How can providers Collaborate to Optimize Outcomes for Children who are hard of Hearing
Consistency of auditory success
Early Intervention Services
Universal born Hearing Screening
98% of children born in US get this, other 2% are home births
Before this HL was diagnosed between 2-5
At the beginning it wasn't thought of as cost effective
Birth-3 Early Childhood Education Programs
Designed to address HL and help children with better outcomes in general education program
Outcomes of Children with Hearing Loss
Want to know about services provided to children who are hard of hearing
Only had this one disability
Data Collection and management
Audiology Service provider Survey
Services and Provider Survey
Professional Development with OCHL
61% had continuing education
A wide range of a one day seminar to university courses
English is primary language
No secondary disability
Increase comfort levels with HA management for SLPs
Specific training programs
Continue education in uncomfortable areas
Tell them to educate others in child's life about troubleshooting
Want parent to be knowledgeable on HA
Identify and fit amplification early
Use best practice for evaluations, verifications, fittings, etc
Monitor HA use with data logging and consistency rating
Collaborative Strategies to support HA use
Data logging and consistency ratings
Regular contact with service providers
What is Telepractice
Provision of a professional service over geographical distances by means of modern technology
Skype like service
Skype is NOT HIPAA complient
Increase in Telepractice
Further a child is from audiologist the longer the delay in getting HA and CI
Shortage of experienced individuals
Benefits of Teletherapy
Provides access to qualified providers
Decrease trvel constraints
Birth-3 services should be provided at home
Reduces number of cancellations
Increase of family centered coaching
Limitations of Teletherapy
Access to high speed internet and computer
Feeling comfortable with technology
Quiet environment at home
Access to materials
Paradise's View on UNHS
Not the best
Not cost effective
Forced audiologists to identify the problem with identifying HL at birth and how to improve UNHS
Arguments Against UNHS
Most infants with SNHL are high-risk in NICU
False Positive could have negative impact on parent-infant bonding and long term psychosocial consequences
Insufficient facilities and professionals to provide follow-up care
Some HL are late-onset this gives parents false hope
Can deal with first 3 bottom still a problem
Increase in UNHS is Due To
Growing body of research supporting feasibility and efficacy
Increased Federal Funds
False-Positive Rate is low
Visual Reinforcement Audiometry
Behavioral Tests, kid turns their head to auditory stimulus
Assesses auditory perception
Via speakers better ear responds
Need motor skills to turn head
Conditioned Play Audiometry
Hear a beep drop a block
Make this FUN for children
Child conditioned to perform action in presence of stimuli
Ear specific and assesses auditory perception
5 minute test
Measure OHC response to stimulus
Have to be quiet for administration
May miss mild HL or auditory neruopathy
Auditory Brainstem Response (Brainstem Auditory Evoked Response)
15 minute test
Electrophysiologic measure of brainstem
Patient needs to be quiet
Small probe containing sensitive microphone in EC
Probe presents stimulus and microphone detects response of OHC
Audiologist places 4-5 electrodes on infants head
Present different levels of sound
Electrical Activity of brain is recorded and represented as waveform
Look at Wave 5
Can be done with AC and BC
4 years and above
Child instructed to raise hand
EHDI vs Non-EHDI
Children identified before 6 months have better language outcomes than children identified after 6 month
1 month of age have hearing screening
3 months of age have HL confirmed
6 months of age begin early intervention
Between 3-6 months have HA fitted
OCHL and 1-3-6
32% met all benchmarks on time
Lowest area was 3 months where only 70% met that benchmark
Causes for Delay of HL Confirmation
Recurrent middle ear infections
ABR was near normal
Reasons for Delay in UNHS Test
Multiple re screenings
Family chose to wait
Family assured that equipment wasn't working
Delayed because of ME problems
Causes for Delay in HA Fitting
HA not initially recommended
Difficulty obtaining clinic appointment for HA fitting
Family decided not to proceed with HA fitting right away
How are Delay's in 1-3-6 Addressed
Professional priorityfor children at "benchmark" appoinments
Education resource for professional and families
Follow-up incase of ME issue
Effects on mild HL or unaided HL on communication development
Communication between professionals about where family is on EDHI timeline
Support at risk families
Importance of Early Identification
Most common birth condition affecting development
