TRANSCRIPT - Hearing Assistive Technology use for Deafblind Students

>>Donna: Let's see. Hello everyone and welcome to TSBVI outreach tech T time. It is day before a long weekend and a day before. TAER week So thank you for joining us. And before we start, let's review our goal. Is to build a community of practice for technology that allows us to support each other when we're teaching technology to our students. In the spirit of that goal. We want as much of an interactive session as we can get. So we encourage you to come, to converse through the chat and the Q&A and to connect with each other. We are recording this session and posting it on our website through the Professional Development Library. Today I am so happy we have Casey Bennett with us today and she is talking about hearing assistant technology use for deaf blind students. S we've gotten so many requests for this, so I'm excited to have her come in and talk to us about it. So I'm going to hand over. To Casey.

>>Kaycee: Fine, everybody. My PowerPoint here. I'm Casey Bet like Donna said. I am a Duff-lined Education Consultant on the Texas Defline Project. Which is housed at the Texas School for the Blind and visually impaired. And my background is in deaf education. I taught that education in the classroom in what we call regional day school program for the Deaf. For a handful of years and then I moved into an itinerant model and I was, at the time it was called auditory impairment specialists. Now it's just, a tenant teacher of the deaf and hardy hearing in most places. And I did that for a long time. When I first started in, the district I was in before coming to this role, there was not and educational audiologist on staff that had been a really small district that grew really rapidly and so they were using I generate staff previously from like co-ops and then got so many kiddos that they decided to hire their own staff. And so they hired me to. Start. you know, the DEFED program there. But we did not have audioological services at the time and I kind of just dove had first into the technology aspect of that. Because I didn't want my kids to have a lag in services just because we couldn't find staff, which of course we're seeing all over the place these days with. Everybody being short staffed as well. And so I learned a lot about hearing technology and provided audioological management for all the students in our district and then as we grew I just kept doing it. I found that I actually really liked it. It became part of my job and then I would consult with an ideologist if there were actual ideological services that needed to be provided. So anyway, I really loved all of that. And so I am going to share with you today some of the technology that we see on our students. Why that why those are picked how they work what they do and then some of the hearing assistive technology or hat sometimes you'll see it written H. A. That we see in the classroom so we'll look at both of those Thanks today. Please feel free as we go if anything doesn't make sense or I start talking audiology speak to you like please throw in the chat have me break it down I will try my best to stay focused on explaining Okay. The first slide I have here is hearing aids. So there are lots of different kinds of hearing aids and honestly they are changing. Every day. There's new stuff coming out all the time like all technology, right? It's changing rapidly. But these are kind of the basic forms of hearing types of hearing aid that we see. In schools for I assume most of you working with school age children. The vast majority of our ketos are wearing what's pictured in D, which is a behind the ear old. So it like fills up almost looks like an ear plug fills up the, external. Ear art called the peta. Builds all that in. Those are made in office and they're nice because they work for kiddos who have the most significant hearing losses. So if somebody has a severe or even a profound hearing loss, they can put. This type of hearing a on them a behind the ear it's the most powerful type of hearing aid and then that ear mold which helps block out external sound and phone Powerful amplification directly into the ear canal. Most of the time we don't see them in clear, like is what's pictured here because we serve kids. And kids get to pick and so they'll have a pink sparkly on the left and a blues sparkly on the right or swirl or all kinds of fun stuff. We try to make them fun for children so that they'll wear them and so that other people will think they're cool. And so we often see that. Sometimes even nowadays, the behind the ear part, is colored too. You might see them with phoneac or Oticon or 2 major brands that serve pediatrics. And you may see them in red or in blue or even in pink or green. So. That is likely the most, common type of hearing aid you'll see on pediatrics in school, but we do occasionally see some of these others. Especially if you serve older children, young adults or teenagers, you may see something that looks more like F, which is also a behind the ear hearing aid, although a little slimmer. And then it has what we call a dome so it has a fair And almost like fishing line then, piece that comes up over the back of the ear and goes into the ear canal and it has this little teeny tiny comb shaped end that they'll insert with their pinky and push into their ear. Very lightly and it sits in there and it's all clear and if They have hair of any kind. It is almost impossible to spot these hearing aids. Which is why they're made like this. Because adults are even more weird about it than kids and don't want people to notice. And so we see these in teens and in young adults. But they don't work for everybody. So you're only a candidate to wear, they call those domes, those little tiny cones that you push into your ear. And you're only a candidate for a dome if you have moderate hearing loss or better if you have a really significant hearing loss it's just not going to get enough power it's just not. If you have a really significant hearing loss, it's just not gonna get enough power into your ear. It's not gonna be able the one in between those 2, labeled E on in here. Same kind of deal as far as the behind the ear, decent strength. And it also had a dull and the domes a little bit bigger and it has a better, at your wax guard on that one that can be changed out but it's really just the fact that it's a little bit bigger means that it can do a little bit more hearing less. So it just kind of depends on that. The top row or what we call in the canal hearing aids. So there's nothing that goes behind the ear. Everything goes in. So in A, where it's completely in. It's called a completely in canal, right? That makes sense. A CIC, completely in canal hearing aids. So the whole thing, the battery, the processor, the speaker, all of it is all in that little piece that goes in the ear. Not for everybody in fact in all my time in education. I've seen one child in this they use them in older folks sometimes. And really we're seeing less and less of those these days because the behind the ears that are so much more powerful and really do a much better job are so inc conspicuous these days. Like what is pictured in F here, that there's really not as much of a need to go weaker. In like is pictured in A, but we do occasionally see them. They're also, a swallow risk. For kids, and for animals, they batteries in them. And so, they typically do not fit children with, with these CIC. Hearing. B is very similar, just a little bowl here. And then C looks like an ear mold here. And then C, it looks like an ear mold, but the whole. Machine is in there. And I've never seen a child fitted with the one that looks like see or the whole ear mold. And it would have to be a pretty mild hearing loss to fit anything on that top row. Just because they can't, they really can't be powerful. Enough for. For a lot of our kiddos. A,

