Why - Why the Medical Society constantly pressure on the Parents?

[jillio]

Why do you think that the reponsibilty lies within The Listening Center at Johns Hopkins, to promote ASL or any other method?

They obviously think it is their responsibility to promote the oral method.

 

[loml]

They obviously think it is their responsibility to promote the oral method.

So what?

 

[jillio]

So what?

Originally Posted by loml
Why do you think that the reponsibilty lies within The Listening Center at Johns Hopkins, to promote ASL or any other method?
Oral can be considered any other method, can it not? It was your question, not mine. And the ethical responsibility of all medical practitioners to to obtain not just informed consent, but fully informed consent prior to treatment.

 

[loml]

Originally Posted by loml
Why do you think that the reponsibilty lies within The Listening Center at Johns Hopkins, to promote ASL or any other method?
Oral can be considered any other method, can it not? It was your question, not mine. And the ethical responsibility of all medical practitioners to to obtain not just informed consent, but fully informed consent prior to treatment.

Please, what has consent got to do wtih them informing people about alternative methods. If the ASL community want The Listening Center to table ASL, then it is the reposnsibility of the ASL community, to approach the Listening Center. It is presumptious of you to imply that parents are making uninformed decsions based on a web site. How could you possible equate oral to any other method?

Yes, it was my question, but you choose to respond to it.

 

[jillio]

Please, what has consent got to do wtih them informing people about alternative methods. If the ASL community want The Listening Center to table ASL, then it is the reposnsibility of the ASL community, to approach the Listening Center. It is presumptious of you to imply that parents are making uninformed decsions based on a web site. How could you possible equate oral to any other method?

Yes, it was my question, but you choose to respond to it.

Because, loml, the surgeons have to have an informed consent form signed prior to surgery. Therefore, they have to provide the information that allows for informed consent either directly or through proxy. Physicians are also bound by a strict code of ethics. Failure to take the steps necessary to insure that patients or guardians of patients are fully informed is in violation of that ethical code by which they are bound.

Why would it be the ASL community's responsibility? They are not the ones performing the medical procedure. The website outlines their mission statement. A mission statement is a direct reflection of the beliefs and practices of the organization. Perhaps you should visit the website and search it for yourself.

Your question was about "ASL or any other method". What do you consider oral to be? You are going around in circles here. Your question implied that it was notthe implant center's responsibility to promote any method, ASL included. However, they are promoting the oral method. Please, stop with the circular reasoning.

 

[loml]

Because, loml, the surgeons have to have an informed consent form signed prior to surgery. Therefore, they have to provide the information that allows for informed consent either directly or through proxy. Physicians are also bound by a strict code of ethics. Failure to take the steps necessary to insure that patients or guardians of patients are fully informed is in violation of that ethical code by which they are bound.

I am familiar with consent for surgery. The consent is only as good as the individual supplying the information. Parents make their own choices when it comes to vaccinations, the move being, although not something that I agree with, none or very few vaccinnations. So even IF the surgeon asked about a vaccinnation does not mean that the parents have consented to the said vaccination. This does not mean that the parents are not making an informed decision. The reposibility lies with the parent.

Why would it be the ASL community's responsibility? They are not the ones performing the medical procedure. The website outlines their mission statement. A mission statement is a direct reflection of the beliefs and practices of the organization. Perhaps you should visit the website and search it for yourself.

What are you talking about? This has nothing to do with the surgery. If the ASL community wants families informed about ASL then the reposnisibility lies with them.

Your question was about "ASL or any other method". What do you consider oral to be? You are going around in circles here. Your question implied that it was notthe implant center's responsibility to promote any method, ASL included. However, they are promoting the oral method. Please, stop with the circular reasoning.

So what if they promote oral. My questions was not about "ASL or any other method, my question was this:

How could you possible equate oral to any other method?

