Round Two Begins!

We're on our way to Vietnam for the Global Foundation's second Mobile Mission. Thanks for checking in. We hope that you'll ride along with us over the next several weeks as we travel from Saigon to Lai Thieu to Nha Trang on this latest adventure.

For a bit of history on our Mobile Mission series.....the participants in our Vietnam Deaf Education Program asked us last year if we could supplement our annual summer workshops at Thuan An Center with visits to their home communities during the year to further their professional development. So, we designed this Mobile Mission series which features in-classroom mentorship and audiology training on location at some of the 38 schools and centers in our program.

Last January's Mobile Mission team traveled to Dalat, Danang, and Saigon. Each location we visited had their own unique strengths and opportunities in their efforts to serve children with hearing loss. Our seasoned professionals did a wonderful job adjusting on the fly to provide classroom coaching to teachers and audiology training to school staff and local hearing aid dispensers. We fit hearing aids on children who needed them. Families came in droves in the evenings to hear our professionals lecture about the role they could play in supporting their children's auditory and language development.


For us at the Global Foundation, the Mobile Missions provide invaluable opportunity to see first-hand our training participants at work in their home environments. We adjust and make enhancements to our summer program based on these experiences. For instance, in January, we recognized a need for more pediatric audiology expertise. So, we added an in-depth audiology track to our 2011 summer program to provide extra training for educational staff so they can better support the audiological needs of the children in their schools.

Our summer program and Mobile Mission series are integrated learning experiences for the participants whom we are working with in this multi-year initiative...lessons learned during the summer at Thuan An Center are reinforced during the Mobile Missions in home classrooms and therapy centers. And by fitting hearing aids on the children attending the schools in our program, we can provide training throughout the year to ensure these children have every opportunity for success.

This February 2012 Mobile Mission team comprises of Judy Simser, Jim Watson, and Lea Watson as our auditory-verbal professionals and Lauri Nelson, Jacque Patton, and Zofia Wald-Mroz as our audiologists. It is a terrific group who bring great teamwork and sense of humor to go along with their years of experience.

We'll be starting at the Children's Hospital in Saigon, training doctors, therapists, and technicians. Then we head out to the countryside of Lai Thieu and the beaches of Nha Trang to work with a group of school programs. In addition to the auditory-verbal and pediatric audiology training, we'll be working alongside the Vietnamese participants to test hearing and fit hearing aids as necessary on over 100 young children. We are in for a very fun, rewarding time for sure.

We're heading out to the airport. Please bear with us as we make our way across this big planet. I will kick things off in the coming days with stories from Hanoi, Nha Trang, and Saigon as I work with our partners there to put the final pieces in place in advance of our Mobile Mission and continue to explore expansion and business development opportunities for the Global Foundation. The rest of the team arrives later in February and we'll get this show started.

I invite you to take a look at our blog posts from the past few years relegating the journey we've taken from 2009 to get to this point. For a summary of our efforts in Vietnam, check out Invent for Humanity's coverage of our work.

Thank you again for your support. There is much, much more to come. We look forward to sharing it all with you!

Curtain Call!

As our summer program draws to a close, it is quite remarkable to reflect on all that was accomplished. In the course of four weeks, we trained 87 teachers who represented 38 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.

We presented to approximately 80 people at the US Consulate in HCMC about pediatric hearing loss and visited two pediatric hospital audiology clinics.

We 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!
Every good program has an incredible team behind it and this one is no exception. I cannot say enough about the efforts of our Thuan An Center partners and our professionals and students who traveled from the US and Hong Kong to share their time, expertise, and knowledge with the Vietnamese participants. They say that “you make a living by what you get, and you make a life by what you give.” To that, I would add, “…and by giving, you can change another person’s life”. Our team did exactly that and I am grateful to each of them.