>>Donna: Hey, see, this is Donna. Are they fitting kids with any open hearing aids? The ones that don't block the ear canal and you get Through sound?

>>Kaycee: Are you talking about bone conduction hearing aids?

>>Donna: Now they have a little ring, that fits in the ear. They call them open. They look like the E and F.

>>Kaycee: I have not.

>>Donna: And it may just be the older population. That has that maybe.

>>Kaycee: Yeah, I have not seen any kids in them. Like I said, things are changing all the time and I've been an outreach 5 years now and so it could be that there's some older kids or teenagers that they may be fitting in those now. But there weren't. Or any of that point. Debbie, Rocket, Grimaldi, out out in the world seeing these kids and she said, they're still BTE. Behind the ear, but have open air moles and she's seen some kids using them but not very often. Thanks, for that. As far as process for introduction, so when it's deemed necessary for a Canada to get a hearing aid and a family decides that that is what they want to do. Do a bunch of hearing testing, figure out exactly what they need. Figure out which type of hearing need they're gonna have and get that set up and then when they put them on it is not like glasses where you put them on and you can see for the most part. Are really different than that. It takes time. For your brand to really process. The sounds that you're hearing and make connections with those into meaningful sound and for your brain to learn what to filter out. And what to focus on. Our brains do this so so, so often that we don't even realize, but for us who are Are you any young adult or the elderly population that moves into hearing aids? We see often, you get there, you get into the. I don't like them. You're allowed. It takes time. Takes time to adjust and to learn to use them properly and focus on, the things that they need to focus on and filter out. The other stuff was not an immediate fix. I think that's something that. Is not always well shared with patients. I think they do a better job with pediatrics than they do with older patients but it's important for staff to know like if a kid just got hearing aids doesn't mean that they're gonna just be doing lovely with a kid just got hearing a doesn't mean that they're gonna just be doing lovely with them. It takes some time usually. And they may have to go several times to get it reprogrammed. They may start it lower than they need it to help them get used to it. And bump up that. Volume if you will as they go. to get into a range that they need to begin. And next thing we see on kettles is a Baja, which stands for bone anchored hearing aid. Good, this is used for kiddos and adults with conductive hearing loss. Which means that the hearing loss is caused due to something on the external ear or the middle ear. So if we bypass those things and go straight to the inner ear and beyond, then it works great. So that's exactly what they do. They use this little Fox, a bone anchor, I mean a conductive, a type of hearing aid for conductive hearing loss and it vibrates. Slightly. And if I was on the mastoid phone. And since. Those vibration signals go straight through to the inner ear and they can hear. And so oftentimes we'll see there's a picture on the bottom of a young girl wearing a Baja on a pink strap around her head. And like a headband. And we often see those bands in young children. They typically don't surgically anchor these, Bajas, until they're I've seen it at like 4, sometimes wait until like 7. And something might choose not to do it at all and they just continue to wear a band. In the top picture there's a picture of like a drawing of a child who has had the, it looks like a snap like a pearl snap shirt like a snap. Put into their head in the right spot on that or it would hit that bone. And then the device, the Baja, actually just snaps in. Nowadays they're also doing some in Madame. Which is really nice because the, around like a snap part. Obviously there's a lot of risk for infection when you have something that's happened and half out of your head. And so we saw that quite a bit. Now they're kind of moving away from that and doing more of the of the magnet. But we do still see both. This is a little bit different than the hearing aid where, oftentimes when you put that on, you hear pretty, immediately that can be it can be pretty clear. It depends on how How significant the conductive hearing loss has been, but typically they adjust pretty quickly with these Bajas. The programming is similar to a hearing aid. They may have to go in a couple of times, but it's fairly straightforward. We do see. Like I said, some that stay in a band. Or other forms of attaching it. And some that have that surgical implantation. And it, you know, it's really families. Choice I've seen high school kids that still wear the band and I've seen little bitty friends that have the So we definitely do see both. Next one is a cochlear implant. We see lots of kiddos with cochlear implants. They There's a picture of a young boy. Probably like. 2 or 3, wearing a cochlear implant with