 

[jillio]

I am familiar with consent for surgery. The consent is only as good as the individual supplying the information. Parents make their own choices when it comes to vaccinations, the move being, although not something that I agree with, none or very few vaccinnations. So even IF the surgeon asked about a vaccinnation does not mean that the parents have consented to the said vaccination. This does not mean that the parents are not making an informed decision. The reposibility lies with the parent.

Uh....I think you got your threads confused, loml. The thread on the increased risk of meningitis and the vaccination and responsibility of the physician to insure that it has been given is a different thread. What we are discussing here is the provision of alternative methods of dealing with deafness. Regarding your statement on the consent being only as good as the person supplying the info......that is the whole point. Which is exactly why the medical community is obligated to provide all information necessary to insure that patients and guardians of patients have the means necessary to give fully informed consent. Your remarks regarding parents choosing not to vaccinate is again, more ofyour circular reasoning. A parent can do anything they want to without informed consent. A physician, however, cannot. At least, if he want to keep his license. In other words, a patient can refuse a procedure without an informed consent on file, but a doctor can't perform the procedure without an informed consent on file. We are talking about surgery. Invasive procedures.
What are you talking about? This has nothing to do with the surgery. If the ASL community wants families informed about ASL then the reposnisibility lies with them.

We are discussing informing patients of all possible options prior to and in addition to surgery. Why don't you check with your local medical society and see what they have to say about informed consent?


So what if they promote oral. My questions was not about "ASL or any other method, my question was this:

[B]I was talking about your question previous to this question. Here it is in case you have forgotten already:
Why do you think that the reponsibilty lies within The Listening Center at Johns Hopkins, to promote ASL or any other method? (copied and pasted from your post.) If it is not their responsibility to promote any other method, then it is not their responsibility to promote oral, either. But they do.
And the fact that they do promote oral from a medical view of deafness is exactly what the topic of this thread was. Have you had a very stressful day, or {Mod Edit: Unnecessary comment removed--~RR}?

 

[jillio]

I am part of support team in discussions of IEPs that is what a special education teacher does. I am on a team that reviews testing and recommedations before the parent meeting is set up. The doctor recommended a Preschool who is going to be implanted move into the hard of hearing class. Our classrooms are primarily ASL and English. It provides either self-contained, inclusion, or part-time inclusion according to the child's needs. The doctor has to release records and that was his recommendation. You can't make a generalization about doctors. I know what was discussed and recommend to the parents and school.

Oh we as a team also provided resources for ASL for the parents.[/QUOTE]

So, parents are not getting these resources provided before the child reaches school? What about the time from birth until then?

And, thank you for the information, but I am fully aware of what an IEP team is, and what the members' functions are. Medical opinion is generally submitted by parents to support their request for a particular service, not requested by the school to support their choice ofplacement. In fact, the very nature of confidentiality laws surrounding the release of medical information is such that a parental consent for release would be mandatory before the doctor could even so much as tell the school that the child was a patient, let alone make reccomendations as to placement based on assessed medical need.

 

[rick48]

Sure.. sure.. everyone that disagree with you are wrong and do not know anything. Let's talk a bit more about your childhood. Comfortable in that couch?

Oh no, I have no problem with people who disagree with me, it is just with pompous blowhards who think that they can lump all the deaf into one group and that they know a deaf child whom they have never met or ever talked to better than the child's own parents, it is with those ignoramuses who instead of accepting that there are people who chose a method different for themselves or for their child other than the one that they endorse, who must continuously predict doom and gloom for those deaf children. It must be some deep rooted insecurity and feeling of inadequacy about the method they chose that they have.

BTW doubt anyone would be comfortable "in" a couch but perhaps they would "on" the couch.

Rick

 

[vallee]

I am part of support team in discussions of IEPs that is what a special education teacher does. I am on a team that reviews testing and recommedations before the parent meeting is set up. The doctor recommended a Preschool who is going to be implanted move into the hard of hearing class. Our classrooms are primarily ASL and English. It provides either self-contained, inclusion, or part-time inclusion according to the child's needs. The doctor has to release records and that was his recommendation. You can't make a generalization about doctors. I know what was discussed and recommend to the parents and school.

