Pediatrics

Practical details to ensure classroom success

Pandemic or not – hearing and learning in the classroom remains a priority.

Over the last eight months or so, educators across the globe have reinvented the landscape of education. Now, I don‘t work in the local schools – but rather for a global company. Near and far, I have colleagues in my town, my state, my country or my planet, and when I ask these varied individuals what is going on with education for their children – their answers are equally as diverse. While a school day’s make up is demonstrably different from one area to the next, I have still felt a great sense of unity.

Deep-rooted in each of us is a passion to help people hear well and be safe, to understand what the frameworks are to make our own decisions that meet the unique demands of our lives. Everyone that I’ve talked to has felt anxious and confused at various points during this calendar year, and my educator friends tell me that they are reinventing the plan for this school year as frequently as the sun rises and sets. How do we make, plan and feel confident with so much uncertainty and unknown? Anyway, this isn’t a therapy session, but rather a place to share the framework of using hearing assistive technology in education during a pandemic.

Both of my children have hearing loss. One is in his last year of preschool (the noisiest place on Earth) and the other will start third grade. Neither one of them listen to me nearly as much as I think they should – and it’s not due to their hearing loss, but because they’re independent thinkers who know what they want out of life – and it’s clearly not cleaning their room.

The goal of helping my children – and all children – hear and learn in the classroom has been my battle cry these last few months. I’m not exaggerating when I say that I’ve put every Roger™ microphone to the test; I’ve sanitized them every which way; and I’ve tried lanyards, belt clips and boom mics. I’ve put masks on the Phonak mascot Leo. No, I’m not in local education – but I’m in the trenches with you.

I’ve collected the most frequently asked questions that educational audiologists, teachers of the D/deaf and pediatric clinicians have asked Phonak. Below you will find a skimmable resource that gives the framework to be more confident in school environments.

Disinfecting hearing assistive technology

  • The basics

Phonak recommends water-based disinfectant solutions or 70% isopropanol solutions on their devices. While new additions to EPA approvals are being made regularly, the R&D teams at Phonak do not have test results to specify how unique sterilization agents may degrade its devices overtime. This is true for both ‘normal’ sanitization cadences and the increased cleaning standards due to COVID-19. That said, a certain amount of ‘wear and tear’ should be expected on surfaces. Keeping your device covered through extended warranties or a comprehensive service plan will ensure these devices can be serviced, if needed.

Read the current COVID-19 Guidelines for sanitizing Roger products in classrooms on our website. Additionally, this how-to document provides tips and tricks for disinfecting multiple types of hearing devices.

  • Specific cleaning product possibilities

In context of the above, and according to the EPA’s criteria, these following are safe cleaning agents for our products. Our local team knows that schools and pediatric clinicians only have minutes to disinfect devices, so cleaning solutions that have short contact time are important.

But, if you’re not looking for a specifically approved product, there are easy to get cleaners, likely already in line with what your infection control protocols have been. Simple and inexpensive alcohol prep pads and wipes meet both the EPA’s guidance and input from Phonak.

You can review the full information from the EPA List-N here.

  • UV lights and fogging machines

UV light sanitation and fogging have been hot topics during COVID-19. Just like other small- scale disinfectant solutions, Phonak does not have empirical evidence to say how these two tactics will impact devices long term. At the end of the day, each district is going to make its choices around what cleaning solvents should be used. The health and well-being of staff and students is paramount. This year, more than any other, we should expect more wear and tear on HAT. Practically speaking, Phonak recommends that you keep technology in warranty where you can. But rest assured, the Roger for Education portfolio of solutions was designed to be durable. So as you prioritize health, don’t perseverate too long over what type of sanitization requirements your districts have.

In the classroom – with masks and distance

  • The basics

Per a recent Hearing Review article, we see that different masks negatively impact speech understanding, attenuating between 3 to 12 dB depending on the mask type. Meanwhile, we already know that children need a positive 15 dB SNR. Taken together, this is a challenge for all students.