3 in 1000 births
93% of children with HL are born into hearing families
Risk Factors of Congenital HL
Family History of HL
In utero Infection
Low birth weight
Low ApGAR scores
Extended NICU stay of greater than 5 days
Challenges in Screening
Standardized methodology, reporting system evaluation
Each state can't regulate another
Rural states vs urban states
Speech inventory (vowels and consonants)
Voice; Sign Ratio
Sign Frequency/Depth Vocabulary
Turn Taking Skills
Speech Production Repetoire
Language: Receptive and Expressive
Cognitive behavioral, emotional health statues
Critical Decision: "Cost" "Benefit"
May need to be flexible
More demand from families for oral/AVT
Consider what works for the family
You want FLUENCY
According to the Authors what is a Reason for limited collaboration between SLPs and AuDs
There is a limited number of educational audiologists in the US
In the survey, what was the most frequent response for how often SLPs performed HA listening checks for clients
What was a limitation in the McCormick et al. Study
Low response rate may have resulted in an unrepresentative sample of school based SLPs
What is a feasible option in improving collaboration between SLPs and AuDs according to McKormik et al
Joint participation on students IEP teams
What was the primary advantage of using Skype for telepractice services for the Sound Beginnings Program in Utah
Relatively stable audio and visual signs
Issues that may arise during telepractice sessions
Poor AV signal
Visual Glare or Darkness
Utah Sound Beginnings Model for telepractice, one goal is that the service provider is the
Coach for the family during the intervention session
Benefits of Teleintervention
Parents take an active role in therapy
Sessions can be recorded for other family member use
Why is the coaching process an integral component of the iHear Program
The coaching process encourage parents to be more involved in intervention which has a positive impact on child language development
Stedler-Brown reports that one of the challenges in implementing telepractice is that it is difficult to continue providing the services are initial grant funding runs out, what does she suggest as a way to sustain telepractice service
Engage multiple local, state, and federal agencies in continued funding
As of 2003 why was there little prospective research on outcomes of infants and toddlers with HL
Until around the 1990s the average age of identification of HL was 2 years
What areas of language development was significantly different between screened and no screened groups according to Yoshinga-Itano
In the section on cognition and language, the authors describe a seminal study by Yoshinaga what was the primary finding
Early identified children with additional disabilities had language outcomes that were similar to late-identified children with no disabilities
Advantages gained by early identified only occur in children who are exposed to an auditory-oral intervention approach
Majority of children in Holte et al met all 1-3-6 guidelines for kids who fail the UNHS
False, only about 1/3 met all guidelines
Which of the following makes it difficult to get families to follow up, after their child fails UNHS
They see their infant responding to sounds and think there isn't a problem with their hearing
Which of the following isn't a finding from Holte
Severity of HL affects timeliness of service delivery (Confirmation of HL, HA fitting, entry in early intervention)
Looking at maternal education level data in Table 2 of Fulcher, what generalization can you make about this particular sample of children with HL
It was an advantaged sample of children
Children in the Fulcher study who failed to attend therapy or didn't wear aids were excluded. What did the exclusion have with determining effects of auditory verbal therapy on language outcomes
Biases results in favor of AVT
Results suggested that early-identified children with severe HL outperformed late-identified children with mild HL
Josie, age 23 months, is beginning to combine words. She primarily uses phrases such as "big cookie" and "silly doggie" in her interactions at home. What type of semantic syntactic word classes has Josie mastered?
Attribute + Entity
For a young baby, according to Easterbrooks and Estes, the main brain task that is important is:
Jamal is a 15 month old with ly diagnosed severe to profound bilateral SNHL. You just saw him for an audiological appointment. During the evaluation, you heard him verbally producing: "ee", "uh oh", and "baba" for mama. You might expect him in a few months to produce which of the following first?
Different vowels and consonant strings
Incidental learning is critical for generalizaiton and has greatest importance for school-aged children
A 3-4 year old child is responsive to a wide variety of sounds at approximately what sound level?
