Hearing evaluations and hearing-aid fittings can be scary for some people, especially those with developmental disabilities.
My patient, Jake Rembrecht, is 22, has Down Syndrome and hearing loss. To get Jake ready for his hearing evaluation, Jennifer, his mother, knew what to do: write a social story.
Social stories?
Some background: Based on her experience teaching autistic children, Carol Gray developed social stories to help prepare autistic people for life’s experiences. Social stories include vivid details of places, people, conditions, successful interactions, and praise for completing objectives.
Social Stories are a social learning tool that supports the safe and meaningful exchange of information between parents, professionals, and people with autism of all ages. —Carol Gray
Fortunately, social stories benefit people with other developmental disabilities too.
Super mom, Jennifer
Jennifer is a dedicated mom and has used social stories with Jake from an early age. Impressed by how much they help him, Jennifer is a social-stories enthusiast. I am too. Jennifer put it this way:
They are very powerful because Jake knows what to expect. It is the same as when we go online to preview hotel rooms or restaurant menus. —Jennifer Rembrecht
A sample from Jake's hearing-evaluation social story.
A novel experience made familiar
Chatting with Jennifer about her experiences with social stories, I learned about her powers of observation and anticipation — and how she puts them to work for her son.
She knew a hearing evaluation would be a novel experience for Jake. So she created a social story that previewed the skills Jake needed to complete a hearing evaluation successfully. Jennifer also included a Skill Checklist.
We use props around the house and go through a checklist of steps. For example, Jake went into our small bathroom and put blocks in a bucket to get ready for one test. I bought earbuds at the Dollar Store, and we had him put them in his ears to practice that skill. We start with the first step one day, and then we add a step each day. We work up to doing all the steps. We also bring the checklist to his hearing evaluation, checking off each step when competed.
And to no one’s surprise, Jake negotiated his hearing evaluation with flying colors.
Jake's next hearing adventure?
Up next, his new hearing aids, which require another visit to fit them properly. In other words, time for Super Mom Jennifer to write Part 2 of Jake's Hearing Adventure.
Jennifer always starts with research. She emailed, asking me for a photo of myself to include in Jake's ongoing social story. To familiarize Jake with hearing aids, she snagged photos of them and one of a hearing-aid charger from the manufacturer's website.
Removing the mystery put Jake at ease. It makes perfect sense. And honestly, isn't this true for all of us? Knowing the details of what will happen to you in a first-time experience helps lower anxiety. It sure does for me.
The power of specific
Before Jake's medical appointments, Jennifer talks with a staff member to determine what's involved — she's used social stories for dental and eye doctor visits. Then, she creates a step-by-step sequence for Jake, illustrated with photos. For example, she included a photo of the exterior of our Crest Hill office.
Jennifer uses one sentence and one illustration per step. Fewer words make it easier to process information.
We always end with something motivating. 'Jake will do a great job and enjoy a Slurpee®' A photo of Jake giving a thumbs up drinking a Slurpee®, reinforces this. We print the story and have several people read it with Jake, which provides lots of positive reinforcement.
Three keys, one goal
Jennifer's keys for social-story success are:
- Personalization
- True-to-life photos (not stock ones)
- Limited text
Her goal is to have social-story templates on healthcare-provider websites complete with photos of medical staff and facilities.
Learn more about social stories
About Christy Brand, M.S., CCC-A
Christy decided to become an audiologist in the 8th grade when an audiologist visited her science class. After working for five years, she gave birth to her second child, a son born with profound hearing loss in both ears. Today, Christy has five children, two with profound hearing loss. As you can imagine, she has developed a love and devotion to pediatric audiology.
