Friday, March 14, 2014

The Power of One and Team

I have two favorite quotes – the first, “if you think you are too small to make a difference, you have never been in bed with a mosquito”.  And the second  – “never underestimate the power of a small group of committed citizens to change the world…indeed it is the only thing that ever has”

There is the power of one and there is also the power of collective.

Our Vietnam Deaf Education Program has been so successful because of the accountability and dedication that each person involved has brought to the effort.  The Global Foundation professionals volunteer their time and expertise year-round to helping the Vietnamese develop the skills, knowledge, and processes they need to support children with hearing loss. Its about empowering others to help their own.

The Vietnamese are applying what they learn to their work and sharing that knowledge. And, they are also acting as stewards of this program. For instance, we had an evening educational seminar for families of children with hearing loss a couple of programs ago that was held at a hotel instead of our usual school or hospital venue. The conference room where the seminar was to take place was difficult to find. Without any prompt from us, one of the Vietnamese teachers in our program - who drove four hours to attend, by the way -- stood outside and directed families into the hotel and up to the conference room. She missed the first hour of the seminar but it was more important to her that the families got the information they needed.

In another example, we had a need for a large volume of interpreters for our Summer Training Program. Concerned about the cost of so many interpreters and the potential impact on our budget, Thuy, our program partner, sought out a new relationship with the Hoa Sen University English department. She worked out an agreement with the administration there whereby students would have the opportunity to volunteer their translation and interpreting skills to our program in exchange for credit hours. This was her own idea and I only found out about it when the deal was done and all the pieces were in place. These students have stayed involved over time, bringing wonderful energy and compassion to the program.

At the same time, this program is about bringing together great minds in Vietnam and abroad to find and address gaps in the system of support so that children with hearing loss can reach their full potential in their hearing communities. Such a clearly articulated goal and a shared commitment towards achieving it makes the process of getting there much easier.  There is no "us" and "them" but rather a cross-cultural team that inspires - and is inspired by - each other.

We have such an opportunity to leverage the power of team to set clear goals and drive to great outcomes. In the process, if we can each take personal responsibility for our contribution to the whole while also encouraging each other to do the same, well…the possibilities for achievement are truly unlimited.

Thursday, January 23, 2014

Holistic Training to Benefit the Kids

Our last week on this January 2014 Mobile Mission has taken us to Thuan An Center, an early intervention and school program outside of Ho Chi Minh City. After weeks in the hustle of the major cities, it has been nice to have a bit slower pace out in the countryside.

Sally Tannebaum is leading the auditory-verbal training this week, providing lecture and hands-on instruction to the therapists in our advanced group who work in school settings around the South.  Each morning, young children come in for listening and spoken language sessions with the Vietnamese participants who then receive coaching support from Sally.  The afternoons are devoted to feedback and lesson planning.  Many of the children and families taking part also engaged in our past Mobile Missions and Summer Training programs. So it has been wonderful to see their progress and the growing confidence of the parents to execute strategies to help their children.

Meanwhile, across the street, Joan Hewitt and Jane Madell are working with a group of audiology technicians who work in the schools and local clinics.

One of our organizational goals is to leverage the relationships we have with the 38 schools in our Vietnam Deaf Education Program. to establish regional audiology centers. These regional centers would be housed in a select group of schools in our program and would be a resource for families who live far away from Ho Chi Minh City. The centers will also enable teachers and therapists at the schools to more quickly respond to the children's audiological needs. Currently, families have to take time off work - often unpaid - and travel great distances to the city to get care.

As part of this vision, we are training the audiology technicians who would support these regional centers.  Unitron donated audiology equipment to support the regional audiology center concept and also several hearing aids that the Vietnamese technicians have fit on young children in need during the audiology training this week.

Joan is also working with Vietnamese technicians who support children in the region with cochlear implants to be sure the children are hearing as optimally as possible.

