--- title: ทดสอบ Revoice ENG 2 subtitle: date: วันศุกร์ที่ 13 มิถุนายน 2568 เวลา 11.28 น. --- (ข้อความสดจากระบบถอดความเสียงพูดทางไกล) being the professionals with the support themwhat are the essential skills and knowledge that Educators and therapists need to help thesechildrenthrivewe are honored to have Dr basa otman with us today a true leaderin professional development as a habilitation manager coccia Asia growth market and former program coordinator for the professional certificationit auditory verbal therapy Dr otman has shaped the skills of countless practitionersrepresentationsupporting students with hearing loss a guide for teachers on transitioning to school with auditory verbaltherapywill provide invaluable insights for everyoneworking with childrenwelcome Dr basa we're ready when you arethank you very much Madame chairperson for the introductiona very good afternoon now I'll come everyonesuh I'm basa from Malaysia and I'm the habilitation managerfor Cochlear Asia growth Marketthis is my disclaimer I am a Cochlear employee and my participation is this conference is fullysponsored by cochlear Limited let's begin by asking ourselves why mainstream education entryis a crucial pointfirstlythat children with hearing loss and their families have the optionwhether going mainstreamor going for special education school or classbefore this recent decadeit's by defaultthat all our children with hearing loss go to special educationthat's no longer the case nowdust wearing a device thus wearing cock implant automatically meansthat they willsucceed in mainstreamyou know the answer mainstream is challenging despite using cock implantand these students they need accommodationin teaching and learning they need extra assistance in teaching and learning of the biggest challenge is learning to read and the HS say that for listening sorry for pre literacy skills to develop children 20,000 hours of listening as the foundation now if you have a child who only just started listening at 5 year old 6 year old will they have 20,000 hours estia Foundationas their basis for literacy skillsit's also reported that many of our children with hearing loss the underachieve in mathematical subjectsthey frequently fail to pass the grapes of lower educational achievement and later unemploymentin lifeso how can teachers helpauditory verbal therapy students but before thatI will not assume that everybody is familiar with auditory verbaltherapy so let me give youa 1 minute crash course on what avt isauditory verbal therapy facilitates optimal acquisition of spoken languagereach through listeningso it is a unique model way of acquiringoral languageand young childrenwho are deaf or hard of hearingit certainly promotes early diagnosis1 on 1personalized therapy and the latest audiologic managementand the latest technology1 Hallmark of auditory verbal therapy is thatparents or caregivers need to actively participatepaid in the therapy process because they are the primary language facilitatefor the child at homeand these can happen through guidance coaching and demonstrationof their auditory verbal therapiststhe goal of EVT is for our child to have the access to a full rangeof Academysocialand career choices and must be conductedin adherence to the principles of listeningand spoken language specialist in auditory verbal therapyso that is avtI'm sure you've heard about clay implant just giving you a veryquickidea about how cocka implant works very differently compared to hearing aidhearingwill amplify the sound and we are lucky in the year 2025the technology of hearing aids are so Advanced that it is not justsimply meaningcranking up the volume or intensity of the sound there are a lot of programs that isdata logging in hearing aids however 1 thing that hearing aidcannot achieve is the amplification and the clarity of soundespecially in the higher frequencies meaning thatvoiced sorry unvoiced positives and fricative soundsthese are often cannot be achievedthe signal clarityvia hearing aidsand that is when we need coal clear implant where the indication in Thailand in Malaysia and many othersaw these Asian country is from severe or Worse hearing levelcocka incline is notuh similar to hearing aids in the way that it is an electrical stimulationthe implant happens in the cochlearand therefore when the COA is stimulated by the implantthen the signals will be processed by the external soundasset processorand this will be processedby the brain because the signals that are sent by theplant goes via the auditory nerve andgoes to the brainnow let's go back to our students with avtbefore they enter our schools this is what happened to themhopefully and I know there are cases where babiesstart to be diagnosed fitted with Device start interventionin Thailand and I'm so happy to hear that but this is an exceptionnot yet to be the norm let's hope that this will be the norm in about 10 years from nowso when these kids are young between 1 to 3 years oldsorry between babies to 3 years old they are diagnosed they are fitted with deviceor cock implantand then