Hearing loss ppt final

Inclusion of children with Hearing Loss into the
classroom

Sheeba Khan
821745502
Lisa McCaie
Centennial College – Progress

Lily
 Lily is a 4-year old child with severe hearing
impairment who has just joined my preschool room.
Till this point in her life, she has always been cared for
by her maternal grandparents, so this is her first time
in a child care setting.
 Lily’s parents are new to Toronto and ask about the
services in the area. They speak some English but
primarily Cantonese. Lily has 2 siblings –> a 6-year old
brother and a 6-month old sister.

Lily’s needs and the needs of her
family:
 Lily has a severe hearing  Lily’s parents primarily speak
impairment. Cantonese, and very little
 Lily has previously only been English.
looked after by her  Lily’s family has just recently
grandparents, so she will need to moved to Toronto.
adjust to the child care  Lily has 2 other siblings so her
environment. parents have their hands full.
 Lily may experience some  The family may have to teach
trouble communicating with Lily sign language, and may
other children in her class. need to learn it themselves too.
The family may fear that their
other children may or may not
have hearing loss also, and may
or may not have been diagnosed
yet.

Hearing Impairment
 Hearing Impairment is a broad term that includes
both deaf and hard of hearing. The term “deaf” is used
to describe a person who has an intense hearing loss
which cannot benefit from any intensification of
sounds. “Hard of hearing” is the term used for people
who may experience mild to severe hearing loss; these
are people who may benefit from amplification.

The International Symbol of Access for Hearing Impairment.

Main Types of Hearing Loss

1. Conductive Hearing Loss: caused by diseases or obstructions in the
outer or middle ear that usually affect all frequencies of hearing. A
hearing aid generally helps a person with a conductive hearing loss.
2. Sensorineural Hearing Loss: results from damage to the inner ear.
This loss can range from mild to profound and often affects certain
frequencies more than others. Sounds are often distorted, even with a
hearing aid.

Statistics
 According to the Hearing Foundation of Canada website, “A
study in the Journal of the American Medical Association
reported that nearly 15% of school-aged children had hearing
deficits at low and high frequencies (Niskar et al, 2004)”.

 The VOICE for Hearing Impaired Children website also states
that many children continue suffering hearing loss through their
school years.

 “More than 2,000 children are born with a hearing loss in
Canada every year, making it one of our country’s most common
birth defects for which screening is available. Approximately six
in every thousand babies born in Canada have some degree of
hearing loss, including profound deafness” (The Hearing
Foundation of Canada).

Causes
Some known causes of Hearing Impairment are:
 A family history of hearing loss.
 Frequent and/or recurring ear infections as an infant or toddler.
 Some antibiotics and chemotherapy treatments that may have hearing loss as
one of the side effects.
 Meningitis, Measles and CMV (Cytomegalovirus) Infection.
 Some syndromes and disabilities have also been associated with causing
hearing loss, such as Down Syndrome, Pervasive Develeopment Disorder,
Autism, Alport Syndrome and Crouzon syndrome.

Other Risk Factors
Children may also be tested for a hearing
impairment if they experienced any of
the following:

 If the child was born premature and/or
weighed less than 2 lbs at birth.
 Required ventilation assistance for more
than 10 days right after birth.
 Scored very low on the Apgar Test at
birth.
 Experienced severe jaundice after birth.
 If the mother had experienced certain
illnesses like German Measles(Rubella)
during pregnancy

Not all children with Hearing Loss look and act the same;
some children may look and behave just as any other
normal child.

One of the most common myths about Hearing Impairment is that individuals
who are hearing impaired are easily identifiable, either by their use of sign language,
clearly visible hearing aids or by their inability to hear speech and sounds.

However, not all children and adults experiencing severe hearing loss look the
same. Especially with early intervention and the right adaptations, they may be just like
any other person out there. The following video demonstrates just how normal children
with even a severe hearing loss may look and act like:

Is This Child Really Deaf?

Infant Screening in Hospitals
 Infant Screening – The Hearing Association of
Canada has been working since 2002 to provide
free hearing screening for babies born in all the
Canadian provinces. “Without screening, the
average age of identification of hearing loss has
historically been between 2 ½ to 3 years of age,
making it difficult for many children to catch up
with communication and social skills” (The
Hearing Association of Canada). Early detection
is the most beneficial, so this program allows for
immediate identification of hearing loss soon
after delivery of the baby, the test is fairly simple
and non-invasive.