It’s likely that a child using hearing technology will encounter educators wearing different types of masks and/or face shields. It’s always important to slow down when speaking to children, and now be mindful of speech reception. Masks can also create vocal fatigue for educators and students.

When considering the use of a cloth mask versus a cloth mask with a clear plastic window, or clear facial shields instead of a mask to make speech cues available, we really need to think about the unique needs of the individual.  When we think of the auditory continuum of a very oral/aural communicator compared to a student who relies on visual cues, possibly including sign language, we know that there will be very different needs and considerations. Students who are more auditory based, may prefer less distorted audio signal and fewer visual cues over more distorted speech sounds with more visual cues. Or vice versa. Every child has unique needs.

  • Using DM (digital modulation) technology to clarify speech signals   

The recommendation from Phonak is to use the Roger mic in ‘lanyard’ mode (i.e., worn around the neck). While using the boom mic is a common idea discussed in schools, internal investigations have shown that lanyard mode is less impacted than the boom mic. If the solution your district adopts includes the boom mic, do keep the mic outside the mask and an inch away from the mask to avoid noisy contact.

In general, the Roger systems work very well even when worn with masks; but understandably there can be some perceived sound quality differences when the mask is in use. Nonetheless, the adaptive gain model and sound cleaning features within the Roger microphone help maintain the best signal-to-noise ratio possible in noise and over distance – especially when we have the six-foot social distance rule.

  • Using Soundfield technology to reduce vocal fatigue and improve learning for all students 

With the degraded speech information, due to masks, in effect we have given everyone a mild hearing loss. Adding a Soundfield system to the classroom is a simple and inexpensive solution to make sure everyone is hearing the teacher as clearly as possible.

We’ve had research for years that adding a classroom Soundfield system can make a remarkable difference.1-4 Last year, we published a compendium5 of the research that shows how a classroom soundfield system can benefit students and teachers. It includes some of the most influential benefits, including:

    • Improves speech understanding up to 50% for normal hearing children
    • Helps children pay attention and improves in-class discipline
    • Improves academic success
    • Reduces vocal strain of teachers
    • Reduced teacher absenteeism due to voice loss and reduced replacement-teacher costs

Because soundfield systems improve the SNR of the listening environment and provide uniform amplification throughout the classroom,6 they can help children pay attention, hear and understand the teacher better, while simultaneously reducing vocal fatigue for educators.7 For more information visit the Phonak SoundField evidence webpage.

  • Using student mics to help all students hear class discussions

Student microphones, such as a Roger Pass-around mic, don’t actually have to be passed or touched. These devices come with a little stand and can be placed on desks. On social media, there are also innovative ideas being shared: such as connecting a Pass-around mic to a dowel rod, so the teacher can use that to almost ‘interview’ students from afar. This allows for hands-free and social distancing objectives to be met. Whether you use the classic, hands-free option of the desk stand or come up with your own solution, there are a few things to consider as you evaluate this solution:

    • Are the students able to easily understand each other without a peer microphone?
    • Are the students adopting the hand washing or sanitization protocols of the school consistently?
    • Are students appearing to be more fatigued and/or distracted this school year than last – could listening fatigue be impacting this?

Pass-around mics could be placed on a students’ desks or in mic stands in a few places throughout the room, and each time individuals contribute, they could hands-free speak into the microphone. The signal would then be routed into the SoundField DigiMaster solution and into the Roger receivers of the hard of hearing student. This approach helps overcome the negative speech effects of masks. With device disinfection protocols and regular student hand sanitization, the benefit to increased incidental learning and peer interaction will be observed.

The home classroom – connecting with people through technology

  • The basics  

There are a lot of different devices that families will be using to connect their student to the education. Some devices will be given to the students, while other devices will be supplied by families when available. Whereas in the classroom, students rely on multimedia at unique moments throughout the day, when virtual learning, multimedia and virtual environments drive the entire educational and social-emotional environment. These complexities can seem overwhelming, but with a basic framework, school professionals can get to the heart of the issue.

