First Cohort of Teletherapy Program by Hear Me

The teletherapy initiative began in January 2019 with the two professionals taking an online teletherapy course. The hiring process began the next month, in February. From March to August 2019, teletherapy sessions were conducted for six months. Two specialists, Dr Basyariatul Fathi Othman and Nurul Akmar Abdul Aziz, will present the therapy.

Hear Me launched a teletherapy project for people in mainstream school to address the availability and accessibility of excellent therapy services. Children with hearing loss and their families can get excellent therapy that would otherwise be inaccessible owing to their age and location. Services would be provided regardless of inclement weather, logistical difficulties, or incapacitating distances. The goal is to give high-quality therapy by highly skilled experts who are certified to work with this demographic.

As a result, Zoom was picked as the teletherapy platform. The dependability and efficacy of each piece of equipment is treated carefully since therapy is offered to children with hearing loss who require limitless access to sound. Families reported utilising laptops, desktops, tablets, and cell phones during teletherapy sessions.

Hear Me approached 40 potential candidates among DHH school-aged children whose families are members of the organisation. The criteria are:

• Children with hearing loss who use hearing devices
• Children with hearing loss who attend mainstream education settings (kindergarten, primary, and secondary schools)
• Children with hearing loss who have not been receiving therapy for the past six months at teletherapy commencement, and will not be receiving therapy for the next six months after teletherapy conclusion
• Access to reliable internet connection
• Access to laptop, computer, or tablet with webcam
• Commitment for the whole six months
• Can afford the fees
• Priority for families outside Kuala Lumpur due to the scarcity of services

Ten families responded to an invitation to participate in a teletherapy project for their child, but only five signed up. One parent dropped out after the first session, because their child regarded the tablet used as a gaming device and was very distracted during the session. The final four children in the pilot cohort are all CI users and were implanted before the age of 3.5 years old. Their chronological ages range from 6 to 10 years old. Three of them are in primary schools, while one is in a private kindergarten.

The language spoken for three of the families uses Malay as the main language of communication while one uses English. Sessions were conducted in the family’s preferred language to facilitate the transfer of activities and skills from therapy into the family’s daily routine.

Domains

1) Speech-language and listening

Each child received two speech-language therapy sessions monthly, once in every two weeks. Sessions were scheduled on weeknights, starting at either 8:00 or 8:30 p.m., lasting for one hour. The parent that sit with the child for the session were usually the mothers.

The first session contained assessments to baseline the children’s performance in listening, receptive, and expressive language skills. More specifically, the focus was on auditory memory and comprehension, narrative skills, and language-related cognitive concepts. A plan was then drawn out for each child, for each week, via discussion with the mother.

After the initial session, the framework of the subsequent sessions was as follows:

a) Revision of home programme given in the previous session

b) Discussion of today’s plan

c) 1-2 auditory skills tasks

d) 1-2 narrative skills tasks

e) 1 cognitive concept task

f) Discussion of today’s performance, and home programme for the next two weeks

g) Wrapping up

Tasks were conducted by:

a) The professional or mother giving instructions to the child:

• Child conducted the tasks using any materials available in the room/at home
• Child and mother looked at the shared screen from the professional where she had materials displayed from pictures/graphs/ etc.

b) Mother conducting the tasks with the child, with the professional observing and coaching mother

c) Mother and the professional going through a recorded video of the child doing the home program task, and they discussed the strengths and improvements to be made.

2) Reading and writing abilities

Reading and writing sessions fall under the category of literacy. Every month, each child had one hour of reading instruction. Each child’s mother was interviewed at the first session about their hearing loss, communication at home and at school, academic achievement, and the mother’s expectations of the programme.

Assessments were given to establish a baseline of the child’s reading and writing abilities (e.g. letter naming, fluency, word attack tactics, and comprehension) (e.g. letter formation, spelling). Following the intake interview, a typical teletherapy session would begin with a review of the previous session’s ‘homework,’ followed by the current session’s plan.