Here are a few shining moments that point to the impact the Global Foundation For Children With Hearing Loss is making as an organization in Vietnam:

1) We've seen a convergence of our various programs – summer teacher training, mobile missions to sites during the year, and hearing aid distribution. Children who received hearing aids from us during the January 2011 mobile mission traveled to us this summer for audiology appointments with our team, their parents met with our therapists about language development, and their teachers were engaged in our training program. So we provided the children access to sound and are training others about how to help these children make the best use of this sound.

2) Participants new to our program this summer were further along in their understanding of the topics we covered than last year's group. The reason is because last year's participants went back to their home schools and shared their knowledge with their peers. The crux of what we are trying to accomplish -- empower teachers to train each other -- is taking root.

3) Our new audiology program involved 18 participants who do audiology work at the schools, a hearing aid dispenser, and medical teams from two hospitals. We integrated our family consults with the audiology training so that the audiology participants not only learned theory and practiced using the equipment, but had the opportunity to practice what they learned on the families themselves with the support of our professional audiologists. This really helped further their training and confidence.

4) We fit 30 hearing aids on children from low-income families. All of these children attend schools in our program so we will be able to monitor their progress and work with their teachers and families to ensure their continued success.

5) We visited 2 hospitals that provide pediatric audiology and therapy support. We will provide training and newborn hearing screening information to them as part of our mobile mission in 2012.

Those are just a few of the highlights that demonstrate the scope and impact of our efforts.

We hope you'll take a few minutes and enjoy this video that captures the experience: http://animoto.com/play/iJjAZcR19Z2qzbX01QRKLA

Thank you for your interest and support of the Global Foundation. We will be returning to Vietnam in February 2012 for our next Mobile Mission. I hope you'll join us on our blog for that. If you would like to stay in touch with us in the meantime, please sign up for our quarterly newsletter at our website at http://www.childrenwithhearingloss.org/contact.shtml. Also, we’ll be presenting at the ASHA Convention in November so if you are there, please stop by!

Thank you again- we are grateful for your support. Until our next adventure….cam on and tam biet!

Finishing Strong and Looking Ahead

It was fitting that on the day we wrapped up our program, the construction crews put the first coat of fresh, daffodil-yellow paint on the new early intervention building at Thuan An Center.

Today was all about inspiration and progress, and the new early intervention center, which opens in a few weeks, plays a part in that hopeful future. The Japanese embassy granted Thuan An Center, our Vietnam partner, funding support several months ago to construct the early intervention building. The staff hopes this facility will become a “center of excellence” for audiology, early intervention therapy, and auditory-verbal education for young children with hearing loss in South Vietnam. Some of the teachers who have been engaged in our Deaf Education Program the past year will work at this new center.

The last day of our program began with a teacher training lecture about assessment. Ann Baumann discussed why and how we establish benchmarks and goals to ensure children with hearing loss progress in their auditory and language development. She explained that a child’s listening age dates to when he or she first had quality access to sound. A child with a hearing loss may be 3 or 4 years old, but have a listening age of just 1 or 2 years. It takes time for that child to make up for lost ground in their auditory and language development. With therapy support, the child should make 12 months’ progress in their first year of listening and then more than that in subsequent years. This way, the child will “catch up” developmentally to their hearing peers over time. Ann demonstrated to the class how to collect data and communication samples to help evaluate a child’s present language and auditory skill level and then use that information to lay plans for that child's progress.

At lunch, Viet, one of our volunteer interpreters gave a farewell speech that touched all of us. Viet is a Vietnamese American who served as captain in the South Vietnamese air force many years ago. He came to the United States at the end of the Vietnam War and started a new life for himself and his family. Now retired, he volunteers his time as an interpreter in a hospital in Salt Lake City. I met Viet through one of our graduate student volunteers who had been serving an internship at the hospital. Viet offered to lend his interpreter skills to our program. I was taken by his good heart and incredible personal story and welcomed him to join us. This was his fourth visit to Vietnam since he left almost 40 years ago and I think he enjoyed the opportunity to spend time with family and old friends on the weekends while serving our program during the week.