a, the processor sitting behind his ear and then he has the magnet on his head. We see still a lot of cooker implants that look like the one pictured, with the behind the ear component. And the magnet but we're also seeing some that are all contained within the magnet part. And the magnet part is bigger. So there's nothing that sets on the ear. There's cochlear Americas came out with one called a can though. That's just like a little like a puck, like a little disc. And it. Just magnetizes on. Magnet is on. I don't know. That's how you would say that but sticks on my magnet. And doesn't have to sit behind the ear. So again, technologies, you know, evolving and changing and giving family options, which is really nice. This cochlear implant, obviously is a surgical procedure. This is not something you can use without surgery. Surgery is the only option if you choose copper and plan. They go in and, open up behind the ear and block it open, go into the inner ear. Where the cochlea is, cochlea is shaped like a snail shell. And they go in with a strip of electrodes and insert that through the cochlea so they like do the spiral through there. Once it heals, then they're able to start introducing the the processor, turn it on. And when it's on and it's connected through that magnet on there. It has a microphone on the processor part that's behind here. Yeah, gather sound and sends it through. Pulses to those electrodes. And the brain then learns. To process those electrical impulses as sound. So as you can imagine through that description is not overnight the surgery healing obviously takes time, but then learning to use those. Electrical and, large propulsive as sound takes time through a type of speech therapy where they explicitly teach individuals to Learn to listen through this means. Sometimes kiddos will wear them on both sides or sometimes just on one side. Typically they don't do them at the same time. They'll do one, adjust them. And then do the other. If they're going to do it the other. And, it, you know, it takes some time. The programming for this is called mapping. And. It's, it's a significant progress process. So they will. Start in one place and then move it gradually and move it gradually move it gradually and move it gradually as they do their therapy and learn to use their canring through this new. Means it's pretty much always changing for quite some time. And of course that process is getting better all the time as well and getting more accurate. Where they're able to read those things. It is only for a specific type of hearing loss called sensory neural hearing loss. So, and it has to be really quite significant in order to be a candidate for a cochlear implant. If you have mild or moderate hearing loss. I'm not going to consider a cooker implant you would be a candidate for. You would likely be a candidate for a key. So typically we're only looking at cooker implantation as an option. If you have profound loss, maybe severe to profound. Because when they go in and they Put that electrode in often time any residual hearing, is wiped out at that point. Now that's improving too. So used to be that 100% of the time you lost all your hearing. When they did that procedure, doctors are learning ways to leave some residual hearing now. But it's, you know, it's still a work in progress. So, We'll see down the road I guess but that at this point you have to have a really quite significant hearing loss. To be a candidate for this surgery. They also look at other things like Are you a candidate for, you know, are you willing to come in on a weekly or even multiple times a week basis for that therapy to come in regularly for mapping. It's quite a Come on, for folks to. Commit to. The commit to commit commitment to decide that they want to do everything that comes with Okay. Martina asked how expensive this type of surgery is. That's a really good question. I've never known anybody to pay out of pocket for this type of surgery. I've only had students who have used, insurance or used to. In order to pay for this and then they just meet their max out of pocket. So I really don't know how much it would cost. Just straight out of pocket. To pay for a surgery like this but I would think if you factored in all of the follow up. That's required. It would be, to have weekly. Appointment for 6 months to a year. I would think, that would think it would add up very much. That's a really good question. Typically in your nose and throat, doctor and E and is the one who does this surgery odor laryngologist oh quilli added implants devices, surgery, rehabilitation, make 50,000 to a hundred $1,000. Yeah, that's great to know. Okay. Luckily we have insurance that Still, Maxado pockets can add up for sure can be a lot. Thank you. For that info. Those were the types of devices we typically see could always come in with as their personal devices. Does anybody have any questions or have seen something on ketos they serve that didn't look like anything I showed today and Wonder what on earth that could be or how that works or anything I explained that didn't make any sense at all.