Signs & Symptoms of a Hearing
Impairment in Children

 The child may experience frequent ear infections.
 The child may be delayed in their language development.
 The child may find it difficult to identify or locate certain sounds.
 The child may watch TV at a really high volume.
 The child may have behavioural issues, displaying inattentiveness and disruptive behaviour.
 The child’s speech may sound different or not speak clearly.
 The child’s vocabulary may consist many words that are often missing endings.

Impact on Child
Hearing Impairment can cause 4 major impacts on the child:
 It may cause a delay in communication skills (speech and language
development).
 As a result, this language deficit would cause learning problems and poor
academic achievement.
 Social isolation and poor self-concept may also be caused by a lack of
communication skills and poor social.

Impact on Family
 When a family receives news of a child’s disability or special need, the parents
sometimes feel denial, guilt, anger or shock initially.
 As they start to slowly accept the news and work towards aiding and assisting
their child in any way possible by making adaptations in their home, securing
resources and financial assistance, etc. they may feel stress, fatigue and
possibly even helplessness.
 Slowly, they will need to make the necessary changes in their home
environment and in their lifestyle to accommodate the child with the special
need.
 In the case of Hearing Impairment, ongoing hearing tests and screening,
meeting with doctors, specialists and resource aids, speech therapy, etc. is
something the family can expect in their long-term future.

Doctors

 In Lily’s case, if her hearing impairment hadn’t been diagnosed at birth, then the doctor
would have been the first professional to be contacted when a hearing loss was
suspected. The signs and symptoms have been discussed earlier that would raise concern
and require a hearing test to be performed. At the family’s request, a family doctor or a
paediatrician would send the child to an audiologist for the hearing test or screening. The
primary care physician may also provide a referral to a doctor who specializes in medical
genetics, to find out if your child’s hearing loss may be hereditary. That may help you
determine if a similar hearing loss could occur in your other children

Doctors
 Because Lily’s parents have recently moved to Toronto, they would need to find
a family doctor or a paediatrician in the area. According to an article in The
Huffington Post, the doctor shortage that we had experienced a few years ago
in Toronto has been resolved. Presently, we may have an influx of doctors in
Canada, some of whom may remain jobless for a while due to the saturation in
that field over the past 5 years.
 When looking to find a new doctor, here are some tips that are beneficial to
use:
1. Ask your last doctor for recommendations.
2. Ask your family and friends for referrals or recommendations.
3. Search locally for Medical Centres in the area.
4. Go to a Walk-In Clinic.
5. Use the CPSO (College of Physicians and Surgeons of Ontario) Doctor Search
online.

Audiologists
 Once a Doctor feels it necessary, he will
refer the patient to an Audiologist for Hearing
Screening. The audiologist is the health
professional that would run the necessary
tests in order to determine if there is a partial
hearing loss, mild to severe hearing
impairment or profound hearing loss and also
the type of hearing loss. This is done by
performing a series of behavioural and
objective tests. The audiologist also is trained
to fit hearing aids and to help you gradually
adjust to the aids. This usually requires
periodic followups to observe changes and
progress in hearing abilities. The audiologist
may also refer you to an ENT (Ear Nose
Throat) doctor for futher screening.
 Because Lily has already been identified as
having a severe case of Hearing Impairment,
she would have seen an audiologist already
and will need to find a new audiologist in
Toronto for future follow-ups to monitor her
hearing.

Some hearing tests performed by
Audiologists:
 Auditory Brainstem Response (ABR) Test - a test that checks the
brain's response to sound; the person being tested can be sound asleep
during the test, they do not need to be awake and active.

 Otoacoustic Emissions (OAE) - a test that checks the inner ear’s
responses to sound. The person does not need to be awake during this
test.

 Behavioral Audiometry Evaluation – this test allows the audiologist
to assess how a person responds to sound overall by testing the
functions of all parts of the ear. The person being tested must be awake
and actively responding to sounds heard during the test in order to
have accurate results.