10 dB HL
Federal law requires an IFSP for infants and toddlers with disabilities. If you were working with a baby with hearing loss, which of the following information might be provided on the IFSP?
Assessments conducted with the child
Related services this child might qualify for
One problem with born hearing screening not identifying children with true hearing losses may be:
born hearing screening may result in false negatives
JCIH guidelines has the intended goal of 1) identification of hearing loss and 2) initiation of services by what ages?
3 months, 6 months
"Finger to ear" cue might be useful to bring a baby's attention to an ambulance sound, or other environmental stimuli.
Nursery rhymes, fingerplays, and children's songs can be useful to teach
vocabulary as well as the rhythm in the language on a receptive level.
They are also useful expressively to aid the child in developing
auditory closure abilities.
Jason, age 16 months, has been using his hearing aids since he was 8.5 months old. Which of the following listening tasks is he most likely engaged in?
Hallmark behaviors of preinflected stage include
Usage of 2-3 words without tense and number
Utilization of a pointing gesture
Increase usage of prominent intonational pattens by family members, teachers, and care givers
Mothers speak more slowly to their infants (motherese) because babies
have shorter temporal resolution than older children and adults
Welcome to Holland
Get told you are going to Italy
You plan for this trip and places you will see
Plane actually takes you to Holland
People may be disappointed because they were expecting Italy and got Holland instead
Emily Perl Kingsley
Wrote for Sesame Street
Had a son with Down Syndrome
Introduced a disabled character to Sesame Street
Pre-Assessment of Children with HL
Key assumed knowledge: ND acquisition information relative to: Auditory status and abilities
Receptive and Expressive Language
Appliances: HA, CI, Glasses, braces, etc
Behavior: Appropriate? Busy? Shy
Communication: Modality? Success?
Support: Who is supporting the child
Initial Diagnosis of Child
Not easy to test/quantify infants
Reacquires multiple testing and evaluations
Consistency in response is important
need to think of time of test is it normally feeding/nap time for child
Receptive and Expressive modality needs to be clarified by examiner: Helps verify what the family wants
Clinician needs to support the decision they have made
What we know to be true about HL in children
Identify by 6 months of
age:consistently outperform later identified children on measures of
language severity of HL doesn't matter
Age of enrollment in interventions is significant predictor of vocabulary and verbal reasoning at age 5
According to Moeller before 11 months shows significant improvement in EI
What concern does the family have
How does it affect child's function
Are their other issues
Across many disciplines (motor skills, social skills, etc)
You aren't licensed to evaluate these
4 year olds can cut shapes with scissors
False, Fine motor skills are not that developed yet, maybe true for a child that signs
Looking at the whole child
Prevalence of additoinal disabilities with HL
No additional disability=60.1%
Verification of HL: Is there a change in the audiogram
Equipment: Major or minor changes
Easier Auditory Variables
More Complex Auditory Variables
Large Set (5+)
Speech Assessment Framework
Always bear in mind developmental expectations for speech as well as auditory perceptual abilities: Compare CI vs HA
Think of Speech Production
HH Child Speech Skills
Speech intelligibility is related to degree of hearing loss
More variable above 90 dB HL
Mild to moderate loss have similar problems to ND
Problems with low intensity high frequency sounds
Severe to Profound HL Speech Characteristics
Consider residual hearing, in general poorer hearing leads to less speech produciton
20% speech inteligibility
Suprasegmental Speech Characteristics
Research has demonstrated that children with hearing loss who are
implanted before five years of age have the potential for
age-appropriate English language abilities.
When testing children with hearing loss, SLPs often have to supplement
language testing with measures standardized on children with normal
Speech intelligibility is directly related to degree of hearing loss,
and the greatest variability occurs for children whose hearing loss is
at or exceeds 75 dB HL.
Carney showed in her research that the average speech intelligibility of
children whose hearing loss falls in the severe to profound range can
range from 0-100% but averages only 20%. Recent research (Chin and
Kaiser, 2000) revealed that children with cochlear implants who are
given the GFTA perform within normal limits when compared to hearing
The auditory-oral approach and the auditory-verbal approach emphasize
the use of sensory aids (as needed) and the role of parents in promoting
learning at home.
