Advice on Distance Learning for Individuals with Hearing Loss

Updated on Jun 30, 2022 | Children's Health, COVID-19, Ear Nose Throat, Your Health

According to UNESCO, school closures in response to the COVID-19 pandemic have impacted approximately 1.4 billion students. Children in pre-primary through high school, as well as adults in collegiate and graduate education are now engaged in “distance” or “remote” learning. While this allows education to continue despite school closures, it is not without drawbacks.  Poor audio quality is an impediment for learners at all levels, and can be especially difficult for those with hearing loss. Maura Cosetti, MD, Director of the Ear Institute of New York Eye and Ear Infirmary at Mount Sinai and David Spritzler, MED, Education Specialist at the Ear Institute, share guidance for distant learners with hearing loss.

Guidance for All Distance Learners

As with a classroom setting, individuals with hearing loss have specific needs related to online education. These steps will improve auditory access for all participants in distance learning.

Request that the presenter uses a wearable microphone and is well-lit throughout the lesson.

Using a built-in mic on tablets or computers can produce muffled audio. A wearable microphone doesn’t have to be anything fancy; a Bluetooth headset or the headphones that come free with a phone will significantly improve sound quality.

Additionally, presenters should be well-lit throughout so that students can speech read their mouths.

Ask for a sound check before the lesson and that student microphones are muted throughout the lesson.

A sound check will ensure that the audio is working on both ends. Teachers or presenters can do this by asking each student a different open-ended question, such as, “What’s the last movie you saw?”

Also, having other learners mute their microphones prevents students from talking over each other and introducing distracting background noise to the lesson. Teachers can have students use a signal, such as waving or holding a thumbs up, when they want to speak.

Reduce background noise. 

Turn off music, TV, and loud appliances and be sure to close windows and doors. If your child must share space with other people during lessons, ask everyone to try to be as quiet as possible.

Let the teacher know when you cannot hear.

Adults are likely to know when they are having trouble hearing, and what to do about it.  However, children are often unaware that they are not hearing well and may be shy about speaking up when there is a problem.  Help your child learn to identify problems by encouraging them to ask themselves if they understand what is being said and to let an adult know if they cannot.

Guidance for Children Who Are Distance Learning

Children with hearing loss have additional challenges regarding distance learning. Parents and guardians should adhere to the following tips to ensure that their child has the best experience while distance learning.

Ask for hearing assistive technology from your child’s school.

Ask your child’s school to send home their hearing assistive technology. This equipment, commonly referred to as “FM”, is usually used to improve the signal-to-noise ratio in the classroom, but it can also be used to connect the audio output from a laptop or tablet directly to a child’s hearing aids or cochlear implants, greatly improving sound quality. Some hearing devices can also connect via Bluetooth, ask your child’s audiologist.

Check your child’s hearing equipment.

Make sure your child’s hearing equipment has been freshly charged and that replacement batteries are on hand.

Additionally, do daily “listening checks”: while standing behind your child, ask them to repeat various letter sounds (could try the “Ling” sounds) in random order, then answer open-ended questions.

Request accommodations from the teacher.

Ask that teachers use captioning for videos and that they send presentations and other materials in advance. This will allow you to “pre-teach” new words and familiarize your child with new content.

Also, get in touch with your child’s teacher of the deaf and educational audiologist. They can help troubleshoot problems as they arise and can provide support to you and your child.

Make sure your child takes a break.

Listening through technology is hard work! Give your child plenty of time to rest in between lessons.

Even in the best of times, children with hearing loss have to work harder than their peers to learn, and commonly experience “listening fatigue” from the increased expenditure of energy. Distance learning is proving to be much more challenging than regular school for all students, and the added stresses of not seeing friends or playing outside make it even harder for kids to pay attention and learn. Therefore, it’s not reasonable to expect children to do the same work that they would in normal circumstances. In order to learn, children need to be presented with activities that are challenging, but achievable. Stress is counterproductive. If your child is resistant to doing schoolwork or participating in distance learning, discuss ways to adjust expectations with teachers.

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Should I Prepare a COVID-19 Emergency Care Kit?

Updated on Jun 30, 2022 | COVID-19, Your Health

Everyone is worrying about COVID-19. At home preparation is essential for social distancing and in the unfortunate event that yourself or a loved one becomes ill. Stocking up on the basics is a good approach. But, what do you need to have on hand? Linda V. DeCherrie, MD, Professor of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai, shares what you should have in your COVID-19 Emergency Care Kit.

What types of things should I keep on hand?

In general, you want to have cleaning and hygiene products, a 30-day supply of any medications you may be taking as well as other health care items, and food.

Besides my prescription medication, are there other medicines or medical supplies that I should have on hand?