ENT (Ear Nose Throat) Doctor or
Otolaryngologist

 After the initial screening is performed by an audiologist, the child will be referred to an
otolaryngologist, who will then determine if there are any underlying issues that may be
(atleast partially)causing the hearing loss.
 The ENT Doctor will also be the one to verify if the problem can be treated medically or
surgically and then will provide such treatment. X-Rays, CT-Scans, MRI scans, etc. may
be required in order to further assess what type of hearing loss is present. After the
assessment, simple treatments could be suggested ( like placing eardrum ventilation
tubes) or other surgical procedures may be required (Cochlear Implants). The doctor
also provides clearance for hearing aid fitting, after determining if no other intervention
is indicated. “If it is determined that your child needs a cochlear implant, the
otolaryngologist, along with the audiologist, will carry out further tests and
examinations, and will carry out the implant surgery” (Role of ENT Doctor).

Early Intervention Specialist
 A professional with an education backgroud, the Early
Intervention Specialist would assist in finding
community resources, defining family members’ roles
through the management of the hearing impairment
and addressing concerns about future educational
placement.

Speech and Language Pathologist

 The Speech and Language Pathologist (SLP) is a
professional who predicts what kind of an impact the
child’s hearing loss will have on his language
development. She will also monitor his progress and
determine if the child needs to be referred back to
the audiologist or otolaryngologist. It is also the
SLP’s job to assist the child to learn proper speech
production.
 If the parents pursue oral communication for the
child, the an Auditory-Verbal Therapist may need to
step in to direct the family towards additional
medical or audiological treatments. The AVP also
teaches the family “appropriate speech/language,
auditory, and cognitive developmental milestones
you may expect for a child with hearing loss” (Role of
Speech and Language Pathologist).

Youtube Video
 Early Intervention for Hearing Loss in Children

This YouTube Video allows us to see how successful Early Intervention
would be for children who experience hearing loss.

Technologies that can help
 Most children with mild or severe hearing impairment have some hearing; this is called
“residual hearing”. Based the parents’ preference, certain technological options can be
used to utilize this residual hearing to the best of its ability. Technology options are:
 Hearing aids – these assist in amplifying the sounds a child can hear so they sound
louder. These come in many styles, but usually for young children, behind-the-ear styles
are recommended for their growing ears. Hearing aids help babies hear sounds better so
they have a greater chance of developing their language skills.
 Cochlear implants – a cochlear implant is recommended when hearing aid is not enough,
mostly in children with severe to profound hearing loss. Cochlear implants do not make
sounds larger; instead, they send sound signals directly to the hearing nerve. A surgery is
required to place some part of a cochlear implant inside the ear, while the other parts are
worn outside of the ear post-surgery. The sound signal is carried from the outer parts to
the inner parts of the cochlear implant.
 Bone-anchored hearing aids – used when children have either a conductive, mixed or
unilateral hearing loss, these aids are also recommended for children who cannot
otherwise wear “in the ear” and “behind the ear” hearing aids.

Other Assistive Devices

 FM System – a Frequency Modulation device that allows a person
with hearing loss to hear in background noise. It is sometimes used
with a hearing aid.
 Closed Captioning – usually displayed at the bottom of a TV
screen, captioning shows conversation spoken within a program (TV
show, Movie, etc.)
 Text messaging – using Text messaging on the phone instead of an
audio phone call.

Other Assistive Devices (continued...)

Flashing and vibrating
Audio loop systems alarms – these alarm clocks
– this is an audio come with a vibrator that is Telephone amplifiers – these
frequency loop placed under a mattress or are portable plug-in devices
Infrared listening that amplify the volume of
system that allows pillow; it vibrates when the
devices - an infrared incoming calls up to 100% on
hearing aid wearers alarm goes off on the clock.
listening device is a corded home or business
to hear more clearly Flashing lights also alert the
small, plastic object phones. Price ranges from $35-
by converting person that the alarm is going
(shaped like a allows a $110, depending on the type of
electromagnetic field off. Price ranges from $50-
person to listen to the device and capabilities.
signals into sound. $140.
audio description in the
theater. It works by
converting an invisible
beam of infrared light
into sound that plays
into headphones or ear
buds.