>>Donna: And Cooley did comment. This is Donna that most insurance companies seem to be covering the costs. At this time, I would think that's that's a good thing. Let's hope we keep it that way.

>>Kaycee: Definitely. And, and that's been my experience as well. I have seen that. Where they if they have the type of hearing loss required. Are covered by insurance. But it's not always like a really simple, that's really not wanting anybody who's dealt with insurance here. In the states has for anything is probably aware that sometimes that could be quite a process to get everything approved and All of those authorizations and things like that. But yes, I, that's been my. My understanding as well.

>>Donna: Willie, thank you for putting that link in for us. And let's see, Debbie says she'll send some other resources about paying for it through the chat in a moment.

>>Kaycee: Yep.

>>Donna: And George and S are all of the hearing aid types compatible with Bluetooth or have Bluetooth capability.

>>Kaycee: Great question. Not all of them. More and more all the time are having that that option. Which is So exciting and makes things so much easier. The big pediatric companies the 2 main pediatric companies for hearing aids are phone app and odicon and they have started rolling them out more and more and more because they realize it's making everything at school so much easier as kids are using Chromebooks all the time. Are using iPads all the time. And so yeah, we're seeing it more and more, but it's certainly not all of them and not all kids come with those. To, companies, especially our teenagers. Sometimes they will not be treated by pediatric. Audiologists. Because they're big because they're 16 or whatever they may go to. Your local neighborhood. Hearing, just said hearing aids on the building. And they may get some kind of, you know, random brand of hearing aid. And in those cases, a lot of times they don't come with the Bluetooth, but, you know, We're certainly seeing it more and more and more. And I anticipate that to that trend to continue that we'll just keep seeing hearing it's being fully loaded and ready to go. Which is quite different than even just like years ago thinking about how much we had to do to get kids connected to technology. I mean, we had kids had. Like pieces on pieces on pieces literally on their ears in order to be able to connect to things. And that's rarely the case these days. So. Making progress all the time. That was a really great question. Debbie shared house bill 4 90 that came out in 2017 that requires insurance companies to cover the cost of hearing a the cochlear implants for children who are 18 and under, including certain treatments or services related to those, and coverage is limited to one hearing aid each year. Every 3 years and one cochlear implant in each year with internal replacement as medically or audiologically necessary. That brings up a good point. Sometimes. The internal pieces of the cochlear implants have to be replaced. And, when that happened, they obviously have to open back up, go back in, take out the old ones, put in the new ones, go through the healing process again and then go through a mapping process again. It does, it does take time. I have had a few students who had to go through that for. Internal failure device failure or infection or other reasons. So, it does happen sometimes. And then Quilli share, is Dr. Todd. Original Medicare typically covers 80% of the cost of cochlear implant. You're deemed an eligible candidate and this enters from Medicare and Medicaid services expanded its eligibility criteria significantly in 2022. Making it even more likely for a person to qualify for coverage. That be shared if your child also has vision loss you can receive support through HGSCs, blind children's program. And yes, if you were serving students who are defining, make sure that they have that. Have that support. Absolutely their families. Yeah.