Oh we as a team also provided resources for ASL for the parents.[/QUOTE]

So, parents are not getting these resources provided before the child reaches school? What about the time from birth until then?

And, thank you for the information, but I am fully aware of what an IEP team is, and what the members' functions are. Medical opinion is generally submitted by parents to support their request for a particular service, not requested by the school to support their choice ofplacement. In fact, the very nature of confidentiality laws surrounding the release of medical information is such that a parental consent for release would be mandatory before the doctor could even so much as tell the school that the child was a patient, let alone make reccomendations as to placement based on assessed medical need.

Yes parents sign a consent form before the doctor releases the records. Doctor records are very important to the discussion of placement and services. If you notice on IEP and Psychologist evaluation there is a areas for school suggestions, that is where the ASL suggestions are going. Our school pyschologist gives out a listing of places to assist with ASL training. Any good psychologist would never not provide resources to parents.

I feel as if I can't explain that anything. Just because you don't want to believe that this child is going to a hard of hearing/deaf classroom starting the 08/09 school year because of the IEP team then so be it. My school system has a fantastic program that offers a great program for families that don't want to send their children 3+ hours away to the school of the Deaf.

 

[shel90]

Yes parents sign a consent form before the doctor releases the records. Doctor records are very important to the discussion of placement and services. If you notice on IEP and Psychologist evaluation there is a areas for school suggestions, that is where the ASL suggestions are going. Our school pyschologist gives out a listing of places to assist with ASL training. Any good psychologist would never not provide resources to parents.

I feel as if I can't explain that anything. Just because you don't want to believe that this child is going to a hard of hearing/deaf classroom starting the 08/09 school year because of the IEP team then so be it. My school system has a fantastic program that offers a great program for families that don't want to send their children 3+ hours away to the school of the Deaf.

So are any of the kids mainstreamed at schools as the only deaf student there?

 

[jillio]

Yes parents sign a consent form before the doctor releases the records. Doctor records are very important to the discussion of placement and services. If you notice on IEP and Psychologist evaluation there is a areas for school suggestions, that is where the ASL suggestions are going. Our school pyschologist gives out a listing of places to assist with ASL training. Any good psychologist would never not provide resources to parents.

I feel as if I can't explain that anything. Just because you don't want to believe that this child is going to a hard of hearing/deaf classroom starting the 08/09 school year because of the IEP team then so be it. My school system has a fantastic program that offers a great program for families that don't want to send their children 3+ hours away to the school of the Deaf.

I did not say that I don't believe it, vallee. I just find it odd that a physician would be determining placement for education, when they don't have any expertise in deaf ed. Medical evals are quite often needed for children with biological disorders, or with neurolgical disorders, and psychologists' input is always taken into account, and most particularly if it is an educational psychologist or a clinical psychologist.

I'm still confused about this particular child's liguistic background, however. If the parents are just now getting ASL instruction, or are just now receiving information regarding ASL instruction, what has been going on with this child prior to becoming involved with the local school system? That is my point.

 

[vallee]

So are any of the kids mainstreamed at schools as the only deaf student there?

Depending on IEP, some are for individual subjects. All communicate by ASL so they have a terp with them in classrooms. It is a classroom within a regular school. I am not sure of the ratio of teacher to student or teacher and aide to student.

 

[shel90]

Depending on IEP, some are for individual subjects. All communicate by ASL so they have a terp with them in classrooms. It is a classroom within a regular school. I am not sure of the ratio of teacher to student or teacher and aide to student.

Are they spread out at different schools or together at one school but go to different classes individually? Sorry for all the questioning.