Medical Treatments
 The Hearing Loss Clinic states that Only about 10% of
hearing losses are helped by surgery or other medical
treatment
 90% of hearing losses can be treated with the use of
hearing instruments

Medical/Surgical Procedures
 In most cases of conductive hearing loss (occurring in the outer
or middle ear), medications or surgery can assist with improving
a child’s hearing.
 Hearing loss caused by a chronic ear infection occurs when fluid
builds up behind the ear drum in the middle ear. If this doesn’t
clear up with medication, a simple surgery can be performed to
place a tiny tube in the eardrum to drain the fluid out.
 Conductive hearing loss due to a part of the ear forming
incorrectly while the baby was growing in the womb can be
improved or corrected with surgery. An Otolaryngologist will
usually determine the steps to take in correcting this issue.
 Surgery is required for cochlear implants and bone-anchored
hearing aid as well!

Physical environment
Labelling System
1. Signs for Direction (names and pictures on- shelves for toys, cubbies, writing and art material holders, etc.)
1. Allergy Board – pictures of children with pictures of items they are allergic to.
2. Bigger, darker labels than normal so everything is clear and simple for Lily to understand and refer to.
3. DAISY – a Digital Accessible Information System, these books contain both sound and text.
4. Closed Captioning – When showing the children an informative video, whether it is part of my own planned
curriculum or whether we have a guest visitor showing a video to the children, we make make sure to have closed
captioning so that it’s easier for Lily to follow along.

Physical Environment
 Promote more learning through a variety of materials
incorporated into many different curriculum areas.

ASL Number Puzzle ASL Alphabet Peg Puzzle
First Signs Match Up Signs Flash Cards
Keep Quiet Sign Language
Cubes Game

I love you Floor Puzzle
Sign Language Vocabulary Cards
Fingerspelling Blocks Sign Language Bingo

Changes in Teaching Strategies
Routines/Transitions
 I will make sure that routines should be clearly
defined with same expectations as for other
children, but allow more time for Lily. I will
have to make sure I follow through on
expectations from Lily.
 I will create a labelled chart of daily routines
(pictures and words)
 I will allow a little more time for transitions
from one activity to another, especially when
going from high activity to low activity & vice
versa, and from indoor to outdoor & vice versa.
 I will learn sign language by signing up for
classes, so that I can communicate with Lily a
little better. While I wait for my classes to
start, I will search for some basic ASL training
videos on YouTube to teach myself and Lily
some simple gestures for common terms and
words.
 Since Lily has never been in a child care setting
(she was looked after by her grandparents), I
will have to give her some time to adjust to our
routines and adapt to the set schedules.

Changes in Teaching Strategies
Adaptive Play Materials
 “Adaptations help children to develop independence, interact with their peers
and manipulate materials”(ConnectABILITY)
 The 4 strategies used in making these adaptations are:
1. Stabilize – secure materials onto a surface underneath
2. Enlarge – add small pieces or materials to make a toy accessible
3. Enhance – when parts of a toy are used differently to make it more accessible
4. Simplify – reduce the number of steps, remove the number of pieces or replace the number of materials
 In Lily’s case, I would especially use the enhancing technique to add
bright/bold colours, add pictures to any toys that have just words on them
and make writing appear larger.
 I would also use the simplifying technique in the beginning, when she is just
starting to use certain new toys or play certain new games with us, that she
might be experiencing for the first time at our centre.

American Sign Language
 “American Sign Language (ASL) is a
complete, complex language that employs
signs made by moving the hands
combined with facial expressions and
postures of the body. It is the primary
language of many North Americans who
are deaf and is one of several
communication options used by people
who are deaf or hard-of-hearing”
(National Institute on Deafness and
Other Communication Disorders).
 Although not all forms of sign language
from different parts of the world is exactly
the same, many words and terms are
similar and correspond with each other,
making it easier for people who are deaf
or hearing impaired to communicate with
others.
 I will encourage Lily to learn some sign
language (if she doesn’t already know it)
and I will use this form of communication
in class regularly.

Teaching New Skills and Routines
 Because Lily has a severe hearing impairment, it will be very important
for me to modify my strategies in the classroom with her, especially
when trying to teach a new skill. One of the things I plan on teaching
her if she doesn’t already know it, is sign language. I would use the
technique of Prompting and Fading to accomplish this.
 Types of Prompts are – Physical, Modeling, Gestural, Visual, and
Positional Prompts.
 Normally, with any child who has a special need, I would use all the
types of prompts in that specific order, with full and partial prompting
at each step. But with Lily, if she does not have any hearing at all, then
the verbal instructions that are a part of the Modeling and Gestural
Prompts will have to be modified so that I’m either using only gestures
with her, or if she has already learned to read well, then I can write
down the words that I would have used while Modeling or Gesturing.

