Tips For Parents Getting Started With Spoken Language Development

HERE is free information

 from the 

Rehabilitation Resources From Cochlear 

www.cochlear.com / HOPE

    

Suggestions to help parents begin the journey of spoken language through listening.

It covers topics such as: 

- How children learn spoken language through listening

- Setting realistic expectations

- Suggestions for listening games and activities at home

Insurance Guide for Parents by Tiffani Hill-Patterson

Take the time to read this comprehensive article by Tiffani Hill-Patterson

Reprinted at: http://www.listeningandspokenlanguage.org

Source: Volta Voices, May/June 2011

Source:www.realitycheck.net

 Tiffani is author of Sound Check Mama, a blog about 

sports, music, and raising a daughter with hearing loss. 

Inquire About Eligibility and Benefits for Auditory Rehabilitation

Steps to Inquire About Eligibility and Benefits

Call the member services number on the back of your insurance card 

to inquire about eligibility and benefits for auditory rehabilitation.

Below are the CPT or procedure codes.

RE: THERAPY TYPE: Auditory (re)habilitation, Auditory-Verbal Therapy

CPT CODE: 92630 auditory rehab, prelingual hearing loss

CPT CODE: 92633 auditory rehab, postlingual hearing loss

RE: THERAPY TYPE: Auditory Processing Disorder

CPT CODE:  92626 Auditory Rehabilitation, 1st hour

Each plan is different and services may be subject to a deductible, coinsurance, or copayment.  Clients with Health Maintenance Organization (HMO) plans are responsible for getting a referral from the primary care physician prior to receiving services.  Lynn A. Wood is not responsible for denials on insurance claims, and clients are responsible to pay for services rendered.

Questions to Ask When Inquiring About Eligibility

It may be helpful for you to contact your insurance company and ask the following questions so you are aware of your insurance benefits.

1.    What are my outpatient benefits for auditory rehabilitation?

2.    Do I have a deductible?

3.    What is my co-pay or co-insurance percentage?

4.    How many visits do I get per calendar year?

5.    Do I need a referral or authorization prior to my visits? How often?

6.    Is my plan’s coverage of outpatient auditory rehabilitation based upon medical necessity? If so, what diagnoses are covered under “medical necessity”?

7.    What is the effective date of my coverage?

8.    Is Lynn A. Wood, M.A. CCC/A LSLS Cert. AVT in your provider network?

            NPI #: 1295853919

            Illinois Licensed Audiologist #147-000172

            Listening and Spoken Language Specialist, Certified Auditory-Verbal

            Therapist #70712318

9.    If not, who is an in network provider that is a Certified Auditory Verbal Therapist and a Licensed Rehabilitative Audiologist within 30 miles from my home?

10. If they do not have a provider in in network, request reimbursement at the in network rate.

Some insurance plans do not cover therapy services unless they are considered to be "medically necessary." Contact your insurance company to inquire about medical necessity guidelines that may apply to your plan

If services are denied, you have a right to appeal the health insurance company for speech-therapy coverage.  The American Speech-Language-Hearing Association (ASHA) has published a document on medical review guidelines that can be used as part of the appeals process.

Bottom Line: Private Health Plan AR Reimbursement

http://www.asha.org/uploadedFiles/practice/reimbursement/coding/AuralRehabforAudandSLP.pdfhttp://www.asha.org/uploadedFiles/practice/reimbursement/coding/AuralRehabforAudandSLP.pdf

Knowledge and Skills Required for the Practice of Audiologic/Aural Rehabilitation

Official statement of the American Speech-Language-

Hearing Association (ASHA). 

Pediatric Auditory Habilitation

Click HERE to read the American Speech Language and Hearing Association's Document on the:

Knowledge and Skills Required for the Practice of Audiologic/Aural Rehabilitation, which was approved by the ASHA Legislative Council and is an official statement of the American Speech-Language-Hearing Association (ASHA). 

