the family. As a result, the child dramatically improved his auditory and language skills in a short period of time and continues to progress quickly.

It has been incredibly rewarding to hear and see the testimonials of the impact of our program.  The ripple effect carries on.

First Stop: Dong Nai

Thuy and I are visiting schools across the South that are enrolled in our Vietnam Deaf Education Program.  Our first stop was an early intervention and  day school program in Dong Nai province. All the teachers of the deaf who work here are enrolled in our program. They have 3 classrooms of 4 and 5 year olds and an early intervention program – about 45 children with hearing loss under 5 years old in total .  

We spent time observing the classes and it was obvious the teachers are implementing approaches that we are teaching in our Summer Training Program.  The teachers have made some adjustments to their techniques and the children are responding well.  In the afternoon, we met with the teachers and administrators who shared their thoughts about the areas they would like further instruction on during our program next summer including more time spent on assessment and how to teach children across different levels of abilities in one classroom.  They are earnest in their desire to continue to develop as teachers. 

One of the main challenges the school faces is ongoing audiology and hearing aid care for the children.  The kids get services from a hearing aid company who travel there 2 times a year from Ho Chi Minh City. Parents travel about 3 hours one way to Ho Chi Minh City to get care in between these visits. Not ideal of course…and so we spent time talking about that issue and how to address. It was a productive day and Thuy and I appreciated warm welcome. We learned a great deal that will be useful to us as we continue to develop next summer's program and in addressing the larger issue of how best to serve these children and their families.

Hitting the Road

The success of our Vietnam Deaf Education program is grounded in strong collaboration with the Vietnamese healthcare and education communities. Through open communication and ongoing dialogue, we have developed mutual trust and friendship and a shared commitment to achieve identified goals.

The Global Foundation's executive director, Paige Stringer, is back in Vietnam this month. One of the objectives of this trip is to visit teachers and administrators working at some of the participating schools in our Vietnam Deaf Education Program. There are 38 schools for the deaf spread across 20 provinces enrolled and they all face unique challenges and opportunities for serving children with hearing loss. We will visit six of these schools over the course of the next week, observing classrooms and meeting with the staffs to gather information and feedback. This information will be useful for continuing to understand the educational landscape in Vietnam, and will help further the Global Foundation's efforts to continue to support the needs of the teachers, therapists, and young children with hearing loss and their families.

We're starting off early this morning on a road trip to school visits in Dong Nai and Lam Dong. We'll be sending updates from the field in this blog along the way about what we observe and learn.  We hope you will join us!

January 2013 Mobile Mission Highlights

The Global Foundation team completed its third Mobile Mission at the end of January 2013. It was another successful endeavor. Here are the highlights....

We spent a week at Children’s Hospital 1 in Ho Chi Minh City. This was our second Mobile Mission at CH1 and third training there. Eighteen doctors and technicians including four from Hanoi attended the audiology training led by Global Foundation audiologists Jane Madell and Elizabeth Preston. The training focused on behavioral and diagnostic testing in lectures, practicum, and live sessions with families. Hannah Eskridge and Lillian Henderson led the auditory-verbal training with 12 therapists, most of all of whom have participated  in our Summer  Training and/or past Mobile Missions.  The mornings were spent in hands-on practice and coaching in therapy sessions with families while the afternoon was devoted to planning and discussion.  All was well received and the hospital has requested that we return soon.

During the Mobile Mission, we also spent a week at Thuan An Center, an early intervention and educational program in Binh Duong.  Global Foundation auditory-verbal education professional Ann Baumann observed the Vietnamese teachers in the kindergarten classrooms and provided them with coaching feedback on strategies and activities used.  Ann and the Vietnamese teachers reviewed concepts taught during the Summer Program and worked together to build on the expertise of the teachers in areas of assessment and lesson planning.  It is remarkable to see the progress that these teachers have made since we first started working with them in 2010.  Back then, they did not evaluate children for their language and auditory skills, set goals, or engage in any structured lesson planning. Now they are doing all of that and more. The children are making noticeable strides in their auditory and spoken language development as a result.

While at Thuan An Center, Jane and Elizabeth coached 18 audio-technicians through the process of pediatric hearing testing, fitting of hearing aids, and counseling parents.  New hearing aids were provided to 7 children. Over 50 children were brought in during the course of the week for testing and the majority of these children are children that we have been tracking over time. By developing case history and working with the Vietnamese to measure their progress, we are ensuring these children are hearing optimally and have every opportunity to learn to listen and talk. The audiology participants also checked the personal FM systems used at Thuan An Center and learned how to troubleshoot and address problems.