>>Donna: Hey, see, this is Donna. Rob asked a good question in the Q&A here. He said who on the team typically supports cochlear implants on campus during the day.

>>Kaycee: That's a great question, Rock. It really depends on the setting. where the child is for their school day. So if they are in something like a regional day school program for the DAV or school for the DAF and their classroom teacher is likely a, teacher the death. And. Have that, has that knowledge to be able to, support them, you know, pretty independently. Otherwise, if the child is in general education classrooms or in like self-contained special education classrooms, then on a day-to-day basis it's likely still the classroom teacher who has received training and support from a teacher of the De and hard hearing. Or teacher of the deaf blind depending on, you know, if it has one and what their what their background is. So that. Training can be done. Typically they put in place daily checks. Using something called, the link sound, LING, to make sure that they have access to the range of speech sounds. And so the classroom teacher can provide that training, provide those resources, to help that a lot of districts have educational audiologists. So if something goes wrong with hearing aids or with a couple of implants or with either I guess during the school day that They can. Reach out and get troubleshooting, support, get, somebody to come out and check it out and then oftentimes these devices are the students personal devices and so they can help reach out to families and help support the connection with their personal audioological teams as well to get those things repaired. To basically cochlear implants and hearing aids. Go back and forth with the kid. Hopefully they have them. All waking hours to be able to utilize. I have worked in districts where they had school aids. And we're seeing less and less of that these days, which is a really great thing. Because we want kids to have access to their devices all the time, not just at school. So instead of providing hearing is at school that stay at school, we're helping families get the resources they need to provide hearing aid that the kiddos can have all the time. In situations where They just can't, they just, it's just not gonna happen. And then of course we can provide hearing aids for the students to use at school. And that, that at least they have the med school. Okay, Margaret shared my experience as a VI teacher. Definitely a team with classroom teacher. Do you know the definite hearing? Iiologist, interpreter, intervener, speech therapist, parents, yeah, I mean these kiddos often have huge teams. So really helpful for everybody to understand all of the technology that the student uses, including their hearing assistive technology. And to have a great tech plan to know when something breaks. Who do we call? Who helps with this piece of technology? Also does this one go home? Does this one go on field trips? Does this one stay at school? Who charges this? How does it charge? And that's another thing, hearing aids cochlear implants and vajas all used to exclusively take batteries. I would walk around with a backpack full of 19 different sized hearing aid batteries ready for any and all. Hearing aids and situations. And they're really starting to shift away from that. There's still some that take batteries, but a lot of them are coming, rechargeable. And so at night when you take them off, you put them on this little stand and they charge overnight. A lot of them charge really fast. So having a charter that comes to school so in case it didn't sit right on the charger or got knocked off in the night or something like that. It can usually charge within you can get a decent charge in like 30 min and you can get a full charge and just like 2 h or so in most of them. So that's something else that has really Shift it, a rechargeable hearing it was like unheard of, years ago. So it's crazy how much things are changing. Quilli shared multidisciplinary teams usually leading with educational audiologists. And yeah, they they can certainly Oftentimes they're the ones leading that, teachers the death if not. And then the batteries. Hoo, yeah, thank goodness. And they used to have poison in them. They used to, they used to have Mercury in these batteries and they stopped doing that. Gosh, I wanna say only like 10 years ago or so. They started shifting away from that. And yeah, they're safer, still not great for you to swallow a battery, but they're safer than they used to be. Because sometimes they're putting these on. 6 month old babies and so sometimes they have locking doors to like the battery doors will lock and they have a special tool to be able to open up. Or just take them out. So yes, we are excited for rechargeable. Happy that everybody everything has moved that direction. Any other questions or thoughts on these personal devices before we move to? School types of devices. Okay, I'll move but feel for you typing feel free to send it so. Okay. So now we're going to talk about FM systems. Or DM systems. FM systems have been around forever and ever and ever and ever and they used to be giant boxes that the kids would wear if you