During his speech, Viet reflected on the supportive environment that he had witnessed during our program this summer, the kindness that he was grateful to receive from the Vietnamese participants, and expressed that for the first time he felt like he had truly come home. There wasn’t a dry eye in the house.

The afternoon brought review sessions for both the teacher training program and the audiology program. The participants are all determined to do well on tomorrow’s final test…some even asking oh-so-politely whether we might consider lowering the bar of what constitutes a passing score. They need to pass the final in order to advance next year and they have been studying very hard to do so. I have been touched by how committed the participants are to our program and acquiring new knowledge that will help them in their work.

The day wrapped up with all the participants and professionals exchanging gifts, songs, and lots and lots of photos. In what may be the best kind of endorsement, we were honored to receive cash donations in support of our program from two of our Vietnamese participants. The owner of a hearing aid dispenser and a medical team from one of the HCMC hospitals made contributions. It was totally unexpected and a kind gesture on both of their parts.

After dinner, I settled in with the interpreters for a post mortem about this summer’s program and to brainstorm for next year. For two hours we bantered and had a great time joking with each other while also devising some creative plans. They were all rightfully very tired but totally engaged and inspired to share their thoughts and feedback. That is one of the things I love about working with our Vietnamese partners…they are such a great group and completely committed to the success of this program. Back at the hotel, the team and I sat out on the patio for one last late-evening gathering over french fries and beverages. We were all a bit wistful that it was over but also very satisfied.

I’m looking forward to reading the evaluation forms from the Vietnamese participants and seeing how they do on the final tests tomorrow. Bigger picture, it has been powerful this summer to see evidence that our efforts here to train teachers and professionals and empower families to help children with hearing loss are taking root so quickly and substantially.

Hearing Aid Fitting Day!

We arrived at the center at 7:30 this morning to a large group of families waiting for us. Little girls in brightly colored dresses and boys in neatly pressed pants played with each other in the school yard while their moms and dads sat with tired eyes on benches under the eaves. Many had arrived hours earlier, some after traveling all night, to be here today to receive new hearing aids for their children. We had a schedule of appointments and previously assured these families that they would be given hearing aids, but they came early anyway.

By the end of the memorable day, we fit 15 children with hearing aids. For some, it was their first pair, including a cute 18 month old boy with a moderate to severe hearing loss. His face lit up when we turned on the aids and he responded immediately to sounds. Others had hearing aids in the past that were damaged or needed replacing. Many had hearing aids on loan from their schools and the families wished to have their own pair. All of these children were from low-income families that didn't have the means to secure hearing aids.

Our audiology program participants were paired up with each family and went through the entire cycle with them --hearing testing, hearing aid fitting, and consultation -- with the oversight of our professionals. It was a wonderful opportunity for them to practice what they had learned in our program in a real-world setting with families. By the end, our students were doing much of the work themselves, their confidence had greatly increased.

We take careful records of each child that receives a hearing aid from the Global Foundation. All of the families we saw today come from schools in our Deaf Education Program with teachers and therapists enrolled in our training programs. So, we will be able to monitor their progress over time.

While the hearing aid fitting was taking place, the teachers in our teacher training program were engaged in lecture and an interactive breakout session about behavior management. We also had a special breakout session where a camera was set up in a few of our family consultation sessions. With the families' permission, the teachers observed Hillary Ganek as she conducted the family therapy sessions from another room. It was an opportunity for the teachers to see how therapy sessions might occur and talk as a group as to what they saw and learned.

Last night, one of the participants in our audiology program treated our team and the audiology participants to a special dinner at a local restaurant. The food was wonderful and the company a lot of fun. It wasn't long before the Vietnamese and Americans started up a competition to see how many children's songs we knew...for the next hour or so we sang back and forth until finally the Americans started to run out of ideas. The Vietnamese kept going strong....completely outdoing us in the song department. We finally waved white napkins in surrender, humbled but loving every second of the experience too!