they start auditory verbal therapyI remember my youngest patient came in start intervention2 and a half months oldand then as they grow older they go to kindergartenmainstream kindergarten they we try we try and we try as terriblepiece to work so hard so that these children will catch upwith their listening and spoken language skillsso thatthere are listening and spoken language skillsat or near each appropriateit's not enough for them to just talk but at which level are theytalkingthat is crucialbecause whenenter mainstream school at 6:07 years old depending on what school they goto we want them to enter school at each appropriate language orat the very worst2 years gap of language age between their peersand their language functioning levelso for teachersoften people will ask what is the main thing when you have a child whowho is mainstreamin the classroomoften we talk about seating yes seating is importantlook at the access black bluegreen and redred is a total no no because it's near the corridornear the windowthat is noisywe have other classes and children would run and talk and whatever across along theCorridor that will be distracting uh uh that's not where we put our childgreenthat's good why that's right at the fronthowever the childwho is sitting in the green spotof what their friends are doingit will be better if they are having more peripheralsorry rather visual cuesmeaning that blue is much betterthey are stillquite at the front and have the students at the front row to help themto get visual cuesblackthat is right in front of the teacher's deskbut how many of you teachers when you teach in the classroomyou are just sitting like me at the teacher's desk and do not get up at alldo you do thatI think if you do that right from your training days you'll be disqualified from beingteacher because you're supposed to get upand be around the class so no black is not the spot you want blueif you have any other seating arrangementCircle or round tableis a good 1or have a semicircle or horse shoe formationthat is also a good 1so that your child will be able to see everyone as of their visual cuebutthat alone is not enough sitting Arrangement is not theend of the storyacousticshow many of you now sitting in this haul you really want to listento me but the person next to you or behind you in front of you are talktalkingand you can't hear me welldon't put up your hand I don't want to offend people in the audienceimagine if you wear cochlear implantand you try to listen to the teacher but find it hard to listenhard to understand because there are noisesso if possible whenever possible identify the source ofof noiseput it far from the childit can be the fanI can hear some worryingnot worry worrying of machine behind me put it behind the childand for Cochlear brand cochlear implant the child can have forward Focuswhere wherever the childmove the head the focus of the listening will bein front noise from the back will be automatically attenuateddon't put noisy student next to our student with avtyou will know who is the noisya bit naughty and cheeky student in the classroomplease put them a bit away from our student with ADTlook around in the classroom if there are hard shinysurfaces these are the ones that are bad for acousticslet's put some soft materials be it curtainsuh paper posterscork boards or something soft to absorb the sound waves and reduce reverberationif you are not sure reach out to the audiologist reach out if the child is anplan user especially koshia brand reach out to tune our bank cardsorry our Thailand country manager who can help with classfrom physical accommodation for noise reductionthis is a little bit technical but I need tosay this that we need to understand aboutsignal to noise ratioregular classroom anywhere in the world where the children areand speaking mainstream classroom the noise is around50 to 60 DB SPLand when the teachers is talking our regular voices without the mindwhen I talk like this which you cannot hear of coursethe best is around 70 decibel but you cannot do this throughout the day otherwise youthe abusing your vocal cordso because usually teachers voices around 65 decibelclassroom noises around 60 DBthe differencefor the signal for the teacher's voice to reach the child's desk is onlyclass 5that's all the incrementof teachers voice that arrived at the child's deviceis that enough nostudent with normal hearing they need plus 6 decibelstudents with hearing loss without mini micthey need about plus 15 to plus 20 decibelfor good signal to noise ratiobut is it realistic to always tell the class be quiet be quiet bequietyou can't do that it's not realistic soremember there is such a thing as remote microphonefor Cochlear brain we have mini micfor hearing aid users there's some FM system or Rogersystemthe mini mic will help our studentto focus to teachers voice because they will hear the voicedirectly going into their processorthis will have to reduce their auditory fatiguebut teachers need to familiarize yourself with the deviceeither get help from the family the parents or