In a bi-bi second language approach, English is developed as a second
language via the written form and access to individuals with fluency in
ASL in the DEAF culture is important.
Which of the following is TRUE regarding children with hearing impairment's early vocalizations?
Their canonical babbling is delayed in frequency and diversity
Libby, age 6, communicates via TC. Her mom wants you to assess Libby's receptive sign vocabulary. You decide to use which formal measure?
Carolina Picture Vocabulary Test
Jacob, age 3, has a mild sloping to moderately severe bilateral SN hearing loss. We might anticipate he would have trouble producing which of the following words?
Preschool children with hearing loss often struggle with mapping language into everyday routines. This can be due to
Limited schema about the event or routine
Less access to language of parents, siblings, and caregivers
Fewer incidental learning opportunities
A landmark study on language acquisition on preschoolers with hearing loss revealed which of the following as a surprise finding?
Late identification with normal cognition scored essentially equal to early identification with low cognition.
What are factors that have significantly changed the speech and language outcomes for children with hearing loss.
Increased Client Diversity
By what age does a typically developing child with normal hearing learn to discriminate the sounds of their native language?
Gregg, age 11, has a profound hearing loss and voicing problems when he talks. Name one perceptual problem we might hear in Gregg's speech attempts if he has sufficient vocal fold adduction.
Gregg, age 11, has a profound hearing loss and voicing problems when he talks. Name one perceptual problem we might hear in Gregg's speech attempts if he has insufficient vocal fold adduction.
The OCHL study is an epidemiological study conducted from three
universities that hopes to inform practices that lead to differences in
outcomes for children who are deaf.
Most students who are identified in school-aged hearing conservation programs demonstrate sensorineural hearing loss.
What is the recommended interval for assessing hearing in children aged birth to three years?
Hearing loss does not impact educational outcomes in children with mild hearing loss.
The reason that early intervention services occur most frequently in the home or in a natural context is related to interpretation of what federal law?
Part C of the IDEA
Family-centered models of early intervention for children with hearing
loss are considered best practice following identification by NBHS
If I was using Mahoney's relationship-focused intervention, I would
encourage a family to engage with their young child in natural contexts
in a very responsive manner.
If an SLP or audiologist is using adaptive strategies with a child, he/she might engage in which of the following behaviors:
Looking for changes in behaviors and adjusting to meet the child's needs
What does the s commentator model reported by Moeller and Condon provides objective descriptions of children's behavior during observed parent interactions. What does this strategy help parents learn?
What is working well
Functional assessment measures are sometimes used to validate as well as
document listening performance in varied conditions including natural
listening environments (e.g. classroom)
Learning by overhearing others (incidental learning) is a behavior that falls under which Phase of the Cole and Flexer model?
Johnny is a CI user. His audiologist has encouraged his family to play hide and seek with him and call his name from different locations in the house. This will work on WHICH auditory skill a la Erber listening hierarchy?
Deaf mentoring for families who choose a bi-bi program for their child's
communication has been shown to reveal greater language gains, yield
higher overall vocabulary, and yield even better English syntax than
controls who did not receive this programming.
In counseling families of children with hearing loss, it is important to
stress that early identification of hearing loss will typically yield
outcomes in the normal range for their children.
In the Emergent Curriculum used in many preschools, developmentally
appropriate units in the curriculum are targeted based on the interests
and learning needs of the child, rather than commonly used themes.
According to McConkey Robbins, cochlear implantation and its technology
provide create the opportunities for meaning to be established in spoken
Children who do not bond to their implants within a short time following
stimulation run the risk of having less robust progress and
communication progress and are at risk for becoming non-implant users.
Formal testing of children with implants helps to clarify performance in
communication particularly on more subtle, higher level linguistic
tasks required for complex conversation.
Which of the following is not correct relative to usage of CIs for children?
All implanted children, regardless of age of implantation, continue to struggle in task transitions from more structured to more spontaneous listening situations
A child is presented with an array of three objects varying in manner in initial position and asked to point to one of the objects in an auditory only condition (show me bat/cat/rat). According to Chute and Nevins, this would be called what kind of task?
