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April 8, 2019
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Chattering Children: Fostering Communication is Key

Serving the greater Washington D.C. area, Chattering Children is a non-profit organization that provides children with hearing loss and their families a wide range of services, including hearing aid and cochlear implant programming, auditory-verbal therapy, occupational therapy, psycho-educational assessments, educational supports, and speech-language therapy. The organization is co-located in the River School, the first and only independent school of its kind in the nation, which provides inclusive education to children with hearing loss as well as their hearing peers from 18 months through third grade. It’s difficult to summarize everything Chattering Children does for its community. But as Pediatric Audiologist, Dr. Julia Reid explains, what it comes down to is fostering communication—between children, between families, between educators, and between speech and hearing health professionals.

“As audiologists, we need to help bridge the gap and empower other providers so that they feel comfortable with the technology and troubleshooting devices.” 
Dr. Julia Reid

Q&A with Dr. Julia Reid (Pediatric Audiologist)

1Tell us a little about the River School and its partnership with Chattering Children.
The River School has a speech pathologist and an educator in every classroom and there are more kids with normal hearing than kids with hearing loss. The idea behind that is to really bolster the language of the kids with hearing loss. Chattering Children is essentially the clinical arm of the school. We also see children with hearing loss who don’t attend the school.
2You also recently started seeing adult patients, too. What’s that been like? Don’t adults feel awkward being treated in a pediatric setting?
[Laughs] well the majority of our adult patients right now are linked to other patients or our staff in some way, whether they are a family member or friend. So they know we’re primarily a pediatric clinic. They’re not surprised when they see toys in the booth. But they do wish the adult hearing aids came in all of the fun pediatric colors.
3Chattering Children recently received a grant for ABR (Auditory Brainstem Response) equipment. Explain why that’s so important.
In our area, there aren’t many centers that offer ABR services and the centers that do are back-logged and it can take a while for kids to get in. There’s so much research showing that the more learning, reading, and talking a child does and the more words that a child hears before the age of three, the better their literacy is by third grade and ultimately, their intelligence. So, our hope is to get kids diagnosed and fit earlier with appropriate technology to begin developing those skills.
4What would you say are some of the biggest challenges in working with children?
Adults are better able to articulate what they’re hearing and so we can adjust programming based on their responses. But with kids, you have to be more in tune with how they’re reacting and how their speech development is coming along. Also, the two-and-three-year-olds who are having temper tantrums: it’s this age range when they know that they can now control something, and the hearing aids or cochlear implants are something they have easy access to and can control. We give families a lot of support to help them with different situations, to encourage their children to wear their hearing aids. Thankfully, the manufacturers also have loss and damage warranties on their products, and they understand that kids sometimes hide things.
5Tell us more about how Chattering Children works with the families of children with hearing loss.
Our psychologist does Parent-Child Interaction Therapy (PCIT) to help coach families on how to encourage language and meet their child where they’re at in order to produce better outcomes and better behavior management. We also have Sound Support which is a monthly program where different providers will come in and talk to parents of children with hearing loss either about a topic that the parents have suggested or just something that we feel is needed. For example, around summertime, we’ll talk about how to help waterproof the devices for cochlear implants or things to do to help pull out moisture from hearing aids. We’re trying to create that relationship between families but then also just have a safe place for them to ask questions to a provider.
6Why is it so important to provide this type of support to parents?
I think that the benefit of having a parent group, besides just having the providers talk to the families, is that the parents can bounce ideas off one another and develop a sense of community. We see that even more in the River School’s Parent-Infant Program. It’s a free weekly program that parents can bring their child to and families are encouraged to interact. Then parents don’t feel like they’re alone in whatever challenges they may have, and some great relationships can develop.
7Aside from its Inclusion Program, what are some other things that make the River School so innovative?
The teachers incorporate a lot of different activities into the school day that focus on developing social skills. There’s also yoga which teaches kids mindfulness, how to respond to their bodies, and to be more aware of their feelings. There are sound field systems in every classroom to help all the children, even the normal hearing kids, to access the teacher’s voice. And the rooms are acoustically modified in order to decrease noise. Research shows that kids need about a 15-decibel-to-noise ratio in order to understand speech well. That’s why the school makes sure its rooms are as quiet as possible. You know, before the kids get in there [laughs].
8Tell us about some of the professional development and training opportunities Chattering Children offers.
We work with schools in the area and provide training for audiology and speech pathology students. We take interns each semester to help them get their clinical experience. And then we also occasionally have professional development opportunities for providers in the area to get CEUs. We’ll invite outside speakers to come in and present on new findings.
9What’s it like working with a team that includes professionals in audiology as well as speech pathology, deaf education, occupational therapy, and psychology? How much collaboration goes into treating your patients?
Everyone here is great to work with. We have several weekly meetings. One is just case reviews for any child that goes to the school, whether they have normal hearing or not. Another is for Chattering Children patients specifically. If we see a child is struggling with something, we put our heads together and discuss their specific situation from each of our respective realms to determine how can we better support them. We make sure to have open communication between the providers.
10Is there anything that you’ve learned from them that’s changed the way you think as an audiologist?
The educational aspect is something that I haven’t always thought about. For example, there was one child who was having trouble differentiating between different vowel sounds for his spelling tests. We found out that he needed a little bit more amplification than what prescriptive targets would suggest in order for him to better differentiate certain sounds. I adjusted his hearings aids and that helped improve his spelling and reading skills.
11What would you say is the most rewarding part of your job?
The biggest joy of working with kids is that you’re helping them ultimately communicate with their families and allowing them to partake in the hearing world. We know that over 95% of children who are born with hearing loss are born to hearing parents and being able to communicate with their child can allow their natural language to develop.