again reach out to tuneThailandor anywhere you come from each country will have all polar Representativesand get help how do I teach myself to familiarizeminimso that wherever you are in the classroom your voice will reach the child'sprocessas if you are talking right next to it1 thing though remember to return the microphone that you useto the childso that the child can give the microphone to the next teacher that comes intoto teach I have had some cases where teachers wear the microphonebecause they forget to give back the microphone to the studentwhere it to the toilet where it when they go gossiping about their familyand our students with cock implant knows all thespeak in a natural clear voice at a regularand do this facing the class 1 thing that you need to be very veryaware is it is very hard for the child to follow your teethifremember the traditional chalk and talk teachingthe teacher faces the child boardand talk while writing uhuh that doesn't work with our a studentwhen the our child does not understandyour sentences you need to repeat or rephraseand you need to do this when other students are commenting or askingor speaking you need to again repeat or rephrase what the other student is sayingto the class because you have the mini micbut other students do not have the minimumso you need to tell it again so your avt student can hearhopefully you have the chance when you want to give new instructionsas the class to be quiet first and then you give instructionactionand I've talked about don't give your backfacing the class when you are talking because this will be hard for our child to followuse what we call gearing up to listen phrasesbecause if you start talkingby just giving instruction for exampleyou start talking and you just sayturn to page 55and by the time the child wants to listen to you the sentence has already endedso you need to have the gearing up phrases like now everyone listen upand you get the attention turn to page 55so use this gearing up phraseswhen child doesn't understand say it in another waytry not to repeat the same sentence over and overbecause the child may get a better idea of what you are sayingif you rephrase itright key information on the board so that the child canwhat you write and what they hear from youconsider having a body systemput a friend next to the child who can help with rephrasing oreating what he said in the classChoose Wisely who is the bodydon't choose a child who is the smartest in the classwho has the highest IQ in the class because usually very smart studentssince they are impatientthey cannot deal with a lot of questions and they cannot understand why some people are soflowI remember my best friend in school before would turn to me and saidyou are on that question too I've already finished and there were 30 questionsbut she was still my best friend she is still my best friend until todayso don't pick the smartest student in the class don't pick the weakeststudent either because we don't want the weakest student to be the role model for our ABstudentPeak student who is in the middlewith a lot of compassionwith a lot of understanding of how to interact communicateand Foster friendship with a friend who has hearing lossand also what teachers can do is orientate your classorientate the other hearing students on how to make listening andand communicationeasier for your ABT studentsthe things that I've mentioned before about speaking clearly and speaking directlydo the sameteach other students to do the same with their avt friendwhen they want to talk with their EVT friendask them to stand closely don't shout from across the roomwas shouting doesn't help them to hear it betterif they want to talk with their EVT friend tell them to get the attentionfirstand when they're talking to your EVT friend tell them not to run while talking that doesn't helpbe stillalwayswatch and if they think that every friend looks lostlooks confusedneed help just approach him or her and askedwould you like me to help youthis just doesn't is not just for our EV studentto have this accommodation but these strategies also help the other hearingsstudents in the mainstream classto have more understanding of how it is to live withfellow students or fellow friends with different abilitiesso what's needed for successful mainstreamingmainstreaming is not just about the child the teacher and the schoolwe need the teamthat worked with the child previouslyparents have to be there the therapist the audiologist If the child hadoccupational therapist or physical therapist or special education specialistor the ministry ofor the Ministry of Education officersall these people need to work together and communicate I justgo straight to thego straight to The Orange Box where they need to communicate with each otherdoes the child have undergone has the child undergoneSage appropriate goalsthroughout the interventionand if yes is this carried out continuing when thechild is in school this includes current level of functioning individualizedgoals precise assessment and measurement across all aspects