Friday, January 17, 2014

Laying Foundations in Hanoi

The Hanoi National Pediatric Hospital invited the Global Foundation to launch a training course at their hospital to help their doctors and technicians further skills to support their pediatric audiology program. This was our first Mobile Mission workshop here as part of this new effort. Jane Madell and Joan Hewitt provided instruction on pediatric testing protocols, speech perception testing, and cochlear implant mapping. Several children were brought in to provide a practical learning experience in the audiology booth and cochlear implant mapping room.

Jay Rubinstein lectured to the doctors about cochlear implant surgical procedures and complex cases. He operated alongside the Vietnamese surgeons in providing a young child with a cochlear implant. It was a solid first training course and we look forward to continuing our program there in the future.

Meanwhile, across town, our auditory-verbal therapy training program continued in its second year with a select group of therapists at Hanoi National University of Education.  Erin Thompson and Sherri Vernelson continued the Global Foundation curriculum with a focus on developing speech goals and strategies. Vietnamese therapists led sessions with children under 6 years of age and their parents each morning.  During these sessions, Erin and Sherri provided coaching support. Feedback sessions were provided later in the day as well as time for planning activities for the following day's therapy sessions.

Wednesday night, we conducted a program for families in the evening. About 50 parents and caregivers attended. They learned about strategies that they could use at home to help their children with hearing loss learn to develop listening and spoken language. The session ran late into the evening but the families remained rapt in attention, just absorbing as much information as they could. It was a powerful evening of deep emotion and cautious optimism.

Friday, January 10, 2014

A Good Week in Ho Chi Minh City

Our first week of Mobile Mission training at Children's Hospital 1 wraps up today. Sherri Vernelson and Erin Thompson have been working with a group of therapist who are rapidly demonstrating good skills to help children with hearing loss make use of their hearing technology and develop spoken language. These therapists have been enrolled in our program for three years. Each morning this week, little girls in their dresses and young boys in pressed pants would come in with their moms and/or dads to engage in therapy sessions.  The Vietnamese led the sessions with the families while receiving feedback and coaching from Erin and Sherri.  Time was also devoted to small group discussions about specific topics and strategies and
to developing plans to help the children continue to progress.

Meanwhile, Jane Madell helped the Vietnamese audiology technicians continue to develop skills in evaluating the hearing of young children through behavorial testing (VRA, play audiometry). Over 50 children were tested this week, providing ample opportunity for the Vietnamese to benefit from Jane's expertise and coaching support.

At one point, it was discovered that a little girl was scheduled to come in for testing on her 3-year-old birthday.  To make the day a brighter one for her, the whole group broke out into a rendition of Happy Birthday as she entered the sound booth. Big smiles all around!

Myriam de la Asuncion worked with audiology technicians on mapping techniques for children who have cochlear implants. Families must pay out of pocket for the cost of cochlear implants in Vietnam. However, growing numbers of children with profound hearing losses are getting them. It will be important to continue to develop the skills of these technicians who work with this segment of children into the future. 

Jay Rubinstein worked alongside the Vietnamese doctors in the operating room to provide three children with cochlear implants. All went well and the families were very grateful. The local media captured the experience and produced a television segment about the work which can be viewed here. The before and after photos:

And now..its on to Hanoi!  

Wednesday, January 8, 2014

Making It Real

One of the key messages that we focus on with everyone enrolled in our program is the importance of collaboration between doctors, audiologists, teachers, and therapists in case management of children with hearing loss.

During our Video Analysis Program last October, one of the therapists captured a video of herself leading a therapy session with a child she works with regularly. She sent the video to the Global Foundation for feedback from our team of auditory-verbal professionals. In her notes that she included with the video, there was a comment that the child did not seem to be hearing as optimally as possible. When we asked her about it, she had not thought to talk to the local audiology department about her concerns.

Today, the doctors, audiology technicians, and therapists taking part in our program were gathered in one room for lecture and discussion.  We asked this therapist to present this child's case. We had an open discussion about the roles of the doctors, therapists, and audiology technicians in case management and how to work together to troubleshoot and address potential problems like this one. The Vietnamese listened intently to the therapist's concerns and then discussed together about what they should do to troubleshoot the situation and try to resolve the issue.

