The use of Interpreters in Paediatric Cochlear Implant Aural Rehabilitation KerryLee Galliard B'A' S

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The use of Interpreters in Paediatric Cochlear
Implant Aural RehabilitationKerry-Lee
GalliardB.A. (Speech Pathology and Audiology)
WitsJohannesburg Cochlear Implant Program
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OUTLINE

• Why the need for this paper?
• Cochlear Implant Programs what do they offer
  currently
• Aural rehabilitation goals in paediatric A.R. in
  general and the techniques
• Using untrained therapeutic interpreters in A.R.
  and the consequences
• How to overcome this an ongoing dilemmabut
  maybe some solutions

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Reasons behind the paper

• The use of cochlear implants is becoming more
  widespread throughout Africa
• BUT
• Limited Information (limited sources) .
• Limited resources
• Audiologists
• Aural Rehabilitation facilities
• Education
• Cochlear Implant programmes

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Why is this an Issue?

• Patients from other parts of Africa who receive
  an implant often have to relocate often
  temporary relocation (Visits often cut short)
• Difficulties Visas
• Finances
• Accommodation
• LIMITED TIME TO ASSESS AND IDENTIFY AND
  EFFECTIVELY MODIFY THE C.I.

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Limitations of Current Programmes

• Limited access to all African languages
• Slade, J. - No institution can afford to house
  linguistic experts to cover all languages
• Translation and/ or interpreting have been
  acknowledged as obvious tools to facilitate
  implementation of our language policy where
  people are able to receive oral communication in
  the language of their choice (Wallmach, K)
• But how well does this work when specific therapy
  techniques and aims need to be achieved??

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Aural Rehabilitation Goals in Paediatric Cochlear
Implants

• Ensure the C.I. Map (the setting of the implant)
  is providing the child with access to all
  frequency specific information needed
• To identify whether the child is using the
  auditory information obtained effectively
  listening skills and oral communication
• To teach the child how to use auditory
  information obtained through the C.I. effectively
  Listening skills and oral communication

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Techniques in fulfilling the A.R. Aims
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Use of untrained therapeutic interpreters in
therapy

• If the child is brought to a program not run in
  the home language he/ she needs to be
  accompanied by an interpreter
• BUT usually a family friend or relative
• Alice Chen (Health Affairs, June 2006)
• The use of untrained interpreters is like
  playing a game of broken telephone Reliably
  unreliable especially when the interpreter in a
  family member or friend

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Problems in A.R. with therapeutically untrained
interpreters

• May be tainted by interpreters
• Bias or own observations
  
• May not be
  
  Not able to
• able to
  
  identify use of
• effectively
  
  individual
• use techniques
  
  phonemes and
• shown by the
  use
  of them in
• therapist
  
  everyday use
• Not trained in
  
  Misunderstand
• language norms
  the
  subtlety of
• 
  
  listening behaviours

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How do we overcome this??

• No simple answer
• Every patient must be dealt with individually and
  their unique needs need to be met
• BUT

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MAYBE
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Other possibilities

• Supplying therapy/ C.I materials in their
  language to the family that they are able to use
  at home where there is an directly translatable
  version for the therapist.
• Addresses/ e-mail addresses of other therapists
  in the world who would be able to talk the family
  through some specifics or supply them with
  information in their language (O.K. for
  non-African languages but limited for African
  languages) also may not be enough knowledge of
  Africas infrastructure.

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Considerations

• Often late identification
• Additional developmental/ associated/ medical
  problems
• Time delay in getting support structure set up
• Parents may not always have insight into these
  problems, which will directly impact upon the
  outcomes of the C.I. and need professional
  guidance as early as possible

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On the up side

• Some parents are very dedicated to their childs
  needs and will go the extra mile to ensure the
  best intervention possible, therefore empowering
  themselves as well as their community
• Other professionals and parents have been
  motivated to get more involved in the therapy and
  educational process e.g. starting up schools for
  children with C.I.s
• There is more drive to set up C.I. programmes in
  other countries and more awareness of the
  structures that need to be implemented
  therefore increased education and information
  sharing

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Conclusion

• Technology has made the world so small
• BUT
• We still need to learn to communicate effectively
  across the divide!