To help a child learn how to report a malfunction in his CI, it is
important to train him/her to respond to silence as an important
Children who can respond to phrases such as "see you later" or "what are you doing?" are engaging in:
Open-set comprehension tasks
When researchers evaluate better outcomes of communication skills in comparison to age of implantation, there is substantial report in more recent studies for and better outcomes associated with implants by what age?
By age two
Research has shown us that significant delays in language development
already exist in most children by the time they receive their CI even if
they are early implantees.
Johnnie is working on his speech production skills. He practiced saying "key", then moved to "keep", then was successful on the phrase "I keep it". His clinician then had him make up a sentence with the word "keep". He responded with: "Keep. I have keep". As his SLP, a good next step on the ladder of speech training skills would be:
Have him try to imitate a sentence that the clinician creates "keep up the good work"
Being able to interpret as well as signal subtle emotional cues with your voice is sometimes difficult for children with hearing loss. This can lead to:
Negative reactions from others when things are misunderstood Difficulty with social nuances such as interpreting sarcasm
Caregivers/SLPS to work on scripting responses in social situations
Many parents elect to use sign as a "stop-gap" measure before implantation. Robbins suggests that this is a good recommendation except in the following condition:
The child is enrolled in a strong program with an auditory emphasis
If I were trying to ascertain a child's functioning in his preschool classroom and wanted to get teachers' input, I would consider giving the
ENL families with CI children are challenging for CI teams in general. This is due to
Difficulty understanding the medical system
Difficulty understanding the education system for their child
Lack of qualified personnel with awareness of cultural differences/language difference
You are working with a ly implanted 14-year-old 9th grade student. He has been deaf since birth. When you are selecting therapy materials to work on speech production tasks, you decide that the best materials would be:
A science worksheet that is due in a week: you select words that have his target speech sounds and he practices those while he completes his homework assignment.
Team coordinator/Case manager
Teacher for Deaf/Hard of Hearing
Legislation/Mandates for Infant and Toddler Habilitation
Necessitate support for children with HL
Developing AR Goals
Receptive and Expressive Language
Ongoing monitoring of equipment for functional status
Ongoing monitoring of child's HL and other medical complications
Discrete skill training
Room treatment/ALD/Classroom System
Shift parent guidance rather than direct intervention with infants
Family Goals (Parent devised)
Parent Skill Training
Describe the skill and why is it important for the child
Model the skill and show parent
Encourage parent to carry out skill in your presence for feedback
Reinforce what parent does well
Develop a challenge for parent using target and objectives
Act of listening is a learned behavior
Develop a hierarchy of listening goals
Consider classroom expectations
Relate to academic functioning
Have parents create a listening journal of things their child responds to
Parents taught to stay within 3 feet of chlid and at the child's level
Listening sequence taught
Attention getting Strategy
Take child to source
Traditional models followed acquisition in normally hearing children
Now we want to focus on intelligibility in context
Order of Speech Control
Production of Prosodic Patterns
Production of Vowels/Diphthongs
Production of Consonants varying in Manner
Production of consonants varying in Place
Production of consonants varying in voicing
Production of Consonant Blends
Maximize Speech Production
Most important cues for acquisition and maintenance of speech patterns
Must have accurate production
Economy of effort
Vocabulary Development will be constant
Form/Use issues increase in significance as child becomes older
Make sure you work on receptive and expressive langauge
Additional Techniques for Language Stimulation
Violation of Routine
Hide an Object
Educational Consequences of HL
Relationship between degree of HL and level of education
Deaf have an average 4-5 grade education
What do you need to be an exceptional learner
Information explosion and how to judge its validity
Want to include D/HH in GenEd Classroom
Want to know how they communicate
Assessment for School Age
Want to know strengths and weaknesses
Talk about strengths and work on weaknesses
Can do this in a variety of ways
Assumptions of Assessments
Needs good SNR
Multiple contexts where language is used
In child's modality
Auditory Issues in Schools
Residual Hearing and thresholds
More comprehension, does child understand
Factors of Auditory Access
Age of identification
Age of amplification/implantation
