Client-centered aural rehabilitation
It is difficult to imagine the use of aural rehabilitation outside the process of client-centered counseling because they are both part of the interpersonal communicative process and mutually complementary. For instance, if one of goals in therapy is to maximize the efficiency with which a child uses a hearing aid, it will be necessary not only to reinforce a positive attitude about its use but also to help the child break down barriers to its acceptance. The obstacles may include emotional conflict, poor self-esteem, embarrassment, denial, withdrawal from relationships with peers, unconsciously motivated destruction of the aid, or any combination of these. The reader obviously can add more forms of resistance based on individual clinical experience.
The effectiveness with which the hearing-impaired child learns to speech-read will be determined not only by perhaps an intuitive ability to use available cues within a communicative situation but also by the desire to learn from the environment. For the professional caregiver to rely on the child’s attitude or emotional state is neither realistic nor efficient. Here, too, it will be necessary to establish the optimum conditions under which the child can learn to speech-read regardless of the severity of the hearing impairment, and this includes the counseling process.
The problems for the deaf child are somewhat similar yet also quite different. Much already has been written concerning the integration of the deaf child within the community of the non-hearing-impaired and about the controversy surrounding the more than 100-year-old war over the oral versus manual approach. Although these are issues that go beyond the scope of this chapter, they are relevant to professionals who must counsel the deafened child.
Probable one of the chief challenges to professional counselors is to separate their own personal biases from the reality of the child’s unique life circumstances and intellectual and educational potential. Counseling here becomes a process in which the counselor needs to learn what expectations are realistic for the child while the child must learn to develop maximum efficiency in communicating, regardless of community within which the child ultimately may function. The counselor frequently may be faced with the dilemma of recognizing objectively that a vast potential for the child exists and should be acutely aware of the child’s environmental circumstances that may impede that potential. Only then can some resolution be achieved.