Zoë is a 10 year old girl who has a younger sister Phobe. Zoë was born at 29 weeks and presented with low birth weight, hyaline, membrane disease, jaundice, apnoea & bradycardia, patent ductus arteriosus, suspected sepsis, chronic lung disease. She remained in intensive care until she was discharged at 60 days

Her diagnoses were:

• At 11 months: Athetoid Cerebral Palsy;
• at 22 months: bilateral profound hearing loss; and
• at 30 months: Myopia.

The Spastic Centre managed Zoë’s Cerebral Palsy, while Australian Hearing managed the fitting and ongoing support Zoë required for hearing aids and her F.M. system.

Royal Institute for Deaf and Blind Children provided Zoë and her family with Early Intervention services related to her hearing impairment.  Australian Hearing referred Zoë and her family to MREIC in November 2002 when she was 22 months old, and she was enrolled at MREIC in May 2003.

At MREIC Zoë and her family received an Individalised Program based on the COMBINE Methodology including the following:

• Cochlear Implant candidacy evaluation
• Ongoing audiological services for his Cochlear Implant
• individual and group sessions involving physiotherapy, occupational therapy, speech and language pathology, early childhood education
• parent support and education
• transition to pre-school/school support
• individual sessions to assist with visual tracking to facilitate reading and speech work to assist voice quality and fluency 

At 2 years 8 months Zoë received a Cochlear Implant. Her switch-on and ongoing mapPing was provided by The Sydney Cochlear Implant Centre but took place at MREIC with Zoë’s parents and MREIC case-manager.

Zoë learned to integrate listening into all of her waking hours through intensive Auditory Verbal Therapy. Her parents embraced all areas of her therapies and ensured that the goals and objectives were carried over into the home setting.

Zoë required intensive speech therapy and physiotherapy to maximize balance, head control and posture. This promoted breath control and improve her voice quality. Zoë’s voice quality and fluency improved dramatically after she learned to walk at the age of 7 years. Until this time her voice quality was breathy and weak and now Zoë’s speech is within normal limits.

To maximize exploration of her environment, manipulation of objects, toys, books, art materials, blocks, lego, puzzles etc Zoë’s physiotherapy and occupational therapy goals were integrated into every individual and group session and carried over into home life.

Zoë’s physical needs delayed entry to pre-school and she required a long transition period and ongoing support from MREIC and the special needs teacher at the pre-school to ensure that Zoë and her family were included in all aspects of the pre-school community. This often required pre-teaching of skills at MREIC.

The use of experience books and time invested to teach Zoë the skills required to develop play was important for Zoë’s social emotional, language and cognitive development. Her sister Phoebe attended sessions on a weekly basis to promote interaction and play supported by the development of conversation.

Mainstream school entry was delayed by one year. An intensive transition to school program was developed to adapt the school environment to suit Zoë’s physical and auditory needs. Zoë was taught orientation skills, key board and computer skills and literacy and numeracy concepts/skills. Activities were provided at pre-school, home and at MREIC to ensure Zoë had time and experiences to develop positive self esteem and social interaction skills. Prior to school entry Zoë and her family were embraced by the school community and she had experienced all aspects of school life.

Zoe has now completed 4 years at school. She is an above average student in all academic subjects. Zoë won the University of NSW International Competitions and Assessments for schools prize for science receiving a distinction and scored in bands 5 & 6 in her National Assessment Program – Literacy and Numeracy (NAPLAN)

Reading score for the Neale Test: age at time of test 8 years 3 months

Accuracy: 10 years 7 months (stanine 7)

Comprehension: 11 years 1 month (stanine 8)