The Global Foundation Mobile Mission team was invited by the Hanoi University of Education to conduct a 2-day workshop in Hanoi as a potential first step towards national expansion of our work.  Thirty-one Vietnamese professionals and 11 Vietnamese parents attended the day program.  Jane, Elizabeth, and Hannah combined lecture with breakouts and practicum to introduce concepts in listening and spoken language development and audiology.   We conducted a parent night during which about 40 parents came to ask questions and learn about how to help their children with hearing loss at home.  The participants of the 2-day workshop gave glowing reviews about our work and expressed a strong interest to have us return for more training on a larger scale. 

We launched a Video Analysis Program last Fall to provide ongoing support to Vietnamese teachers and therapists enrolled in our Deaf Education Program during the year. The Vietnamese submit videos of themselves working in classrooms or therapy sessions. The videos are transcribed into English by Vietnamese university student volunteers. The Global Foundation professionals review the videos and provide feedback that is then translated to Vietnamese and shared with the Vietnamese professionals, The introduction of this program was very popular with the Vietnamese. They set up study groups to analyze their videos and our team’s feedback together to get the most out of the experience. We will conduct our next round of video analyses in March 2013. We identified therapists and teachers from CH1 and Thuan An Center that are demonstrating potential and invited them to participate in this program.

We are now laying plans for our fourth Summer Training Program, scheduled for July 2013 at Thuan An Center.  Vietnamese teachers and therapists will take part in the Level 3 and 4 early intervention and classroom tracks and we will also conduct audiology training. The more advanced participants will be asked to lead some of the training of their peers.  We plan to instruct teachers from mainstream schools about audiology and how to address the needs of children with hearing loss in their mainstream classrooms.  We will also provide counsel to school administrators and other professionals looking to set up audiology programs in their communities. We will again have a parent program for parents of children with hearing loss. The Global Foundation’s team comprised of audiologists, deaf educators, auditory-verbal specialists, and speech pathologists is in place. It is inspiring to be a part of an effort that is empowering many who are asking for and are open to new ideas and advancement in their approaches to their work. 

Homecoming

Tonight we had a Parent Workshop for about 30 local parents of children with hearing loss. We started the night with a video captured earlier in the day of a former student of Thuan An Center. He was born with a hearing loss and wears two hearing aids but has been successfully mainstreamed into his neighborhood school. This child has been a part of our summer program in the past and his mother took lessons learned to help him develop his spoken language skills. He was here today for a hearing test with our audiology program.. While he waited for his appointment,  he agreed to be filmed as an example of success for our Parent Workshop. While the camera rolled, he sat in Thuy's office bantering away with his mother about ice cream and stickers like any other 10 year old child.

We also invited a parent who is in the Collaboration Coalition to share the story about her own young child's hearing loss. She talked about how she worked to educate herself so that she would be better able to advocate for her child's needs. She gave specific examples of strategies and tools that she learned through the Global Foundation's summer programs to help her child at home such as how to make experience books to foster literacy and language. Her daughter is on target in her listening and spoken language development.

Back in 2010 on the eve of our first summer workshop, I met a father who had just learned his 2 year old daughter has a hearing loss. He was feeling helpless and concerned about his daughter's uncertain future as he didn't have any knowledge about deafness. He enrolled into our daytime program that year and also attended the evening parent series so he could learn everything he could about how to help his daughter learn to listen and talk.  He continued his education with us in subsequent years, set up a therapy room in his home, and sought the support of the teachers at Thuan An Center who are engaged in the Global Foundation's program. 

His daughter is now in kindergarten and doing very well. Last summer, the Global Foundation and our Deaf Education program was featured on Talk Vietnam, a Vietnamese national television show. The segment included the story of this family as an example of what is possible when children with hearing loss have access to appropriate hearing technology, trained professionals, and a committed family.  The little girl was outgoing and poised beyond her years in demonstrating her spoken language abilities in spite of a big television camera and a stranger of a cameraman directly in front of her face.  Today, this child and her father came to Thuan An Center for a hearing test by our audiology program. While she waited for her appointment, she talked away to a big circle of parents and teachers who  all were clearly inspired.  This little gal has a bright future ahead.

Back at tonight's parent meeting, Jane gave a presentation about language development and the auditory brain. We wrapped up by answering questions from the parents that ranged from listening checks to deciding on hearing technology to their children's language and speech. These parent nights are one of my favorite elements within our training programs because of the passion these families have for helping their children.