The document was prepared by the Working Group on Audiologic Rehabilitation in response to a charge from the American Speech-Language-Hearing Association's Executive Board to update the Association's definition of and competencies for aural rehabilitation document.

Adult Auditory Rehabilitation 

Knowledge and Skills for Audiologists Providing AR Services

Basic Areas of Knowledge

Audiologists who provide AR services demonstrate knowledge in the basic areas that are the under-pinnings of communication sciences and disorders. These include the following:

1. General Knowledge
   1. General psychology; human growth and development; psychosocial behavior; cultural and linguistic diversity; biological, physical, and social sciences; mathematics; and qualitative and quantitative research methodologies.
2. Basic Communication Processes
   1. Anatomic and physiologic bases for the normal development and use of speech, language, and hearing (including anatomy, neurology, and physiology of speech, language, and hearing mechanisms);
   2. Physical bases and processes of the production and perception of speech and hearing (including acoustics or physics of sound, phonology, physiologic and acoustic phonetics, sensory perceptual processes, and psychoacoustics);
   3. Linguistic and psycholinguistic variables related to the normal development and use of speech, language, and hearing (including linguistics [historical, descriptive, sociolinguistics, sign language, second language usage], psychology of language, psycholinguistics, language and speech acquisition, verbal learning and verbal behavior, and gestural communication);
   4. Dynamics of interpersonal skills, communication effectiveness, and group therapy

Special Areas of Knowledge and Skills

Audiologists who provide AR have knowledge in the following special areas and demonstrate the itemized requisite skills in those areas:

• III. Auditory System Function and Disorders
  1. Identify, describe, and differentiate among disorders of auditory function (including disorders of the outer, middle, and inner ear; the vestibular system; the auditory nerve and the associated neural and central auditory system pathways and processes);
• IV. Developmental Status, Cognition, and Sensory Perception
  1. Provide for the administration of assessment measures in the client's preferred mode of communication;
  2. Verify adequate visual acuity for communication purposes;
  3. Identify the need and provide for assessment of cognitive skills, sensory perceptual and motor skills, developmental delays, academic achievement, and literacy;
  4. Determine the need for referral to other medical and nonmedical specialists for appropriate professional services;
  5. Provide for ongoing assessments of developmental progress.
• V. Audiologic Assessment Procedures
  1. Conduct interview and obtain case history;
  2. Perform otoscopic examinations and ensure that the external auditory canal is free of obstruction, including cerumen;
  3. Conduct and interpret behavioral, physiologic, or electrophysiologic evaluations of the peripheral and central auditory systems;
  4. Conduct and interpret assessments for auditory processing disorders;
  5. Administer and interpret standardized self-report measures of communication difficulties and of psychosocial and behavioral adjustment to auditory dysfunction;
  6. Identify the need for referral to medical and nonmedical specialists for appropriate professional services.
• VI. Speech and Language Assessment Procedures
  1. Identify the need for and perform screenings for effects of hearing impairment on speech and language;
  2. Describe the effects of hearing impairment on the development of semantic, syntactic, pragmatic, and phonologic aspects of communication, both in terms of comprehension and production;
  3. Provide for appropriate measures of speech and voice production;
  4. Provide for appropriate measures of language comprehension and production skills and/or alternate communication skills (e.g., signing);
  5. Administer and interpret appropriate measures of communication skills in auditory, visual, auditory-visual, and tactile modalities.
• VII. Evaluation and Management of Devices and Technologies for Individuals With Hearing Impairment (e.g., hearing aids, cochlear implants, middle ear implants, implantable hearing aids, tinnitus maskers, hearing assistive technologies, and other sensory prosthetic devices)
  1. Perform and interpret measures of electroacoustic characteristics of devices and technologies;
  2. Describe, perform, and interpret behavioral/psychophysical measures of performance with these devices and technologies;
  3. Conduct appropriate fittings with and adjustments of these devices and technologies;
  4. Monitor fitting of and adjustment to these devices and technologies to ensure comfort, safety, and device performance;
  5. Perform routine visual, listening, and electroacoustic checks of clients' hearing devices and sensory aids to troubleshoot common causes of malfunction;
  6. Evaluate and describe the effects of the use of devices and technologies on communication and psychosocial functioning;
  7. Plan and implement a program of orientation to these devices and technologies to ensure realistic expectations; to improve acceptance of, adjustment to, and benefit from these systems; and to enhance communication performance;
  8. Conduct routine assessments of adjustment to and effective use of amplification devices to ensure optimal communication function;
  9. Monitor outcomes to ensure professional accountability.
• VIII. Effects of Hearing Impairment on Functional Communication
  1. Identify the individual's situational expressive and receptive communication needs;
  2. Evaluate the individual's expressive and receptive communication performance;
  3. Identify environmental factors that affect the individual's situational communication needs and performance;
  4. Identify the effects of interpersonal relations on communication function.
• IX. Effects of Hearing Impairment on Psychosocial, Educational, and Occupational Functioning
  1. Describe and evaluate the impact of hearing impairment on psychosocial development and psychosocial functioning;
  2. Describe systems and methods of educational programming (e.g., mainstream, residential) and facilitate selection of appropriate educational options;
  3. Describe and evaluate the effects of hearing impairment on occupational status and performance (e.g., communication, localization, safety);
  4. Identify the effects of hearing problems on marital dyads, family dynamics, and other interpersonal communication functioning;
  5. Identify the need and provide for psychosocial, educational, family, and occupational/vocational counseling in relation to hearing impairment and subsequent communication difficulties;
  6. Provide assessment of family members' perception of and reactions to communication difficulties.
• X. AR Case Management
  1. Use effective interpersonal communication in interviewing and interacting with individuals with hearing impairment and their families;
  2. Describe client-centered, behavioral, cognitive, and integrative theories and methods of counseling and their relevance in AR;
  3. Provide appropriate individual and group adjustment counseling related to hearing loss for individuals with hearing impairment and their families;
  4. Provide auditory, visual, and auditory-visual communication training (e.g., speechreading, auditory training, listening skills) to enhance receptive communication;
  5. Provide training in effective communication strategies to individuals with hearing impairment, family members, and other relevant individuals
  6. Provide for appropriate expressive communication training
  7. Provide appropriate technological and counseling intervention to facilitate adjustment to tinnitus;
  8. Provide appropriate intervention for management of vestibular disorders;
  9. Develop and implement an intervention plan based on the individual's situational/environmental communication needs and performance and related adjustment difficulties;
  10. Develop and implement a system for measuring and monitoring outcomes and the appropriateness and efficacy of intervention.
• XI. Interdisciplinary Collaboration and Public Advocacy
  1. Collaborate effectively as part of multidisciplinary teams and communicate relevant information to allied professionals and other appropriate individuals;
  2. Plan and implement in-service and public-information programs for allied professionals and other interested individuals;
  3. Plan and implement parent-education programs concerning the management of hearing impairment and subsequent communication difficulties;
  4. Advocate implementation of public law in educational, occupational, and public settings;
  5. Make appropriate referrals to consumer-based organizations.
• XII. Hearing Conservation/Acoustic Environments
  1. Plan and implement programs for prevention of hearing impairment to promote identification and evaluation of individuals exposed to hazardous noise and periodic monitoring of communication performance and auditory abilities (e.g., speech recognition in noise, localization);
  2. Identify need for and provide appropriate hearing protection devices and noise abatement procedures;
  3. Monitor the effects of environmental influences, amplification, and sources of trauma on residual auditory function;
  4. Measure and evaluate environmental acoustic conditions and relate them to effects on communication performance and hearing protection.

Tips For School from www.cochlear.com

This article is available HERE from the http://www.cochlear.com/ website.

(adapted) 

1. Assessment and Individualized Education Plan (IEP)

Each year, your child's progress in each area of skill development must be monitored in order to determine the best approach for continuing momentum or improving the rate of progress. The approach to completing this assessment varies by school district. Information gathered for the yearly assessment provides the foundation for the discussion and goal setting of the Individualized Education Plan.