Using Visuals
 With Lily, I would use some other tools besides classroom
labels, to help her learn routines.
 First/Then Board – I would use a First/Then Board with
Lily to teach her the sequence of events in our routines. It
will also assist with skill-building when I need Lily to do an
activity she doesn’t enjoy very much by showing her that a
more-preferred activity will follow.
 Choice Board – During some parts of the day (eg: free play,
outdoor playtime, etc.), an individual choice board can
allow Lily to make her own choices of what materials/toys
she wants to play with. In the beginning, I will include a
non-preferred activity choice on the board to teach her to
make choices, then I will only include the activities she
enjoys.

Offer support for Self-esteem and
Motivation
 I will make sure Lily has many opportunities to work with me one-on-one or in small groups with
other children in order to learn through a variety of interactions and social situations.
 I will offer her a variety of open ended materials and developmentally appropriate experiences so she
can be challenged and create her own learning.
 Some other things I will constantly check and implement as strategies for successful integration are:
1. Philosophy – children are more or less the same, and we should all work together as a team.
2. Observation – look longer and deeper at what Lily can and can’t do, and especially remain observant
of her non-verbal behaviour and interactions with others.
3. Physical Presence – even if I’m not standing right beside Lily, I should position myself in such a way
at all times that I can see her and get to her quickly should the circumstance arise that she needs me.
4. Modeling – I will learn to use sign language and use it consistently so I can effectively model to her
the behaviour I want her to learn.
5. Choices - since Lily has a hearing impairment, she will need a little more time to understand what
needs to be done (rather than just being able to hear instructions and follow them quickly); I will
have to be patient in allowing her time to follow instructions and also in making her own choices.
6. Praise and Encouragement – because of Lily’s situation, I would use more non-verbal gestures like a
pat on the back, high-5, wink and nod. I will also have to use precise facial expressions a bit more
than I would with other children in the room.
7. Active Listening – I would have to be extra attentive to Lily when she approaches me for help or needs
something. During times of high activity (playing outdoors, getting ready to head home, etc.) I
would need to keep my eye on Lily and the children around her to read her non-verbal behaviour and
react appropriately.

The child as a part of the larger
group of children
 I will create awareness of Lily’s Hearing Impairment by talking to the
children about this. I will use storybooks, a short video or two about
Hearing Loss, and other resources to teach the children about this
special need. Then I will allow them time to formulate and ask any
questions they have so I can provide them a complete understanding of
Lily’s situation and ensure empathy from them. I will, of course, go to
the library to research appropriate books on hearing loss, search for
youtube videos and look for any other resources to use with the
children.
 Then I will also use Social Stories to teach the children about accepting
others, sharing and caring, etc. so they can learn what is appropriate
and not when they are interacting with Lily every day. A social story is
a tool for teaching social skills to children. In this case, the social story
will be used to prepare the children for the new event of having a child
with a hearing impairment in our classroom; it will teach them positive
behaviour.

Collaborative Planning, Staff Training and Communicating with
Parents of Child with Special Needs
 I will research many different sources in order to learn more about Hearing Impairments
and what more I can do for Lily in my classroom. I will also research resources to help
Lily’s parents in their situation.
 I will set aside some time on a weekly basis, and as required by Lily’s parents, to connect
with them about Lily’s learning and development progress. We will collaborate and plan
towards her future. Regular charts and a Home/School Communication Book will be
created in order to track issues, concerns, accomplishments and overall progress.
 I will also try to learn some Chinese, or initially have an interpreter present for my weekly
meetings with Lily’s parents, since they don’t speak English too well. I will also refer to
them some ESL classes if they wish to find out how to learn more English or get fluent in
the language.
 Materials will be added to our classroom to promote diversity and add to Lily’s sense of
belonging while she is in our classroom (Books on Chinese culture, Dolls to match her
looks a little more, Photographs of Chinese Traditions, Paintings, etc.)
 Using our “Identifying Skills to Teach” handout from Week 6, I will follow the steps
closely to first choose a single area or skill I want to teach, break it down into smaller
steps, build Lily’s confidence and motivate her through reinforcement, keep track of the
progress and invite other teachers and Lily’s parents to join in teaching the skill as well.

