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Patient Handout

Advocate for Collaborative Care: Tips for Families of Children who are DHH

Weaver, Ashley Mahlstedt MED; Huzzy, Rebecca AuD, CCC-A

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doi: 10.1097/01.HJ.0000752328.10300.8d
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Collaboration between teachers of the deaf (TODs) and audiologists is critical to the care of children who are deaf or hard of hearing (DHH) and use hearing technology to access sound and spoken language to communicate. Caregivers can help their child succeed by taking advantage of all eligible benefits with experienced, interdisciplinary professionals.

Shutterstock/Lamella. Hearing loss, accessibility, healthcare.


Children who are DHH have the right to interdisciplinary support teams that could include a TOD, an audiologist, a speech-language pathologist, and other related service providers, such as occupational or physical therapists. Outcomes of children improve when these service providers work together. Consider the work of audiologists and TODs:

Audiologists are part of a child's clinical team and lead testing, diagnosis, amplification, and the general course of treatment. Their work produces a valuable snapshot of a child's progress and performance at a given point in time. Their evaluation can benefit from the situational knowledge a TOD brings to the course of treatment.

TODs are special education teachers who receive transdisciplinary training in speech and hearing science, and in perceptual, cognitive, communication, and social-emotional development. They work more closely and frequently with children than with audiologists. They can share more intimate knowledge of a child's functional communication skills to inform audiological testing.

Audiologists and TODs are most effective when they work interdependently. The strategies implemented by a TOD with a child and his or her family are only as good as the child's technology, amplification, and access to sound. And the course of an audiologist's treatment can only be fully implemented at home and in school when an experienced TOD applies the right strategies and coaching.

Consider the following in building positive relationships with a child's support team.

Seeking a collaborative audiologist for your child?

  • Partner with a clinical team housed in one facility, if possible.
  • Select a team with at least 50 percent of its caseload dedicated to children. Their test results will be more reliable, and they will excel at anticipating the family's needs.
  • Ask for a second opinion. Evaluate the course of treatment and the people proposing it. Find an audiologist who is a good fit for you, your child, and your TOD.
  • Seeking a collaborative TOD for your child?
  • First, know that all children with a diagnosed hearing loss are eligible for TOD services.
  • Ask about clinical relationships. Experienced TODs will have established relationships with pediatric audiologists.
  • Functional hearing knowledge is key. Experienced TODs should understand the clinical aspects of hearing loss and how it relates to children's outcomes.
  • Determine the desired outcomes for your child. If your goal is to support the child's auditory, speech, and language development, ask for TODs with experience in listening and spoken language.
  • Take the time to find the right collaborators. Here are a few outcomes of successful collaboration:
  • Getting the most out of testing: Together, TODs and audiologists can optimize audiological testing by recreating social environments and activities.
  • Direct communication: Regular meetings and progress updates facilitate open communication and lead to the sharing of techniques and strategies to address needs as they arise.
  • A long-term working relationship: While TODs and audiologists may change as children grow older, the collaboration should not. Open communication should continue as children learn to advocate for themselves.
  • Clear direction: Supporting children who are DHH requires a dedicated team. Collaborative teams confer and provide a unified course of treatment, empowering the family.
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