2. Organize a support team to work with your child

Encourage discussions, set up meetings, and highlight the role of each member in your child's support team. There are many people who should be considered members of your child's support team including:

• Classroom Teacher/Special Teacher
• Auditory Verbal Therapist(s)
• Speech Language Pathologists
• Educational Audiologist
• Someone from cochlear implant center/clinic
• School Principal/Administrator
• Tutor, aid, school nurse, others
• Parents + child + classmates
• Interpreter, notetaker (depending on age and needs of your child)

Each member of the team will play a key role in your child's educational progress, from the teacher who is ensuring your child understands and is on par with academic goals, to the school administrator who provides leadership and allocates funds, to your cochlear implant center communicating your child's changes and progress. As the parent, your job is most important to ensure that you:

• Communicate with all team members
• Monitor equipment, homework and educational progress
• Be a presence at school
• Participate in child's developmental goals
• Ensure a routine for your child
• Provide an auditory learning environment at home
• Encourage your child advocate for himself by talking, asking questions, and engaging with others around him/her

3. Set up an initial meeting with your child's support team

• Show the team your child's audiogram and explain it
• Help the team understand the benefits and limitations of hearing aid and  cochlear implant technology
• Show the team your child's technology and let them handle it
• If your child uses an FM system, explain why the FM is important
• Determine who is in charge of troubleshooting and develop a plan for how that will work

4. Review classroom acoustics and ensure proper classroom seating

There are many factors in a child's classroom that may impact their ability to hear, such as noise, distance and reverberation. Keep in mind the following when choosing a child's classroom seat: Close to front but visually accessible to entire room

• Seat away from noise generators (HVAC fans, hall doors)
• If your child has one cochlear implant, seat them so that the cochlear implant ear is away from noise sources (HVAC fans, projectors) and towards center of room
• Aquariums often generate noise (from the pump operation) and should not be placed in the classrooms of children with hearing loss

5. Review support services for your child

Work with your child's support team to determine what support is best for your child. When needed, consider options such as FM systems , interpreters, itinerant teachers of the deaf and other support services. Provide your teacher with extra batteries and troubleshooting tools to use in the classroom.

6. Provide tips to your child's teacher

Remember, your child's teacher may have never taught a child with hearing loss and feel that the "burden" is falling on them. Provide the teacher with some tips such as:

• Always face forward when talking
• Stay within the child's vision, closer is better
• Don't "bounce" around
• Speak clearly, naturally and directly to the child
• Make sure the child is looking at you when you begin speaking
• Ensure volume is appropriate
• Speak just a little slower—too slow is not natural and will make understanding harder
• Don't ask the child directly "Did you understand that?"
• Learn to recognize "the look" that means the child didn't get it, or use a signal or "secret sign" so she can tell you she missed something
• Repeat once, then paraphrase
• Explain things a different way
• Encourage the child to ask
• Write difficult (key) word(s) on the blackboard
• Provide key new words/concepts to parents or team members in advance
• Use visual tools, concrete materials or natural gestures to illustrate points
• Write assignments and directions on the board
• When someone else is speaking, point to the speaker
• Understand and use additional amplification equipment - repeat classmates' questions thru the FM system
• If you think the child might have missed a comment, rephrase or restate what another child has contributed
• Don't be afraid of the child's cochlear implant equipment

7. Involve classmates

Many children are not aware of cochlear implants. It is important to involve the classmates at the start of the school year to help them understand your child's technology, learn how to interact with your child and talk about how your child is the same as other kids, but with a little extra technology to help them hear. You may also want to assign another child as your child's "hearing buddy" to help keep your child on task and share notes, if they are old enough.

Remember, while you want to address your child's individual needs, you also want to place your child in the "least restrictive environment" to serve their needs. Set appropriate but high expectations. Children with cochlear implants should follow the same learning process as other children.

Parent and teacher resources

For additional resources on assisting your child and their cochlear implants at school, visit the HOPEwebsite.