have been teaching for many decades and you remember that. Back I wanna say Do, 9, to, the, early 2,000, maybe? Okay, Rachel Rumbers body 8. For me a year, Rachel. I want to say in the 2,000. That's why early 2,000 is when I moved away from that but I could be wrong. I started teaching in 2,009 and body 8 were gone by that so it was before that. But they had these giant boxes that they would wear. Hello. No. Yeah, Debbie, said she remembers in 1985 to be a large body aids, that were strapped on the kids so they couldn't take a walk. Oh my gosh, yes, they used to have these like ones that they looked like suspenders but they were like an X on the kids back. Oh my gosh. That's what that's what kids need, right? Right, I'll let you remember seeing them on students. She was in elementary school, on peers. Yeah, so we've come a very long way since the body aids. And now we use these, these fancy little things. And, the one on the left, they're both Fonac Roger systems. The one on the left is what I used, what we used as the district as an FM system. It uses at them like a like a radio wave and we'll look at the second about what is on the student side, but this is what the teacher would wear. And the little button across the top slides on that's a microphone that unwinds. The teacher would clip on There's a mute button and a pairing button It's really simple. And it would pair to the students. Devices. And the teacher would wear that microphone. And, then. A few years ago, 5 years ago, they came out with DM systems and that's digital modulation. And it's just a fancy FM, basically. It's clearer. There's, less, static. I was like, what's the word in English? This, there's less like static in it that they're hearing. Less times of intermittency. So it's not it's not disconnecting and reconnecting and things like that is often. Let's just save here. Their touch screen. So that on the right is what that looks like. It's almost like a tiny iPhone kind of look. And what I do like about these is that bottom button is the mute button that's giant and like the only button so teachers will use it. That is the biggest complaint that we hear from students about their FMRDM systems is that the teachers don't use the mute button properly. If you're using the mute button properly. You should be pressing it like a hundred plus times a day. Every time you don't want your direct voice, you as the person wearing it, your direct voice. Directly to that student. Then you have to mute it. If you're wearing a microphone. 6 inches from your mouth. Your voice sounds like You're like this. Leaned in 6 inches from that student. So anytime you don't want that, you have to hit mute. Well, when you're wearing a microphone, but you don't hear the amplified sound, it's really easy to forget. That you're wearing it at all. They're very lightweight as well. I'll get to being able to hear those in a moment. Something that both of these can do is connect to one student or connect to several students. So in the case of having one teacher with. 3 kids who are differ hard hearing, you could connect to all 3 students and the teacher can wear one microphone and, and be able to transmit that to all of the kiddos. That's what we see when we see the little group picture on the right on the fancy DM Roger system. And but they both can do that. I imagine you guys see these could be different brand to Oticon also has similar similar system. I just pulled phone app pictures. I'm sure that you see a lot of this. Out in classrooms and and serving students. There are times that the FM is super helpful and appropriate. And times that it is Not super helpful and appropriate. For example, in a lecture based setting where there's a teacher standing at the front giving a lecture and there's a group of students listening. That's a fabulous time. For an FM system or a lecture hall or an auditorium, anything like that where there's a primary speaker and there's an audience of some kind that's a fabulous time to use an FM system. What these FM systems do, like I said, is bring that voice in. It also typically, lifts the voice. 5 decibels, so just a smidge louder than the rest of the noise that's being picked up by the microphones on their personal devices. So it's it's to support that signal to noise ratio it's called so brings that signal a little bit louder than the noise. So it's great like I said in those lecture based situations where you want the teacher or the person who's speaking's voice to be a little bit louder than the person next to you who's like chatting with their friend or something, right? So great for those situations. Where I have seen the used, where I'm like, no, no, this is not such a great situation. Is During travel in orientation of mobility, so I work exclusively without flying children. If you know if folks don't understand the purpose of these FM systems or what exactly they're doing, they just know it's in their accommodations that we use this FM system. Or we use the DM system or it helps them hear better. Then. So wear it and they'll use it and think that it is helping the student. Where it's actually going to make it much more difficult for the student to hear traffic. Or localize or do