The Teachers' Point of View

Many of the families taking part in the audiology and therapy consults that I blogged about in my last post live 400-800 km away. They are making the long trip to our program here by motorbike or public transportation -- often overnight – to spend time with our professionals. It’s really remarkable and a testament to the fortitude of parents to do their best by their children.

While the families are meeting with our audiologists and therapists, their children’s teachers are close by engaged in our teacher training program. It’s a two-pronged effort to help these children from 35 schools and early intervention centers spread across South Vietnam maximize the use of their hearing aids and progress with their spoken language development.

We’re in the middle of the second week of our teacher training program for Level 1 teachers. The 45 first-year participants have been immersed this week in lecture and interactive practicum on topics related to teaming with families, language milestones, literacy and reading, and auditory development strategies.

The Level 1 teachers have also signed up for individual consults with our deaf education and therapy professionals. These sessions offer teachers the opportunity to get advice about lesson plans and curriculum development and new ideas for addressing the needs of specific children they work with. They are also asking questions about our daily lectures here and how to apply the lessons learned to their own classrooms, indicating they are absorbing the information and thinking through the material they are being taught. I enjoy sitting in on these one-hour sessions for the insight they provide into the varied and unique situations and school environments that the teachers face.

In a feel-good moment, one of the teachers shared that her school started an early intervention program this year. Some of her peers who teach kindergarten attended our course last summer. They learned about the value of early intervention and proposed that the school start a program for younger children with hearing loss at their school. Previously, the school had children wait until they were kindergarten-age before they would start to work with them. Now, they are launching an early intervention program and this teacher is one of the first to work in this new program.

Another teacher shared her concerns about consistent access to hearing aids for her students. Her families receive off-brand or used hearing aids donated through international organizations and charities. When the hearing aid breaks, there often isn’t a place to get it repaired or a means for getting a new one. As a result, the child no longer has access to sound.

She said, “It is very hard to deny a child after they have been provided a hearing aid and are learning to listen and talk. When we cannot find a replacement or the family cannot afford one, the child loses all their progress. That is so much harder than not providing a hearing aid to the child in the first place.”

The Global Foundation is working with a few other Vietnam charities on a plan to establish a micro-credit process whereby hearing aids would be provided to low-income families. The families would pay for the hearing aid over time, allowing us to source more hearing aids and sustain the program.

The Kids Are Alright

“Yeah!” The three-year-old girl cheered loudly each time she heard the pure tone through the audiology headphones. She would then enthusiastically drop the audiometry toy into the bucket with an extra punch. Moments like these put me in a good mood very fast.

We started our audiology clinics and family consults this past Monday. These two aspects of our program work in tandem. Forty-eight families of children with hearing loss representing a wide swath of schools in our Deaf Education program are scheduled one audiology and one therapy appointment over the next two weeks. A few of these children received their hearing aids from the Global Foundation during our January Mobile Mission. It has been inspiring to see the children’s progress and know that we are training their teachers and families about how to help them utilize their hearing aids and sustain their auditory and spoken language progression.

Each family starts with our audiology team. With our professionals’ careful oversight, the students in our audiology training program are practicing what they learned in the first two weeks. Each child gets an audiogram and their hearing aids checked. Our professionals and audiology students review case history and discuss audiological management with the parents. In some cases, the child’s teacher is joining in the conversation as well. New hearing aid fittings for some children will take place later this week.

After the audiology consult, the family goes on to meet with one of our deaf education professionals, auditory-verbal therapists, or speech language pathologists. During these sessions, the focus is on providing families with techniques and strategies they can use to help their children make the best use of their hearing devices. The parents are coming with their children, often as couples, wholly engaged and anxious to learn. In hour-long therapy appointments, our professionals demonstrate and practice play techniques with the families.

The convergence of our teacher and audiology training efforts, hearing aid distribution, and family consultations across the 35 schools involved in our summer and mobile mission programs has really come to life this week.