 

[jillio]

Depending on IEP, some are for individual subjects. All communicate by ASL so they have a terp with them in classrooms. It is a classroom within a regular school. I am not sure of the ratio of teacher to student or teacher and aide to student.

Not to jump in, but it's a self contained program?

 

[vallee]

I did not say that I don't believe it, vallee. I just find it odd that a physician would be determining placement for education, when they don't have any expertise in deaf ed. Medical evals are quite often needed for children with biological disorders, or with neurolgical disorders, and psychologists' input is always taken into account, and most particularly if it is an educational psychologist or a clinical psychologist.

I'm still confused about this particular child's liguistic background, however. If the parents are just now getting ASL instruction, or are just now receiving information regarding ASL instruction, what has been going on with this child prior to becoming involved with the local school system? That is my point.

The doctor does not decide placement, his medical records assist in placement. He stated that he believes that best placement is with a classroom that uses ASL and not an oral Kindergarten or a Developmental Delayed classroom. We as special educator respect the doctors views. The pschologist and team feel the same way.

The child wears hearing aids. They know some sign. The child has been in the system since age 3. It is a reinforcement to the parents not give up ASL just because of CI surgery. You also have to understand, I am a resource. They have a real person to go to and ask these questions. The psychologist and team has worked with me for 14+ years, they know the work I have put into my CIs. They ask me questions - what will happen, how will it sound, what can the parents expect. Then we use records, testing, and all available data to discuss the appropriate placement. That is how it is done. In order to get the best educational plan for a child, there needs to be more than just an IEP meeting.

 

[vallee]

Are they spread out at different schools or together at one school but go to different classes individually? Sorry for all the questioning.

We have 3 full time classrooms spread out in the system and then teachers of the deaf that float from school to school as needed.

The students will attend classrooms within the homeschool. It depends on the students ability. The terp who now teaches at my school told me that they had one student who went out for the whole language arts block and back for afternoon classes in the hard of hearing classroom.

 

[jillio]

The doctor does not decide placement, his medical records assist in placement. He stated that he believes that best placement is with a classroom that uses ASL and not an oral Kindergarten or a Developmental Delayed classroom. We as special educator respect the doctors views. The pschologist and team feel the same way.

The child wears hearing aids. They know some sign. The child has been in the system since age 3. It is a reinforcement to the parents not give up ASL just because of CI surgery. You also have to understand, I am a resource. They have a real person to go to and ask these questions. The psychologist and team has worked with me for 14+ years, they know the work I have put into my CIs. They ask me questions - what will happen, how will it sound, what can the parents expect. Then we use records, testing, and all available data to discuss the appropriate placement. That is how it is done. In order to get the best educational plan for a child, there needs to be more than just an IEP meeting.

I agree, vallee, the IEP needs to be a team effort, and a psychologist and audiological records are an important part of that. I also agree that it is a good move not to have the parents give up ASL, particularly since this child is not even implanted yet.

I have no doubt that you have been extremely successful with your CI, and that you can be a valuable resource to both the school system and the parents. I am not discounting that in any way.

My concerns are this, and it has nothing to do with you personally, but is an observation of the system itself:

A) Physicians have no expertise in educational matters. If it is a matter of a child having a medical disorder that requires specialized care throughout the school day, then by all means, that input is valuable. But as far as educational placement for a child who is deaf, all a physician can do is report on audiological findings. To do otherwise is to step outside their professional expertise. To make recommendations for educational placement without specific medical needs for care, he is beyond his scope of practice. That is not to say that he should not submit audiological findings. But his expertise ends there, unless he also possesses some training and education in deaf ed.

B) And please do not take this as an insult, because it is not intended as such in any way....but to base the probable success of a prelingually deafened child with the actual success of a post lingually deafened adult is unrealistic. The issues are different. Again, that isn't to say that your experience is not valuable. It is only to say that the experience of a post-lingually deafened adult is not the same as a prelingually deafened child.