It is moments like these that bring the theory and study of best practices to life.The next time there is concern about a child's hearing, these therapists and audiology technicians may be more likely to think about reaching out cross-functionally to address problems. Fostering trust and shared accountability is important, especially for the child whose hearing is in question.

 It would have been easy for our Global Foundation audiology professionals to test the child and make any necessary adjustments while they are here in Vietnam. However, that would create dependency. Our goal is to enable the Vietnamese to take care of their own children. With coaching and guidance, our team can share new ways of doing things that may help the Vietnamese professionals in their own work.  When we are not here, they then have the skills, knowledge, and most importantly -- the confidence  -- that they can address situations like this one themselves.

Monday, January 6, 2014

Mobile Mission 2014 Gets Underway

It felt a bit like visiting the home of good friends when we arrived at Children's Hospital 1 today for the start of our latest Mobile Mission program. The room was filled with familiar faces of the therapists and audiology technicians who have been enrolled in our program for the past 3 years and have been working diligently to apply the lessons from our curricula into their daily work. The ENT doctors filed into the room in their white coats with big smiles, eager to hear from our team of professionals.  

Jane Madell started things off with a group lecture about language and the auditory brain. She stressed that good auditory access by way of hearing aids or cochlear implants is directly tied to performance in speech perception and vocabulary development.  The therapists then gathered with Erin Thompson and Sherri Vernelson to review the Global Foundation curriculum and discuss strategies and goals related to speech development.  That was followed by a planning session to prepare the therapists for live therapy sessions with children starting tomorrow. 

Meanwhile, the audiology technicians and ENT doctors listened to Jane Madell and Myriam de la Asuncion lecture about cochlear implant technology and pediatric testing protocols. Tomorrow, we start bringing children into the booth for practicum in behavioral testing and evaluation. Myriam will coach the participants on mapping strategies for children with cochlear implants. Jay Rubinstein will lecture to the ENT doctors on cochlear implant surgical procedures with live surgery scheduled later in the week.   Let's get this started!

Monday, December 30, 2013

Here We Go!

The Global Foundation For Children With Hearing Loss is starting the 2014 new year off with a bang and we are looking forward to sharing the highlights with you.  Audiologists Myriam De La Asuncion, Joan Hewitt, and Jane Madell, auditory verbal therapists Sally Tannenbaum, Erin Thompson, and Sherri Vernelson, and surgeon Jay Rubinstein are joining Paige Stringer in Vietnam for the Global Foundation's fourth Mobile Mission program which all gets started on January 6 in Ho Chi Minh City.

The Mobile Missions are one piece of the Global Foundation's multi-faceted Vietnam Deaf Education Program. The program, now in its fourth year, is building capacity amongst Vietnamese medical teams, therapists, teachers, and audiology technicians to help young children with hearing loss make use of hearing technology and learn to communicate through listening and spoken language.  There are no formal training programs in audiology, early intervention, deaf education, or auditory-verbal practice in Vietnam.  The Vietnamese professionals who work in these areas have asked for additional training.  Our Vietnam Deaf Education Program addresses this need.  Developed by Global Foundation professionals in collaboration with the Vietnamese, we work to fill gaps in expertise and prepare the Vietnamese to not only support the children they serve but also to train and collaborate with each other as to elevate the system of support for these children with hearing loss and their families.

The January 2014 Mobile Mission takes place in Ho Chi Minh City, Hanoi, and Lai Thieu over a three-week period. We'll start at Children's Hospital 1 in Ho Chi Minh City where Vietnamese therapists who have been engaged in our program for the past few years will continue to progress their learning in the Global Foundation's curriculum.  Live therapy sessions between Vietnamese therapists and young children and their families are scheduled to provide opportunity for feedback and coaching by Erin and Sherri. Meanwhile, the Global Foundation's audiologists will focus training on pediatric audiology testing and cochlear implant mapping with audiology technicians.  And, Jay will lead the doctors through cochlear implant surgical procedures.

We'll be posting stories about Vietnam,and the Mobile Mission on this blog in the weeks to come. Please join us!