A Focus on Classrooms

We're spending the week at Thuan An Center, an early intervention and school program for children with hearing loss located in a semi-rural community outside of Ho Chi Minh City. Thuan An Center is the Global Foundation's partner in Vietnam and the host of our annual summer training courses in audiology and auditory-verbal practice.

The goals of this week are two-fold. We're furthering the auditory-verbal teaching skills of the Thuan An kindergarten teachers who have been engaged in our summer training program. We also are training technicians and educational audiologists and checking the hearing and hearing technology of children we are following in our audiology program. We want to be sure these children are hearing as well as possible so they can continue to develop skills in - and learn through  - listening and spoken language.  

And because audiology and education cannot act in isolation to benefit children with hearing loss, we continue to promote more collaboration between the technicians and education staffs. This is so fundamental to the Global Foundation's Deaf Education Program and why we have an integrated model across therapy, education, and audiology. We cannot help children with hearing loss learn to listen and talk well without good communication and synergy between those who manage the children's hearing and those who work with them on their language development, including the parents.

There are 3 classroom teachers and 3 therapists in Thuan An's kindergarten program and 35 children enrolled who are all between 5 and 6 years of age. They have hearing aids, cochlear implants, and FM systems to help them hear. The teachers are developing and carrying out strategies to help the children make use of hearing technology and further their oral communication skills while in the process of learning.

This week, Ann Baumann is observing classroom activities in the morning and providing feedback for the teachers via video and discussion each afternoon. We're focused on assessment and lesson planning. Ann is also helping the teachers continue to move away from a focus on rote teaching to a more experiential model. One of the priorities is to help teachers incorporate listening and language goals seamlessly into their classroom activities so that these skills are developed throughout the day rather than just during a structured period of time. We listen and talk as a part of our daily lives and so we want to create the same experience for children with hearing loss as they go through their educational process.

Jane Madell and Elizabeth Preston are working alongside the Vietnamese audiology program participants who are checking the hearing and hearing technology of children enrolled in our Deaf Education Program. Most are from Thuan An Center but there are others from outlying areas as well.

For a twist on things, the town turned off the power grid today to make some street repairs. That meant no electricity (or air conditioning) was available- which was a problem for audiology.  Fortunately, we  were able to secure a generator to power the audiology equipment and we were back in business in time to test 12 children today (even if our team was left a bit warm for comfort).

We have followed the progress of many of these children over time through our program and through communication with the Vietnamese professionals. All of the audiology participants this week have engaged in our past audiology training programs. We are ensuring their continued professional development in pediatric audiology and effective case management of the children.

In addition, we are checking the hearing and hearing aids of children involved in a collaboration coalition pilot project. The Vietnamese started this coalition after our 2012 summer program. The objective is to set protocols and processes for serving young children with hearing loss and their families across hospitals, early intervention centers, audiology clinics, and the schools. The coalition has identified a group of 40 children around which to build a support system. Once the structure is in place, the goal is to expand the model to other parts of Vietnam so that children with hearing loss and their families have the network of support they need to be successful.

We're seeing progress made by participants in both programs and the positive impact that such progress is having on the children. We'll take the observations from this week, gather feedback from the participants, and incorporate it all into our plans for our fourth year summer program this July 2013.

Road Map to Learning Language

Global Foundation auditory-verbal therapists Hannah Eskridge and Lillian Henderson have been working this week at Children's Hospital 1 with 12 therapists from Ho Chi Minh City and Hanoi. They are furthering the expertise of these Vietnamese professionals in developing plans and strategies to help the children make use of hearing technology and develop spoken language. 

We are developing and customizing a curriculum for teachers and therapists enrolled in our Vietnam Deaf Education Program that addresses the nuances of the Vietnamese language. We rolled out the curriculum this week and the response from the participants thus far has been positive. 

This week's workshop is focused on vocabulary development and how to set audition, speech, and language goals.  Each therapist has been assigned to a family for the week.  In the morning, the therapists are executing on lesson plans they developed for their family. The afternoons are devoted to short lectures and planning sessions for the following day's therapy sessions.  It has been fun to watch the creative juices flowing as participants are grasping the process and coming up with innovative ways to help children reach goals while in the midst of play activities.

Over 75% of the Vietnamese participants in this workshop have taken part in the Global Foundation's Mobile Missions and Summer Training Programs over the past 2 years.  They have been demonstrating great progress this week in their acumen and confidence for applying auditory-verbal approaches. It is translating to positive language development outcomes for the children they serve.