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November, 2010                                                          Early Childhood Hearing Outreach (ECHO) Initiative
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Don't Ask - Do Tell:  Elicit Cooperation from Children During OAE Screening

In an attempt to be respectful to children during the Otoacoustic Emissions (OAE) hearing screening process, many screeners fall into the pattern of asking, "Can I put this in your ear?" or "Can I test your hearing now?"  It should come as no surprise when children respond to these questions with an unequivocal "No"  and shake of the head!  A screener may then attempt to turn the child's "No" into a "Yes" by saying, "Please will you let me put this in your ear?" or "Don't worry, it won't hurt."  This typically has the reverse effect of making a child feel even more wary that something unpleasant
is in store.

While it is important to respect each child's autonomy and physical boundaries, it is also important to complete the hearing screening in a confident and efficient way.  Successful screeners have found that their tone of voice, along with the words they choose to describe what is going to happen, plays a big part in eliciting cooperation.  Many successful screeners use language such as,  "Let's play a listening game. I'm going to put this in your ear so you can hear the birdie!"  They are gently directive, using the same positive tone that a teacher might when saying, "I'm going to help you put on your coat so you can go outside to play." This directive approach can actually be more reassuring to a child than a question.

If you feel that a child needs to see and touch the probe prior to insertion, you may let the child feel the probe tip while commenting,
"It's very soft--like a little pillow."  For very young children, it is sometimes better not to draw attention to the probe by saying anything about it at all.  Instead, help maintain a focus on something the child enjoys touching or looking at by commenting on the object or toy, rather than diverting attention to the sensation of the probe being placed in their ear. 

Every child is different and experimenting with a variety of approaches will build your repertoire of screening skills.  If you can maintain a creative attitude, while using words and a tone of voice that have positive associations for children, it will signal to them that they can relax and trust the process. 

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Probe:  What verbal cues have you found to be effective in eliciting a child's cooperation? 

Some screeners are very successful screening reluctant children. Often it is because they are using specific strategies and verbal cues that create reassuring and even fun environments for children. Thoughtful observation and experimentation can allow other screeners to develop that same knack for making screening a pleasant activity for all involved.

Have you ever asked other particularly successful screeners what works for them?  If not, consider doing this.

And, if you have found particular strategies helpful in eliciting children's cooperation, please share your successes with us by emailing us here. 

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Probes and Tips is a newsletter from the ECHO Initiative that provides monthly TIPS
to enhance early childhood 
hearing screening and follow-up practices
 about current activities so we can learn from one another's successes and challenges.

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