Communicating with Lily’s Parents
 The first thing I will do is to speak with Lily’s parents and identify what
her situation is like, in detail. If this requires an interpreter, I will
contact one through the Agency Supervisor, so that we can
communicate properly without any obstructions.
 I will find out what type of Hearing Loss Lily has and at what her
history has been like. Of most concern will be whether or not Lily has
been fitted with any hearing aids or implants or if she’s undergone any
surgery to correct her impairment. I will also check with her parents
whether or not Lily uses any technology or assistive devices to help her
in everyday activities and communications. Then I will ask if they use
sign language to communicate with her. The answers to these
questions will help me get a holistic idea of Lily’s situation and will
help me in planning for her more effeciently.
 Then, together, we will decide on a joint approach to assist Lily in her
learning and development at home and at daycare.

Providing Support/Resources
 Family Support Services
 For Lily’s parents, whether they have just recently found
out about Lily’s hearing loss or have been aware of this for a
long time, they would still need a lot of support.
 “Parents of children with recently identified hearing loss
can seek different kinds of support. Support is anything
that helps a family and may include advice, information,
having the chance to get to know other parents that have a
child with hearing loss, locating a deaf mentor, finding
childcare or transportation, giving parents time for
personal relaxation or just a supportive listener”(Family
Support Services).

Doctor
 The doctor is who makes the initial diagnosis and then makes
the referral for diagnosis and links the parents to other resources
for support. Lily has already been diagnosed as hearing impaired
so in this case, the doctor would be needed for the other
assistance rather than the diagnosis.
 Because Lily’s parents have just recently moved to Toronto, they
would need to find a doctor for her. This can be done using an
online database of doctors, called The College of Physicians and
Surgeons of Ontario. This online search is free of charge, serves
all residents of the province of Ontario and does not require a
referral. Any person can go online and search the database by
plugging in some key information about what type of doctor you
want, whether you would like to request a female or male doctor
specifically, what language is primarily spoken, what area you
prefer the doctor’s office to be located in, etc.

Audiology at Rouge Valley Health System
(Centenary Site)
 Audiologists screen patients for hearing loss by running tests and assessments. They also provide intervention
supports for children who have hearing loss.
Audiology at Rouge Valley Health System –Centenary
http://www.rougevalley.ca/rehabilitation
2867 Ellesmere Rd
Scarborough, Ontario
M1E 4B9416-281-7266
Fax: 416-281-7224
audiologists@centen.on.ca
The Audiology department at the Centenary Hospital in Toronto provides all audiology services: audiological evaluation,
hearing aid prescription, aural rehabilitation, central auditory screening, auditory brainstem response assessments and
infant auditory brainstem response. Their children screening services are top notch- all tests are play based. One test
utilizes peg boards (the child should add a peg to the board each time a short sound is played in his ear. The results are
recorded to see, on average, how many times he was successful in hearing the sound and placing the peg on the board).
Another test requires the child to sit on a chair in the middle of the sound room, and then a short sound is played at
short intervals to see if the child acknowledges the sound. These sounds vary in pitch, allowing the audiologist to
assess and record the range of hearing for the child in both ears individually. These are some of the tests used on
preschoolers and school age children. Services are available in French, Cantonese and Mandarin, which is benefical to
Lily’s parents who speak Cantonese primarily and only a little English. The clinic is child-friendly, welcoming the
patient’s siblings to also play with other toys provided for the purpose of keeping them occupied and happy so parents
are less stressed.
Fee – Covered by OHIP
Referral – usually referred by a doctor, but services can also be arranged independently.
Availability – some waiting period, usually 6 months to a year, depending on the diagnosis and age of child.