  • Understanding the teacher lessons via multimedia     

There are different documents available to walk professionals through how to connect computers and tablets to HAT. Refer to Phonak.com on their Roger Reference Sheets for Teachers page. Additionally, See, Hear, Communication Matters has created practical resources you may want to review.

After you’ve figured out these answers, then you can begin setting up the output and input configurations. When it comes to connecting Roger microphones, you just need a 3.5mm cable to plug the DM or accessory into the computer. If the parent needs to listen, a simple Y-splitter will accomplish this. Lastly, if the input setting deactivates the computer’s internal microphone when you plug in DM, you can try to manually override the input settings on the device in the control panels. If not, you’ll need a little splitter with an audio out (for the student) and an audio in (for the student’s external mic). This is available from Phonak or online retailers. If you need to split the audio out into two (student and parent) and then also route audio in, there are solutions via online retailers.

    • Last, you’ll need to know if the student is expected to speak.
    • Next, you’ll need to determine if a parent will need to listen to the whole session or just do a listening check – or if there are siblings in the same grade, would they need to participate simultaneously?
    • When trying to figure out how to pair HAT to the computer, the first question to answer is – What HAT will the student use? Is it a Bluetooth hearing instrument? Will they connect through FM/DM technology (like an Touchscreen Mic, Multimedia Hub or old Inspiro)? Or will they connect through an accessory like a ComPilot or TV Connector?
  • Parent support while learning

On HearingLikeMe.com, parents and teens can find real stories by real people with hearing loss. There are some great FAQs and blogs about remote learning, college and COVID-19 available.

My children will both start the school year remote this year. I’m not even sure when they’ll be back in their school buildings. As I said, my daughter will be in third grade. I remember my third-grade classroom in great detail,  including the math chart hanging next to the chalk board, the pet bunny next to the reading nook, and our classroom, being next to the door to the playground. Thirty years from now, when my daughter looks back at this year – I know she will remember her third grade classroom much differently.

I hope that with increased understanding of some of the above details, that my daughter’s teacher and all teachers, despite living through something brand new will be confident that the hearing technology will be able to keep up with whatever COVID has to throw our way.

 

If you’d like to learn about these topics in more depth, you can watch a recent two hour training done by the Phonak US Pediatric team. Visit the Training page. One thing educators shared after those trainings is that they loved learning from each other. In the comments, please share what new ways you’re supporting the D/deaf and hard of hearing students you work with.

 

References

  1. Bennett-Long, A. (2001). The effects of soundfield amplification on reading achievement. Valdosta State University. Retrieved from http://citeseerx.ist.psu.edu/
  2. Flexer, C. (2002). Rational and use of soundfield systems: An update. The Hearing Journal, 55(8), 10-18.
  3. Larsen, J.B., Vega, A., & Ribera, J.E. (2008). The effect of room acoustics and soundfield amplification on word recognition performance in young adult listeners in suboptimal listening conditions. American Journal of Audiology, 17, 50-59.
  4. Millett, P., & Purcell, N. (2010). Effect of soundfield amplification on Grade 1 reading outcomes. Revue canadienne d’orthophonie et d’audiologie, 34(1), 17-24.
  5. Appleton-Huber, J., Bacic, L., & Venkatesan, A. (2018). Phonak Compendium. A review of soundfield amplification systems. Retrieved from https://www.phonakpro.com, accessed August 19, 2019.
  6. Crandell, C.C. (1998). Using Soundfield FM amplification in the educational setting. The Hearing Journal, 51(5), 10–19.
  7. Roy, N., Weinrich, B., Gray, S.D., Tanner, K., Toledo, S.W., Dove, H., Corbin-Lewis, K. & Stemple, J.C. (2002). Voice amplification versus vocal hygiene instruction for teachers with voice disorders: A treatment outcomes study. Journal of Speech, Language and Hearing Research, 45, 625–638.

 

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