BackTable / ENT / Podcast / Episode #10
Comprehensive Care For Deaf and Hard of Hearing Children
with Dr. Rachel St. John
We talk with Dr. Rachel St. John from Children's Health about the importance of early language access and collaborative care for children who are deaf or hard of hearing.
BackTable, LLC (Producer). (2020, November 24). Ep. 10 – Comprehensive Care For Deaf and Hard of Hearing Children [Audio podcast]. Retrieved from https://www.backtable.com
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Dr. Rachel St. John
Dr. Rachel St. John is a practicing ENT and Associate Professor of Clinical Medicine at Children's Medical Center Dallas/UTSW Department of Otolaryngology.
Dr. Ashley Agan
Dr. Ashley Agan is a practicing ENT and assistant professor at UT Southwestern Medical Center in Dallas, TX.
Dr. Gopi Shah
Dr. Gopi Shah is a practicing ENT at UT Southwestern Medical Center in Dallas, TX.
In this episode, Dr. Rachel St. John joins our hosts Dr. Ashley Agan and Dr. Gopi Shah to speak about different aspects of care for Deaf and Hard of Hearing children, from counseling to medical treatment.
Dr. St. John first speaks about what a comprehensive evaluation of a deaf child entails; from counseling the patient and their families, to educating families about current and future management, and rounding it off with the importance and effectiveness of collaborating with a multidisciplinary approach. She continues to talk specifics in terms of work-up regarding labs, imaging, and the possibility of genetic testing. A key aspect of this decision making is in speaking with families and understanding what their priorities and goals are and working as a team to set realistic ones.
The discussion continues while touching on specific causes of pediatric hearing loss, including Enlarged Vestibular Aqueduct among others, and the management and treatment thereof. Dr. St. John also speaks about counseling the patient as well and taking into account their age and giving guidance to setting realistic expectations, both in their school and home life.
Lastly, Dr. St. John discusses the importance of early language intervention and stresses the importance of introducing some aspect of language into the child’s development as early as possible, regardless of hearing loss or not. The early years can be vital for learning and chidren have a narrow window for language development; early intervention can greatly improve learning later down in life in Deaf and Hard of Hearing children.
Family Focus Center website - https://www.childrens.com/specialties-services/specialty-centers-and-programs/ear-nose-and-throat/programs-and-services/ffc-for-deaf-and-hard-of-hearing-children
American Academy of Pediatrics, Early Hearing Detection and Intervention - https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/PEHDIC/Pages/Early-Hearing-Detection-and-Intervention.aspx
[Rachel Saint John MD]
First, I just want to thank the two of you for inviting me to be part of this. I love what you guys are doing on this podcast. I think you're very organic interviewers. And it's a lot of fun just kind of chatting with you guys. But it's also fun to talk about work. Sometimes it's fun to not talk about work. Yeah, I mean, I think it's not anything new. I think the entire reason, in my opinion, that I have the job that I do, and what I think is the most important about it, is making sure these kids have access to language. I think it's very easily forgotten. I think sometimes we focus on all the micro stuff. We check off boxes for things like speech therapy and hearing aids. But the big thing is looking at the entire person. And I realize that I am in a clinic situation where I am built to do that. These are things that take time. But one thing I always tell parents when we look at an audiogram, I say, "I never look at an audiogram and determine if somebody needs hearing aids. I always look at a child."
So if you have a mild hearing change, and you're a straight-A student, and socially you're doing great, and you're crushing everything, am I going to double the quality of your life by putting a pair of hearing aids on you? Versus you have the same audiogram, and you're borderline failing a couple classes, and you're really struggling, and you are really hating school, that's somebody who would benefit from hearing aids substantially more. So I think that's a conversation that I think is great to have with families. But it really does take looking at the child that's in front of you and not just that piece of them in context. Because at the end of the day, this is all about function.
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