Administering Ertmer's Open and Closed Set
First Open Set
Clinician has child repeat them
Second Closed Set
Clinician has child find a picture
Questionnaire for child's behaviors
Have areas that focus on quiet and loud environments
Takes one week
Give the parent a unit to score their child
Have expressive and receptive units
May look at different SSQs to see patients hearing experience over time
Administering Carolina Picture Vocabulary Test
"Point to XXX"
The child points to one of four pictures
Bracken Basic Concept Scale
Subtest categories for develop awareness of the world
Lets you know how child is developing
Subtests 1-5 are School Readiness
This score determines where you start for tests 6-10
Listening Inventory for Education-Revised
8 years and up with HL
Questionnaire describes ease of listening
Screening Instrument for Targeting Educational Risk (SIFTER)
5 areas with 3 questions each
3 years - 5 years
Tests the child in a classroom setting
Test for Auditory Comprehension of Language (TACL)
3 years - 10 years
Tests Vocabulary, Morphemes, Sentences
Treatment variables for School Age Habilitation
What are the goals of therapy
Sufficient information to develop reasonable goals
Am I using EBP in my treatment protocol
Child Specific Variables
Degree of HL
Age of ID
Establishing Therapy Plan
Specific Skill Training
Clearly defined behavioral objectives specific to skill or sub-skill being learned
Prepare to shift based on clients response
Task ability vs direction comprehension
Plan and execute
How to Maximize Learning
Increase relative clent: clinician talk time
Scaffolding Strategies for receptive and expressive
Documentation for School Age Habilitation
Track behavioral change
Monitor usage of HA/CI
Relate to academic progress
Adjust goals based on data obtained
Purpose of Communication Strategies Training
Specific training aimed at helping the person with HL to successfully utilize anticipatory and repair strategies to facilitate improved communication
Facilitative Communication Strategies
Used to prepare for communication interactoin
"Could you face me"
Environmental listening adjustment
Harder for children to anticipate than adults
Adults may be hesitant to draw attention to themselves
Preparation for Content and Speaker Differences
Researching company before an interview
Become familiar with vocabulary of setting
Specific Repair Strategies
Request for repetition
Communication Strategies Model
Understanding Basic Communication Process
Understanding Communication Breakdown
Introduce Repair Strategies
Practice Using Communication Strategies
Understanding Communication Breakdown
Definitions and examples
Causes of communication breakdown
Ways people signal confusion
Information to be transmitted
Evaluation of the receiver's position
Evaluation of the sender's ability
Identify Sources of breakdown
Implement receptive repair strategies
Be alert to confusion signals
Identify causes of communication breakdown
Implement expressive repair strategies
Practice Using Communication Strategies
Structured to "real world"
Simple message to more complex message
Discuss feeling associated with "broken communication"
Data logging is very useful for determining the amount of usage for a CI during school day hours
It is important to teach children with hearing loss to advocate for
their hearing needs as well as inform their teachers/support personnel
and sometimes classmates about their hearing loss
Some hearing loss issues for school-age children are more complicated to manage. One example is children with milder losses and those with chronic conductive losses. Problems with speech, language, academic and other social/educational functioning have been reported in what percentage of these mild bilateral or unilateral hearing loss children?
ASHA in defining CAPD, suggested that three key auditory areas be assessed. Name the areas
Binaural Separation and integration
Monaural with background noise
Besides conducting an ecologically valid assessment, it is important to
also include observations of the child with the HL in the class setting
to best gauge functional abilities
For SLPs working with school aged children with HL, discrete skill
training should always be a focus of intervention even if it does not
directly relate to the curriculum established or classroom functioning
Josie, who has a severe to profound bilateral HL, has been aided since age 3. She has language-learning problems secondary to her HL. When reading Romeo and Juliet and writing an essay for her class assignment from Juliet's point of view, Josie is struggling. IF we think of the language requirements for this specific task, which of the following is probably the main area might Josie realistically be challenged by?
As social demands increase for students in elementary school, they have increased experience learning to shift their manner of conversations dependent on the communication partner. If we refer to the 1979 Bloom and Lahey model of language, which area is the most related to?