You might want to stock up on daily multivitamins, vitamin C tablets, and electrolyte replacement drinks, such as sports drinks. Over-the-counter medications are also helpful—including cough, cold, and diarrhea relievers as well as pain and fever relievers like acetaminophen or ibuprofen. If there is a child in the home, be sure to pick up  children’s versions.

If you have special medical supply needs, try to have at least 30 days of supplies such as oxygen supplies, catheters, syringes, as well as blood test monitors and strips. Ensure any medical equipment you use is in good repair. This includes oxygen equipment, nebulizers, CPAP machines, hearing aids, glasses, and assistive technologies.

Also, you might want to have a pulse oximeter—which measures both oxygen levels and heart rate—as well batteries to operate the device. And, if you use a cane, crutch, walker, or wheelchair; check to make sure it is in good shape.

Are there specific cleaning and hygiene products that I should use?

When it comes to basic sanitation and hygiene items, try to have bleach, soap, hand sanitizer, antibacterial wipes, face masks, laundry detergent, and garbage bags on hand. You’ll also want to have some basic first aid supplies at home, like an inexpensive digital thermometer, gloves, and bandages.

Be sure to think about the non-food items you regularly purchase at the pharmacy or grocery store and try to have at least two weeks’ worth on hand. This includes toilet paper, toothpaste, tissues, batteries for hearing aids, and contact lens solution.

What should I have in terms of food?

The best case is to have about 30 days’ worth of food on hand. You’ll want to have nonperishable or canned food in your cabinet or pantry. Basics like rice, beans, and peanut butter are inexpensive and keep well. You might also want to have chicken soup, fresh ginger, onions, lemons, and oregano as well as high-calorie nutrient-rich foods such as avocados, honey, and pectin-rich foods like bananas and apples. If there are people in your family who need special foods—such as infants or people with dietary restrictions—be prepared for their needs as well. For more on how to stock your pantry during COVID-19, read this advice from Mount Sinai nutritionists.

If you have a pet, don’t forget stocking up on food, kitty litter, and pet medications.

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How Older Adults Can Protect Themselves From COVID-19

Updated on Jun 30, 2022 | COVID-19, Geriatrics, Your Health

COVID-19 is a concern for everyone. But the elderly may be at increased risk of contracting this virus–or developing a bad case of it. Linda V. DeCherrie, MD, Professor of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai, shares information that the elderly and their caregivers can use during the time of COVID-19.

How can the elderly protect themselves from COVID-19?

The best plan is to avoid contracting the virus. To protect yourself, follow the guidelines from the Centers for Disease Control and Prevention. That means stay home as much as you can. Wear masks and gloves if you must go out in public. Make sure home health aides and any family wash their hands when they come into your home. And, keep in close communication with your doctors and health care team so that you can notify them immediately of any new symptoms.

Should older adults make plans for what to do if they get sick?

It’s always good to think ahead if you can. Now is a good time to talk about the “what ifs” and begin your advance care planning, if you have not done so already. The social workers at your hospital can help. You should also tell your loved ones what your wishes are.  

How can I avoid social isolation and depression?

This is always a concern for people living alone—and even more so now with widespread directives to practice social distancing. Fortunately, we’re in much better shape to address this potential for loneliness now than we were even ten years ago. Use Skype, FaceTime, Zoom, or other video chatting technology as much as you can to connect with loved ones.

It also helps to keep as close to a normal routine as possible. Make your bed every morning and don’t let dirty dishes sit in the sink. Get some exercise, either in your home or by taking a walk, while maintaining social distance. This is also the time to try activities that you don’t usually do: paint a picture, play an old-fashioned board game, piece together a 1000-piece puzzle, read that novel that’s been sitting on the shelf. Equally important, try to limit how much time you spend reading or listening to the news.  

Additionally, you might want to get to know your neighbors and talk with them about emergency planning. If your neighborhood has a website or social media channel, think about joining it for access to people and resources nearby.

While it is true that the available data shows that older adults—and those with serious illnesses—are at somewhat greater risk for severe outcomes if they contract COVID-19; it is important to remember that many older adults will not get the virus. And, among those who do, most will survive. Remember, this will pass. We will get through this together.

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COVID-19: Managing Anxiety and Depression

Updated on Jun 30, 2022 | COVID-19, Mental Health, Psychiatry, Your Health

The outbreak of COVID-19 is challenging all of us to cope in new ways. For people with depression and anxiety, life can seem overwhelming in normal times. Rachel Yehuda, PhD, Professor of Psychiatry and Neuroscience at the Icahn School of Medicine at Mount Sinai describes ways to deal with the feelings of anxiety and depression during this crisis.

Stress levels are high for everybody these days. For people who are already dealing with anxiety and depression, what advice would you give?