In an earlier blog post, I shared that one of the Level 2 teachers brought a video of her therapy session with a boy who received his first pair of hearing aids during our January Mobile Mission. He has a moderate hearing loss and attends a school in a rural part of Vietnam. His teacher has been in our training program for the past two years.I reflected on how great it was that the boy had hearing aids and a therapist in our Level 2 program who was now engaged in a video analyis about how to help him with his spoken language progression.

Well, the boy, his mother, and teacher came for his audiology and therapy appointment yesterday. We answered their collective questions and collaborated to make a few adjustments to his hearing aids to help increase his auditory potential. Thanks to his teacher and family’s efforts, the boy has made good progress with his listening and spoken language skills since January.

In another example, a mother of a 4-year-old entered our teacher training program last year. Her son had just received his first pair of hearing aids. Over the course of this past year, the mother practiced the auditory-verbal strategies and techniques she had learned during our summer program and our January mobile mission with her son. She came to our Level 2 training course this summer and attended the parent program. Her son now has a more extensive vocabulary and is able to identify sounds without looking at the person making the sounds. The next step is to help him articulate those sounds without visual reinforcement. During the therapy consult, one of our therapists, Helen Zuganelis, showed her some strategies to help him achieve that.

The success stories are heartwarming, but there are somber tales too that drive us. A little girl in one of our family therapy sessions was identified with hearing loss at age 1. The family is extremely poor and bought the cheapest hearing aid they could afford for her. Unfortunately, the body aid broke after just a week and the child has been without a hearing device for 2 years. She has no language at all - no spoken language or sign language. Hospital test results indicate this child is a candidate for a cochear implant. The price? $20,000. Vietnam health care does not cover the cost of hearing aids or cochlear implants. The family qualifies for some financial support, bringing that price down to about $11,000. As my audiology friend in Seattle would say, "that's jumbo shrimp" -- meaning, when you're poor, $11,000 is still very much out of range.

One of the things that we are finding in our audiology consults is that children’s hearing aids are not matching their audiograms. The hearing aids are often not powerful enough or are set about 20db too low for the child to understand the speech sounds. Our audiologists have been adjusting the hearing aids as they can. They are also showing the audiology program participants how to use hearing aid test box results to ensure that the hearing aids are adjusted to fit the audiogram of each child to maximize their hearing potential. This concept is a new one for them. So more training needs to be done... meanwhile, we'll savor the bright moments as they come.

The Ripple Effect Carries On

Last year, I wrote an article for the ASHA Leader titled "The Ripple Effect of a Powerful Idea" in which I explained the goal of our Vietnam program is to empower teachers, professionals, and families with knowledge that they can then share with each other. Our collective efforts will ensure that more children with hearing loss can succeed. We cannot change the hand that fate has dealt, but what we can do is help each other make the most of what we've got.

In the ASHA article, I talked about how parents who had taken part in our parent program last summer found inspiration in the idea that they could take an active role in their children's development. They banded together to start a parent group to network with each other to provide support and share insights. Last Friday, another example of this ripple effect idea came into play....

On my way to the lecture room, I passed Hein, one of our interpreters who has been working with us for the past two summers. Hein has her own early intervention center in Nha Trang. She had asked Thuy if she could be the interpreter for our audiology program this year because she wanted to increase her knowledge about the discipline.

We stopped for a quick chat and I asked Hein how the audiology program was going. She broke into a big smile and said it was a terrific curriculum and that she and the others were learning a great deal. Hein went on to explain that the hospital in Nha Trang doesn't have an audiology clinic. Her families and others in the area that have children with hearing loss have to make a 8-10-hour trip to Ho Chi Minh City when their child needs audiology services, even for minor issues.

Several staff members of a hearing aid dispenser are enrolled in our audiology training. Hein shared the problem with them and now they are making arrangments for some of the staff members in our training workshop to offer audiology services at the Nha Trang hospital on a periodic basis. It was heartwarming news to receive at the end of a very rewarding week.

Today marks the halfway point of our month-long training program....we accomplished much in the first two weeks but there is much more to do. We are looking forward to the days ahead!