any of the other things that that you may be hoping the student will do during travel. Because your voice and breathing on the street corner and all of those things is being amplified above. The sounds coming in from the environment. That is a place where it would not be appropriate and you don't have to disconnect and take the whole thing off if you are giving some instruction out there and want your voice Livated for part of it you could just press the mute when you're not using it. You just want to make sure that it's being used properly. This is such, that's such a great place. For teamwork. And for collaboration and planning, having that teacher the DAF or even the educational audiologist. Out with you on, of mobility lessons if any of you are comes, or can share with your comes. It can be so so helpful to be talking about those things talking about what's When should I be using this and when should I not be using this? Of course that goes for the classroom and any other location that we're working as well but being out in the community that is where and travel street crossing things like that obviously safety's our number one priority and while a lot of people think it may be healthy, it could actually be hurting. So we want to make sure. But that is used. We did get a question. How, when those situations occurred, did you use ASL or PTA to sell when it was only you in the student during O and M lessons or wrote on a small notepad. I worked with Debian students who were oral RL. So they spoke and listened. They did not know any sign language. And, so we would. I'm not the orientation mobility specialist. But I, I would have the orientation of building specialist work with them in a small. Indoor location, fully explain what's going to happen. Have everything prepared ahead of time before they go out there. I have done consultation on some students who, use. Sign language, whether it be PTL or ASL or combination. Or signed English actually just didn't want to find English. Where we do similar things and that may be a part of their lesson and they may use technology in addition to that and they may not. So, you know, each kid is so, so different. And those are certainly. You know options for helping with clarity in orientation. Mobility. Yeah, cool. I know that the the complex sound the sound complexity in using the system stirring navigation yeah and they definitely can be most of the time we're needing separate programs for travel anyway through, their devices and that's a whole nother session for travel anyway through through their devices and that's a whole nother session. If you've not seen on the tools that we have called sound travels. That's something that I really love to talk about. And, if you're going to TR next week, I'm gonna do a presentation on it. So you can come to that. But we, talk a lot about that in, in those and talk about programming and, all the different things needed for travel for these kiddos who are deaf or hard gearing. So yes, such great points. Okay, on the kids side in my last few minutes here. There's ear level. And then there's some field systems So the ear level, there's a picture on the left of a behind the ear hearing aid with a dome attached. And on the bottom it has this little metal box. Those little metal box they have like a little like prom, 3 little songs that stick out of it that attach to the bottom of the hearing aid. And that little mailbox is called a boot. Like a cowboy book, boot that you put on. They're tiny Very expensive. Kids lose them left and right. So that's That's a con for the boot. But what's really nice about it is they're pretty inconspicuous. They don't make any extra sounds They. You know, the sound from the teacher's microphone goes directly to the student's ear, brings it straight in so there's nothing else that can filter that sound away. But the teacher will often forget their wearing their mic. There's pros and cons right to all of these types of technology. The other thing that's on the screen is a sound field system which is essentially The microphone, piece. That goes to a speaker. Like a like a boom box. I'm aging myself with the word boombox like a sp like a speaker, okay? And can be a blueprint speaker can be a big Oh, and speaker like what's on the screen here and in fact these big ones are the ones that we used. Quite a bat when I first started in this field. They go on or near the desk typically of the child who is never heard a hearing. Teachers love them. Because they How their own PA system in their classroom and they don't have to straighten their voices as much. They use them much more consistently because it benefits them and whole class. Often helps other kids in there who struggle to focus. For various reasons. So they really like those. A lot of times our kids who are definitely hard hearing don't like them as much. They feel single now because the speaker needs to be near them and it's like. Big and people notice it. And, there are things that can then block sound. From the speaker to their microphones that are on their heads. So the kid next to them is still making a whole bunch of noise. It can still, it can still be, muddling that sound that's coming in.