Many mental health providers are seeing their patients through telehealth. Should you not be able get to an appointment in person, your provider will likely be available to talk to you by phone or by online chat services like Zoom or Skype. It’s very important that while we isolate ourselves physically, we don’t isolate ourselves from the world or from people. If you can’t talk to your provider, make sure you are talking regularly to somebody, whether it’s a family member or a friend.  I encourage people to talk by phone, video call, Skype—or to reach out through social media.

The more we’re in touch with the idea that we’re all in the same boat, the less anxious we may become. Many people with depression and anxiety feel that no one understands them, and this increases the isolation.  Right now, a lot more of us are feeling isolated, so we are experiencing feelings that some people struggle with all the time.

Anxiety and depression are heightened by the feeling that no one can understand. But right now, we’re all going through the same thing and this provides an opportunity to really connect with each other as we realize that we’re part of a greater culture and humanity. I see an opportunity for healing, because more people will be able to empathize. Staying connected on social media and seeing what everyone else is going through may help people not feel so isolated.

I imagine being on social media can be a double-edged sword. How do you gauge when you’re exposing yourself to too much social media?

You certainly have to strike a balance. But I think the problem isn’t so much too much social media, but negative social media. It’s a matter of choosing your friends wisely, and choosing what you engage in. Sometimes we engage with people who trigger us with their negativity or politics that we don’t agree with.

But if you have friends who are posting important news information, humorous things, or positive items, this can be a great way to stay connected. It’s a good distraction from all the uncertainty and can be a pleasant way to spend some time. The positives of social media should be used to their fullest. Some people are sharing life-affirming stories about how people are helping each other. My rabbi posted a short, 20-second prayer that you could recite while washing your hands, while being mindful that your actions are helping to protect other people.  It can be a time to be inspired and connected to all the positives of humanity when we pull together.

Of course if you have friends who are posting things that you find upsetting, blocking or unfriending those people may help you feel in control at a time when you are controlling much less than normal. And that can be healthy. We have the power to mute negative messages.

What warning signs should you look for regarding anxiety and depression?

If you’ve gone a while without bathing, if you’re not eating, or not caring about getting dressed in the morning, letting the house get messy and out of control, then you should be getting outside help or trying to talk to someone. If you have thoughts that keep coming into your head that you can’t get rid of about becoming infected, or feeling everything around you is unsafe, that is also a sign that you might be getting very anxious. Even though there is truth to the idea that things on the outside might not be currently safe, social isolation, self-quarantine, and taking precautions should make you feel in control. If you can’t feel in control or feel your actions aren’t effective in increasing your safety, that is a warning sign.

We are in a real emergency. So it’s appropriate to have rational plans about worst case scenarios. What will I do if I get a fever or a cough? Do I have enough cough syrup in the house? Do I have a thermometer? These are reasonable thoughts to have, and formulating a plan for those things should provide reassurance.  But if they do not, it’s time to reach out to someone.

Mental health is being conducted on hotlines and many medical institutions have been preparing to deliver care like this for quite a while now. This is the day we’ve been preparing for—where people in need can have a reassuring voice on the end of the line that can walk them through their fears and anxieties.

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How to Talk to Your Child About COVID-19

Updated on Jun 30, 2022 | Children's Health, COVID-19, Mental Health, Psychiatry, Your Health

Discussing difficult topics with children can be uncomfortable and this pandemic is no exception. Aliza Pressman, PhD, co-Founding Director and Director of Clinical Programming for the Mount Sinai Parenting Center, shares information parents and guardians can use as they care for  children during the time of COVID-19.

Should I let my children watch the news?

If you want to give age-appropriate information to your kids, I recommend reading articles from reputable sources—either to them or with them—and then talking about the information. You may want to stick with resources that do not show images as it can be hard for children—and adults—to get images out of their minds.

We don’t want our children to see difficult images that we cannot control. For that reason, I would recommend turning off the news completely in front of younger children. In fact, older children and teenagers don’t really need those images either. Ideally, you should set aside time to watch the news to when you are alone or with other adults. This will also help manage your own stress because you will be limiting the amount of time you spend taking in this information.

I would discourage people of all ages from watching the news too much. Having the news on 24/7 heightens stress in the household and sends the message that you’re scared to turn the news off because you’re afraid you’ll miss something.

How do I help my child understand why they cannot see their friends and loved ones?

It can be hard for children to be unable to visit friends and loved ones, like grandparents, who they might be accustomed to seeing regularly. Try to empathize with your child and help them come up with proactive ways to connect with grandparents or other loved ones whom they cannot see.

This is the time to take advantage of social media and digital devices to empower your child to forge a connection with someone when they are not in the same room. Help turn sadness into productive action by encouraging your child to write letters, send notes, call, and video chat. These are beautiful ways to connect and show children that there is something they can do to help a person they love feel better.

If your child doesn’t have someone to connect with, there are organizations that can help you reach out, write letters, and draw pictures for elderly and vulnerable people who are currently isolated.

Should I tell my child if a loved one is seriously ill?