ofdevelopmentrememberfor the whole child management is not just speaking and listeningwhat about self-help skills what about daily living activitiesabout psychosocial developmentthis is something that I must stressfor a child to go to mainstream they need to have age appropriate language you will hear merepeating this again and againif it's not at each level at least near age levelbecause for them to access the curriculum in a mainstream settingvia listening they need each appropriate languageand then needs to be pre and post teaching of Conceptsand again I must stress use stage of remote microphonewhen teaching and learning occursjust to give you the ideaof what is neededbefore this child if it student enters Schoolthey needthe learning to listen periodthis 1so infancy to pre kindergarten this what happenedhopefully when they have enough adequate and good quality of learninglistenperiodthen they can go to kindergartenthey enter our schools with the skills to listen to learnif this doesn't happenall this happened poorly or this happened in a very short periodbecause they only started habilitation or intervention at the age of 5at the age of 6there isn't enough time for them to learn to listenwhat happened when they entered this phaseit's hard or almost impossible for them to use listening to learn because listening did notnot existlet me share you some data from Malaysiathis is an old data because this was when I was still working with Universitythe nearly 400 childrenimplanted by you the university we found that 60% of these children uselanguagenow compare that with education placementdo we have 60% here in mainstreamnot quite but nearly 60 what happened to the 2% you askthe 2% in the in Special School cute speech school or integratedSchoolcall in Malaysia integrated School meaning that is special education classwithin a mainstream school so that when the child in special classimprovesthey can do semi inclusionall full inclusion when the child actually reaches the level that enablesthem to function inmainstreamso they don't have to change Schoolthat what what this means is that the mode of communication that wechoose for the child is very crucial because it will decide where the child will gothe second thing that we learned is that just because the child uses Auto languagewhich doesn't mean that the child will become mainstream school studentit is harder to be mainstream compared to learning to talkand this brings me to the second data that I want to shareagain from Malaysia when I was still therewith every 1 month delay of cochlear implant patientthe odds of our child to be able to speak will be reduced by2.6%you time this by 12to know if we delay COA implantation by 12 monthsor 1 yearthenwhat is thedecreased probabilityfor this child to talkusually you don't delay by 1 month some parents say oh we need to look for moneyfind funding and all that we don't have that wonderfulthe Federation and things like that like what you have here in Thailand we don't have such things in Malaysiasometimes they delay by 1 and a half yearsso imagine how much reduction of probability for the child to speaknowto enter mainstream school is much hardereveryone months decreased sorry every 1 month delayof implantationthe odds of going to mainstream Schoolwill be reduced by 3.3%time this by 12how much reduction of probabilitythe child will have to go to mainstream Schoolif we delay the implant by a yearlet that sink in for a secondso there is a Continuum of how our children with hearing losscommunicateI'm so happy to today to see quite a number of peoplein our audience who uses sign languagemany of our children with hearing loss will also use sign language and they are hereor herethey are fully visual or mostly visualcommunicatorif they are fully visual they go you're signing only if they are mostly visualthey probably will use a lot more signand some oral languagewill they be in mainstream school without interpreterprobably not they need interpreter in school how many Bangkok schools have sign languageinterpreter in mainstream class9 the same with Malaysiachildren who use sign language cannot be in mainstream schools in both Malaysiaand also Thailand I know thatsoour children who are more visual despite using hearing aidsdespite using even cccia implantthey are here they are not supposed to be in mainstreameven with implantsearly in plan really good habilitation then theymost probably will end up being fully auditory in communicationthey're listening and speakingor maybe mostly auditorytheir language level may be not age appropriate but just slightly delayedabout 2 years delaythen this grewcan bein mainstream settingif you try to put this group in mainstream setting you canand then you will realize after 6 months 1 year what will happenthey need to be replacedin special education settingyou are setting the child up for failurelet's Ponder on several points let's takeas somethingfood for thought you just had lunch you had food for your stomach now food for your brainand I'm talkingfrom the heart of a habilitation list looking after