I have over 20 years of attending IEP meetings under my belt. I am well aware of how the system works, both as a parent on the outside of the school system, and as an employee within the school system, from the perspective of public mainstream education and deaf education. I also know from experience that a public school system takes a very different view of appropriate placement than do specialists in deaf ed. My son's first IEP team told me that my son did not need a terp because he was only going into kindergarten and they would consider providing a terp around the 4th or 5th grade when the curriculum got more difficult. That was a school system in the same area you are in now. Yes, his physician got involved, but only to support my decision to take the school system to due process, and to provide audiological and historical information regarding his case. It might be interesting to note, as well, that this physician was a board certified pediatric neuroligist who had privileges at Vanderbilt Hospital, and a few years later, also became a CI implantee. He also admitted that he actually knew nothing more than physiology of deafness at the time, and spent many hours going over linguistic research and educational research with me that I brought to him in order to better inform himself on all of the issues of prelingual deafness. He actually took it upon himself to learn some basic signs so as to be better able to communicate with my son during office visits. So, yes, there are a few excellent physicians out there. But the most amazing thing about him was that he was willing to say, "This is beyond my scope of practice. Let's learn together, not just about the medical diagnosis of deafness, but of the educational and sociological and developmental aspects as well." But his attitude is certainly not the average attitude that is encountered.

I have no doubt that you are a dedicated educator, just as I am a dedicated advocate. I have no doubt that you strive to create the best learning environment for your students that you can. My objections to the way the system functions have nothing to do with you personally. My observations of the inadequacies of the sytem are not observations of you personally.

 

[vallee]

B) And please do not take this as an insult, because it is not intended as such in any way....but to base the probable success of a prelingually deafened child with the actual success of a post lingually deafened adult is unrealistic. The issues are different. Again, that isn't to say that your experience is not valuable. It is only to say that the experience of a post-lingually deafened adult is not the same as a prelingually deafened child.

.

I don't take it personally. Just give me credit for also bring into the team experiences and knowledge from the Deaf Community on these issues. I read a lot and spend time with blogs and research on this very issue. I would never offer my opinion as an adult where the issue is a child. My experiences are unique, just remember I grew up deaf - who really remembers life as a three year old. I only remember myself as a HOH/deaf individual. My information is research base, not opinions to the team. I don't let my personal experiences cloud my professional committement as an educator.

 

[jillio]

I don't take it personally. Just give me credit for also bring into the team experiences and knowledge from the Deaf Community on these issues. I read a lot and spend time with blogs and research on this very issue. I would never offer my opinion as an adult where the issue is a child. My experiences are unique, just remember I grew up deaf - who really remembers life as a three year old. I only remember myself as a HOH/deaf individual. My information is research base, not opinions to the team. I don't let my personal experiences cloud my professional committement as an educator.

I'm glad to hear that you don't take it personally, and I have given you credit for the experience you bring to the table. I said as much in my post. May I ask the same consideration from you?

It is not a matter of what one remembers as a 3 year old. The simple fact of the matter is, that memory of the time period or not, the linguistic issues, and therefore, subsequent eductional issues, are different for a prelingually deafened individual and a post lingually deafened individual.

You yourself stated, (copied and pasted from post #487 ) "You also have to understand, I am a resource. They have a real person to go to and ask these questions. The psychologist and team has worked with me for 14+ years, they know the work I have put into my CIs. They ask me questions - what will happen, how will it sound, what can the parents expect". Therefore, it can be assumed that the other team members are indeed relying on your experience as evidence of special expertise.

My information on the subject is a combination of formal education, informal education, personal life experience, professional life experience, and research experience. If one cannot sythnthesize the personal experience with the formally learned knowledge, then one does not benefit the other. It is a valuable skill to be able to combine the two. It is called critical thinking, and it is what allows us to apply the knowledge we learn to different situations through seeing the parrallels. That does not mean that it clouds committment, but that it greatly enhances it.