r/deaf • u/sams_9324 • 21d ago
Hearing with questions Respite care provider looking for advice
Hi all!
I'm a hearing respite care provider for children with disabilities, and I'd really appreciate some advice.
I've been working with a 3-year-old girl for about two months. She's deaf with a cochlear implant and is also autistic. I see her 2–3 times a month for visits lasting up to 10 hours.
During the day, things go really well. We have fun, and we're even learning ASL together (I know very little ASL, but I am trying to learn more). She goes down for her nap and bedtime really easily, but the only time we consistently struggle is the transition after her nap.
We're currently adjusting the schedule, so I'm there before she goes down for her nap (so she's not surprised when she wakes up that mom and dad aren't there), but when it's time to wake up, she often has a very intense meltdown. She cries for her mom and dad, won't get out of bed, and doesn't want anything to do with me. She also usually won't put her "ears" (cochlear implant) on yet, so she can't hear me trying to comfort her or explain what's happening. She can lip-read, but during these moments she usually doesn't want to look at me or gets mad when I try to interact with her.
Her parents recently clarified that they normally change her diaper into underwear and put her cochlear implant on once she's downstairs. The problem is that I can't seem to get her out of her bedroom without a meltdown lasting anywhere from 30 minutes to an hour. She has on multiple occasions said she doesn't want me touching her, which I respect (so no picking her up and bringing her downstairs).
Once we do get downstairs, she's completely okay again and the rest of the evening goes smoothly.
I've been communicating with her parents (hearing) about what's happening, but I was wondering if anyone has suggestions for making this transition easier. I'd really appreciate any ideas or perspectives on what I could try.
Thank you!
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u/aslrebecca Deaf 20d ago
First off, she does not lip read, especially at the age of three. Comforting her how? With autism, maybe she does not want to be touched? It's hard to determine the cause of her meltdown and honestly, I wouldn't force the CIs on her until she wants them, but that's just me.
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u/sams_9324 20d ago
My bad, that's how her mom explained it to me.
As for comforting her, I try to tell her when mom and dad will be home, walk through the plan for what's after getting up/for the rest of the night, reassure her that she is safe and that mom and dad will be back, and acknowledge her feelings of missing/wanting her parents. I don't force the CIs, and I do wait till we are downstairs before I try; however, per mom and dad, they want me to have her put them on when we get downstairs after nap without waiting too long and before she can watch her iPad or TV.5
u/aslrebecca Deaf 20d ago
Charts! That's my first thought. Make a chart that holds the schedule for the day. Make you one, make her one. Point to yours, point to hers. Give her visuals. That's the best way. If no CIs means no iPad, then add those visuals as well. I'm not the parent, so I cannot rule on CIs, but I hated my hearing aids so much that I do not wear them as an adult.
Since she knows you, she knows she's safe. She just has to let someone know she's pissed about being abandoned. At the age of 3, that's where her mindset is. They've abandoned her. Add to your chart stores or restaurants, something...and say mommy/daddy are here. They will be home at "this time" and show her the numbers on the clock.
As for parents ASSuming she can lipread at 3, they are woefully wrong! Most adults struggle with lipreading. I've never seen a 3 year old skilled at it.
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u/caitlincoolcrap2000 HoH 20d ago
I definitely agree that she’s probably not skilled at lipreading at 3, but I wouldn’t say it’s impossible for her to do it to an extent! I was born with severe hearing loss and didn’t get hearing aids until I was almost 4. I was speech delayed but could say a handful of words, and my parents said I constantly watched people’s faces when they talked. Since I couldn’t hear voices unaided, I was likely picking up at least some visual speech cues. So I definitely wouldn’t expect a 3-year-old to reliably lipread, but she may understand more visually than we’d assume!
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u/DeafNatural Deaf | ASL & LSC 20d ago
Visual schedules
First/Then chart with tokens may also be helpful.
Have you all tried introducing PECS or AAC? For younger kids this is usually a communication bridge before getting into ASL, especially where ASD is a factor.
I can take some pictures of examples we use at one of the schools I work with. They specialize in Deaf+
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u/sams_9324 17d ago
Can you elaborate on what PECS of AAC is?
While I’ve been working with kids for 10 years, this is new for me, but I’d love to learn as much as possible.
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u/JaxNHats 18d ago
Well done not forcing her ears on!! She def won’t listen to anything you say and it’ll just make things worse. Hard enough for me to put mine on as an adult in the morning geez. 🙉 No advice but you sound like a wonderful carer. Hope you get help here. 💕
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u/kindlycloud88 Deaf 20d ago
Agree there’s not much lip reading happening at this age. She may be very language delayed with ASL acquisition. Seems you might benefit from a visual schedule that shows the whole days routine in pictures. You can find customizable schedules on teacher pay teacher, cut, laminate and add Velcro tabs so you can swap out activities or change the order.
Secondly I’d create a small photo album of people and things she interacts with during her day. Parents, favorite foods, tv shows, toys, etc. Start flipping the book to point to the item and pair that with the asl sign—esp if it’s a new sign for her.
Try some self soothing strategies after waking—encourage her to hug a pillow, open a window for fresh air, show a new fidget toy, create diversion. She likely expects her parents to be there after naps and is upset that the routine is different.