Daniel, age 8, is a second grader at Wendell Elementary and has a bilateral severe SNHL. His teacher needs instruction on how to use his FM system and consistently use preferential seating to maximize his functioning. Relative to the components of the CORE model, which aspect will you as the SLP or audiologist be focusing on?
For hearing and hearing impaired listeners, what happens to mean word recognition scores as RT increases?
Mean word recognition decreases
Which of the following are common intervention areas for SLPs working with children with HL in the school setting?
Expand World Knowledge
Problem Solving Skills
Verbal reasoning skills
Improve Study Skills
Without systematically monitoring equipment used for children with hearing loss including FMs, hearing aids, ALDs, the failure rate found by researchers is expected to be approximately what level?
In discussing how best to educate children with hearing loss, Matkin and
Montgomery argue against utilization of a "failure based" model. In
such a model, students are placed in a regular education program
initially and then moved to a more restricted special education
classroom when success is not realized.
Cochlear implants may provide cognitive, environmental, and social value
to children with profound hearing loss and additional disabilities.
PL 99:457 Education of Handicapped Act mandated service to include...
Birth to 5 including AR services for children and their families
Joey, aged 8 has a profound bilateral SNHL and communicates via TC with some speech approximations. He is transferring to your neighborhood school where he will be the only child who signs in his school of 350 children. What problem(s) might you assume Joey might have?
Difficulty communicating with peers
Problems using his interpreter at his school
Peers not knowing how to use an interpreter
According to Schow and Nerbonne, a deaf 17 year old with profound HL may have the vocabulary level of
Below 3rd Grade
Recent research has noted that some CI users have more difficulty
accessing appropriate school services since their speech intelligibility
may mask other auditory, language or learning problems.
According to your text, by 2005, nearly 50% of students with hearing loss in K- post high school settings are educated primarily in what setting?
Children with auditory neuropathy often
Demonstrate little benefit from hearing aids
May be a good candidate for a CI
Are variable in their developmental levels and auditory abilities
Robbins includes an auditory-visual continuum for language learning in
her discussion of educational challenges for students with CIs.
According to Robbins, if a child has access to usage of a CI, even if
the child's educational environment does not focus on listening and
speaking, the child will make good usage of his auditory cues.
Often when communication strategies programs begin, the leader of
the program typically sets up the "rules" for the group. The primary
reason is to ensure a safe environment for sharing feelings, concerns
and solutions for the group members.
For communication strategies training with frequent communication
partners, Tye-Murray might suggest using shorter, less syntactically
complex sentences to enhance the message.
"Go get your coat" was misunderstood by Johnny, age 4 who has a bilateral severe SNHL. His mother then continued: "Johnny. We're leaving and we both need a coat. Go get your coat." This is an example of:
According to Tye-Murray, when conceptualizing the stages of
communication strategies, it is important to move simultaneously through
the three steps: formal instruction, guided learning, and real-world
Living with a spouse or family member with hearing loss can be
stressful. Sometimes this is caused by increase noise in the home or
increased vocal effort on the part of the partner. There may also be a
sense of social isolation.
The clinic I work in uses role-playing to develop specific communication skills. This is an example of real-world practice.
"I didn't understand what time you said. Would you mind repeating that appointment time?" This is an example of what kind of communication behavior?
In the SPEECH program, several key concepts are stressed including
improving proximity, easing the listening burden and manipulating
environmental variables to improve the S:N ratio. Another suggestion is
to use slow and exaggerated speech to enhance intelligibility for the
person with the hearing loss.
Rory, Abby and Simon all third graders with cochlear implants, are working in group therapy together. They are learning social conventions for phone usage in a role-playing situation. They are most likely working on
Social Constraints of Message Formulation
Lily, age 8, has a severe hearing loss. She has a lot of difficulty interpreting the reactions when people do not understand her speech. Lily might benefit from training at which step of the Elfenbein model?
The goal of the article was to determine if there was a long-term benefit to born hearing screening for high-school aged children with hearing loss. How were the authors able to determine if born hearing screening was beneficial?
About half of the children in the study were born during periods of born hearing screening in the UK, and half were not, so the two groups could be compared.
How did the authors measure the primary outcome measure (i.e., what type of test score did they use)?