>>Donna: Hey, see, this is Donna. I've started to see in some of the newer built schools.

>>Kaycee: Go ahead, Donna.

>>Donna: Something like the sound field being installed in the classroom. That then has like pods. So if you've got kids in groups. There are desk communications so the teacher can even drop in to the desk almost like you're dropping in through your Alexa to the next room. And you can talk directly to that team or hear what's going on in that team and what's happening. And so they've kind of taken this and almost put in in a. Classroom management type. Setting and that may help our kiddos even in not feeling singled out, but I would think there could be some cons to those systems as well.

>>Kaycee: Absolutely. Yeah, I, I mean, I think with any, with any of the tech, right, we've got pros and cons. But yeah, this Teachers love. Teachers love up. You man, you mentioned behavior manage man classroom management. That's 1 of the things I hear most often from teachers about this. Oh my gosh, I can get control of this class so much easier. I don't have to scream. I'm not as tired at the end of the day, teachers low. And so, yes, that doesn't surprise me that they're starting to build them into classrooms and it will it will benefit our kids who have trouble focusing are our kids who maybe hard caring in classrooms. Absolutely. Okay, let's see, we got a question. Oh yes, Quilli, sound traveled. There's also a coffee hour recorded that I didn't not to want to go with some of my colleagues. So, so check that out too if you aren't going to see. Okay, Debbie said I've noticed a lot of the newer hearing aids don't have the connection piece on the bottom to add a boot. Does it need to be requested? So in those cases, sometimes it can be requested. Sometimes it's just a battery door change. So sometimes we'll change out the battery door that it comes with and put on a battery door that has the connection piece. And that's something the school can order. They can order battery door pieces. Sometimes the personal audiologists can like get them and so we could say hey do you have one of those back door pieces and get that from them usually it's faster than going through the vendor system and getting them through the schools. Of being able to swap those out. And a lot of times they're coming Bluetooth now where we don't even have to put the boots on anymore. We can connect directly to their hearing aids. Which is really exciting.

>>Donna: And, I'll check that out that you sent. Thank you for linking that. I do not remember the company that we used to bring in for our specific sound field systems when we used it as go at conferences.

>>Kaycee: Hmm.

>>Donna: But there's a lot of different companies out there.

>>Kaycee: Yes, definitely we used. Light speed for many years. I don't even know if they're still around but is that what you used?

>>Donna: Light speed was the one we used as well, yeah.

>>Kaycee: I get that it's been a little while but That's what we used and I know it's time to give it back to Donna my contact information is on the screen. It's my last name BBEN NETT. At TSBVI. Dot edu, feel free to email me if you have any Questions or had any other things you want to talk about we didn't get to today. I'm happy to connect with you and Whereview that.

>>Donna: Awesome. Thank you so much, Casey. We appreciate you coming and sharing. Let me get here. All right, so next week we will not, I'm gonna speed read through here. We will not have a session next week, TA-E-R, come find us, come say hello. We are having an AT session on Saturday, so you have to stay for that. Can't go cut now early. Gotta come Saturday morning. On the eleventh we'll have a little vision with Cindy back for and carry Farage. And the eighteenth, it's how to get your students to use their devices. We want our kiddos to be excited about using their devices. Kathy is going to talk about that on the eighteenth. Love is your own M with Audra Bishop and Kelly Nicholson. And then May, we are going to have Sydney back for back with Alicia Davison, Shannon Blankenship and Alexa Printer talking about in the driver's seat. And then we're gonna wrap out the year. As we end this very busy spring. With mental health trauma in the brain. Coming from Rebecca Russell. So we're excited about that session. Your end code is. 8 7 2 0 6 7. Take a jump to this QR code if you have a suggestion for next year starting to build out those different topics And. Let's see, somebody. These sessions will be loaded on our site. We're getting them. Slowly up there. So our media team is gonna be working on that and by the end of summer we hope to have all of our sessions from T time loaded onto the website. And so those and are hopefully some of our back sessions. They're all in our meeting media library. They're just not yet posted like Casey's or posted so nice and neat with coffee hour. But we're getting there. We're in our infancy and learning. Thank you all for your wonderful questions. If you have anything else you need, please feel free to drop one of us an email. And we will see you next week at TAER in the week after at T time. Have a great weekend everybody.

>>Kaycee: Thanks for having me.

>>Donna: Thank you, Linda. It will be just in time, hopefully, to get to our new place.

>>Kaycee: Quilli, I saw that you were looking. For the session that I mentioned, it's gonna be under the coffee hour library. So that one will be under, if you go to the TSVVI website and go to professional development. And statewide resources and then professional development there's a link on that page that says coffee hour it'll take you to all the archives you'll be able to see.