No matter how old your child is, it’s important to be honest and give your child the information needed. How you explain the situation depends on the child’s age.

For younger children, if a close family member is ill and you know how that illness is progressing, you can tell your child that the person tested positive for COVID-19. Explain the care that person is receiving and that you need to support them from afar.

If the person is very ill and you do not know what the outcome will be, it’s okay to express that to your child. Explain that the person is receiving great care and that you will keep in touch to see how things are going. You do not want to tell your child that everything is fine and then, all of a sudden, the person’s condition deteriorates.

On the other hand, if the person is asymptomatic and has tested positive, you don’t necessarily need to tell your children.

What if I or my partner becomes ill?

If you or your partner are sick, you need to tell your child what is going on. Explain that COVID-19 is very contagious. Explain that, in order to keep their body healthy and their parent’s body healthy, you will need to be separated for 14 days. You can make a calendar as a visual reminder of how long you will be apart. This can work well for the whole family as even adults can benefit from being able to check off each day of quarantine as it passes.

When you explain anything to children, be sure to check in first. See what they know already and then you can see where to begin with the explanation.

Dr. Pressman is the host of parenting podcast Raising Good Humans. Recently, she and Mariel Benjamin, LCSW, from The Mount Sinai Parenting Center, answered questions from health care providers and staff on the front lines to help support their parenting curing COVID-19. Additionally, The Mount Sinai Parenting Center maintains a COVID-19 resources page for parents, caregivers, and health care workers.  

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Managing Your Child’s Anxiety Caused By COVID-19

Updated on Jun 30, 2022 | Children's Health, COVID-19, Your Health

The COVID-19 pandemic is incredibly stressful for adults and can be puzzling and frightening for children. Aliza Pressman, PhD, co-Founding Director and Director of Clinical Programming for the Mount Sinai Parenting Center, shares advice for parents and guardians on how to manage your child’s anxiety as we navigate the uncertain times of COVID-19.

Are there steps I should take to help my child’s mental health?

This is a very confusing time for adults and kids. Typically, when kids are going through a new experience it is one that we, the adults, have been through. We’ve worked through it, we’ve grown up, and we’ve come out the other side. In this case, none of us have ever been through this and so our kids can’t look to us for that safe secure feeling. We don’t have a road map.

Be honest with your kids. Tell them that you know this is a new experience for all of us. Tell them that you understand if it feels scary or if they are worried. Remind them that you are right there with them.  

How should I respond to my child’s anxiety?

Give your child permission to talk about what they are feeling and worrying about. Acknowledge their anxiety even if it has nothing to do with COVID-19 or is only slightly related to the pandemic. For instance, children may feel stress because they miss their friends or aren’t allowed to celebrate an event like a graduation or birthday. Try not to diminish their feelings or say ‘we have bigger things to worry about than your birthday party.’ Instead, tell them that you know it’s really hard. Let them know that you are aware that this is a big change. Assure them that you can figure out how to have celebratory experiences, even if they are not quite how you originally planned them.

This is a very challenging time for everyone. You can explain to children that they are being asked to be health superheroes. Through the practice of social distancing and by washing their hands thoroughly, they are keeping themselves safe and helping to protect others who are more vulnerable. This is a wonderful, empowering message that does not scare children.

Is it important that I keep my child’s routines going?

Although it can be hard to keep routines going during a time that has very few routines, kids and adults thrive on knowing what to expect each day. So, try to set up a flexible routine for the coming weeks or months.

I encourage writing out a plan for your children. If they are younger, you can draw a picture of the routine of the day or use photos from magazines to help them understand what to expect. Ask older children to come up with what they think is a good daytime routine. You want to make sure they are comfortable with the schedule, but you also want to get certain boxes checked about what needs to happen each day. Make sure that it includes something healthy for their bodies, something healthy for their brain, something healthy for their relationships, and so forth.

It’s also important to let children have some enjoyment. Allow them to be happy about getting out of some obligations they had prior to practicing social distancing. Your kids might be a little bit happy about spending more time at home with their parents. Let them know that it’s okay to have mixed feelings.

Also, allow yourself to embrace the new normal and accept that there may not be a completely perfect routine and predictable day-to-day experience. Children need to know what to expect, but they’re also very flexible if you explain clearly that there may come a time when the unexpected will arise. Children can take in new information and, if you are consistent, they will understand that you are there for them. Finally, if you are having any concerns about you or your child’s health and wellbeing, be sure to reach out to your health care provider for guidance and support.

Dr. Pressman is the host of parenting podcast Raising Good Humans. Recently, she and Mariel Benjamin, LCSW, from The Mount Sinai Parenting Center, answered questions from health care providers and staff on the front lines to help support their parenting curing COVID-19. Additionally, The Mount Sinai Parenting Center maintains a COVID-19 resources page for parents, caregivers, and health care workers.  

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