Although we have no standard to assist us in case-by-case intervention, some generic guidelines may be useful regardless of degree and quality if hearing impairment :
1. Assess the hearing along with the psychosocial status of the child. It may be useful or necessary to have access to the services of a psychologist or psychometrist who is acquainted with the hearing problems of children.
2. Educate the child about the hearing loss. Too frequently, we educate the parents and assume somehow that the child will get the information through osmosis. Informative data need to be given to the child, geared to that child’s age and intellectual level.
3. Orient the child to the use of a hearing aid. Fitting the aid is not enough. Teaching its use and care is meaningful only if we (a) allow the child to express his or her feeling about wearing it and respond empathically to possible resistance or concern, and (b) allow for possible resistance as an expression of real difficulties the child may be having with a particular aid and consider refitting if necessary.
4. Have the child teach us what is needed to function more adequately. We cannot assume that the age or naivete of the child precludes awareness of obstacles to maximal use of residual hearing. We need to be open to whatever information is forthcoming from the child and place it in proper perspective with data we objectively gathered.
5. Distinguish emotional issue associated with hearing loss from those unrelated to it. This is no easy task for the counseling audiologist, because none of us behaves in a linear manner but instead responds behaviorally to the sum of our experiences. What necessary is that we discover those negative influences in the child’s environment that at least appear to be unrelated to the hearing loss. These may include the effects of (a) being raised by one parent, (b) divorce, (c) extreme poverty, or (d) an emotionally disturbed family.
6. Deal with emotional disturbance in the child. Somewhat related to guideline 5, it may be necessary to refer the severely emotionally disturbed child for more extensive psychotherapeutic assistance, preferably to a professional who is well acquainted with the problems of hearing loss in children.
7. Provide a supportive, empathic, and trusting therapeutic environment. An environment in which the child feels free to express concerns regarding the loss of hearing and its many implications provides a valuable opportunity in which to apply our audiological knowledge effectively. Too often children against them, regardless of our best intentioned efforts. Therefore, of the child in the most genuine is that we relate to the child in the most genuine way possible rather than pose as individuals who “know what’s best” for the child. This does not imply that we act the role of “buddy” but that we appear to child, and the child appears to us, as distinct persons in our own right.
8. Use special counseling techniques. Consistent with the philosophy expressed throughout this text, we need to feel free to use whatever strategies with which we feel competent and that them are confrontation, self-disclosure, and contracting. In most instances. These will need to be connected to aural rehabilitation strategies, but always bear in mind that the child matters, not the technique.