Octolaryngology at Sunnybrook Hospital
 Otolaryngology is a “medical specialty concerned with
illness or injury of the ear, nose, and throat (ENT), as well
as medical and surgical treatments for diseases of the ear
and skull base” (Octolaryngology at Sunnybrook).
Octolaryngology at Sunnybrook Hospital
http://sunnybrook.ca/content/?page=Dept_ENT_Home
Sunnybrook Health Sciences Centre
2075 Bayview Avenue,
Suite M1 102
Toronto, ON M4N 3M5
Tel: (416) 480-4138
Fax: (416) 480-5761
The Octolaryngology department is located in the Sunnybrook Health Sciences Centre building and provides many medical and
surgical treatments sought by people suffering from a hearing loss. Services provided are – Audiology, Cochlear Implant
Program, Dizziness Clinic and Vestibular Lab, Head and Neck Oncology Clinic, and the Hearing Aid Centre. A referral is
required from a doctor or audiologist; forms are provided online.
Fee – covered by OHIP partially/Insurance or Full payment of costs and services
Referral – made through a doctor or an audiologist. Forms are provided on the website.
Availability – usally about 6-9 months for an appointment

Interpreter
MCIS Language Services
 An Interpreter translates the message from one
language to another after each person speaks in a
conversation.
MCIS Language Services
http://mcislanguages.com/
789 Don Mills Rd
Suite 608
North York, Ontario
M3C 1T5
MCIS Language Services is an online website providing Oral Interpretation Services, Translation and Transcription, and Social
Intitiatives in over 200 languages. Requests can be made online 24/7 for an in-person interpreter, or for a scheduled
phone/video interpreter.
Fee – unable to find accurate fee unless a form for interpreter services is filled out and submitted.
Referral – no referral required
Availability – phone and Video interpretation services are available immediately upon request, but if an in-person interpreter is
reqired, it takes about 24 hours is the suggested waiting period.

Speech and Language Therapist
Toronto Preschool Speech and Language Services
 Speech and Language Therapists work with a child to
assist in the development of the child’s verbal and
non-verbal communication, language and also their
swallowing and feeding skills.
Toronto Preschool Speech and Language Services
Preschool Speech and Language Program
Toronto Public Health
416-338-8255 (voice)
416-338-0025 (TTY)
tpsls@toronto.ca
Toronto Preschool Speech and Language Services provides an excellent program for children who may require a wide range of
services or assessments due to delays in language or speech development. Services are free, do not require OHIP coverage, and
are provided for all ages from birth till entry into senior kindergarten. Services provided include – assessment of children’s
language development, speech and language workshops for children and their families, therapy in groups or individually if
needed, and a transitional plan for the child when he is ready to start kindergarten.
Fee – No cost to the family.
Referral – No referral required. Parents, Caregivers, Nurseries, etc. can call the agency directly.
Availability – Appointments are given in a timely manner; at the most, 1 month wait.

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Week 4
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 McCaie, Lisa. Centennial College. Inclusion of Children with Special Needs. Class Handout.
Identifying Skills to Teach. Week 6

 Online Website. Family Support Services. Centers for Disease Control and Prevention. Retrieved on March 18, 2013 from
 McCaie, Lisa. Centennial College. Inclusion of Children with Special Needs. Class Powerpoint. Week 9

 The College of Physicians and Surgeons of Ontario. Online Database. Retrieved on April 1, 2013 from
http://www.cpso.on.ca/docsearch/
 McCaie, Lisa. Centennial College. Inclusion of Children with Special Needs. Class Powerpoint. Week 9. slide 9
 Rouge Valley Health System Centenary. Learning Disabilities Resource Community. Retrieved on April 1, 2013 from
http://www.ldrc.ca/community/directory/?id=131
 Audiology at Rouge Valley Centenary. Retrieved on April 1, 2013 from http://www.rougevalley.ca/rehabilitation
 Patient Services. Octolaryngology at Sunnybrook Hospital. Retrieved on April 1, 2013 from
http://sunnybrook.ca/content/?page=Dept_ENT_Prog
 Octolaryngology at Sunnybrook Hospital. Welcome. Retrieved on April 1, 2013 from
http://sunnybrook.ca/content/?page=Dept_ENT_Home
 Interpreter Services. MCIS Language Services. Retrieved on April 1, 2013 from http://mcislanguages.com/interpretation/
 McCaie, Lisa. Centennial College. Inclusion of Children with Special Needs. Class Powerpoint. Week 9. slide 12
 Toronto Preschool Speech and Language Services. Preschool Speech and Language Program. Retrieved on April 1, 2013 from
http://www.tpsls.on.ca/psl/services.htm

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