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Adult CI: Beginning Practice Listening Suggestions at Home

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Simple Practice Suggestions at Home

Immediately after your activation get started learning to listen with your cochlear implant. 
Begin listening with a close friend or a family member who wants to be your Listening Coach:


www.davisandco.com


1: Follow along as your Listening Coach reads a passage in a book.
Ask your reader to stop at certain words, so you can speak the words out loud. After this exercise, have him/her randomly read any sentence in a paragraph, so you can guess which sentence it was.
2: Without relying on speech-reading, have your Listening Coach voice

            Names of people you know
            Simple sentences: "How are you?"or "Nice to meet you."

3: Listen to basic "read-along" children's books available on CDs at the library.
Work up to more challenging literature as your training progress.
4: Listen to public radio or sports radio.
Talk shows are a good source of practice because they often deal with current news or familiar topics – giving you clues about the gist of conversation.

Be sure to prompt your Listening Coach to –
"speak slowly and clearly...
 use short sentences...stay on topic, etc."

SEPTEMBER: Listening and Spoken Language Calendar

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Click  HERE  to download your own printable calendar for the month of September with ideas for home or your Auditory Verbal Therapy. 


Suggestions Before School Starts For Parents of Children With Hearing Loss

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Teacher and Staff In-Service Meetings

 It is important to get your child involved whenever possible. This can include having your student talk and present with you depending on their age, contribute slides to the PowerPoint, or create a media presentation  to introduce him/herself. 

Playing simulations is a great way for staff and other students to “experience” hearing loss. This link from Karen Anderson contains many resources including simulations of a variety of losses with hearing aids, cochlear implants, and with and without FM. The Unfair Spelling Test for elementary students and adults is interesting are everyone is always surprised at their results.



Student In-Service Meetings

Sometimes it is beneficial for your child to present their hearing loss and needs to his/her classmates. Such projects and presentations can easily be tied to self-advocacy objectives. These presentations can be supported by books or posters made by your family, PowerPoint presentations, or multi media presentations. Inclusion of simulations of hearing loss and model hearing aids and cochlear implants enhance this experience for the other students. 



Important People at School 

Find out who is on your child's team! Be sure you introduce yourself not only to the classroom teacher, but also to the receptionists, administrators, “specials” teachers, cafeteria staff, librarian, school nurse, IT department and anyone else you meet in the hallways!   The more people your child and you know now, the easier it will be when you inevitably need their help later in the year.

Audiological

  • Be sure you have recent audiogram, speech perception testing and CI programming 
  •  Know who the managing audiologist as well as the FM audiologists are and have their contact information available (for some students this is the same person, for others FM is managed by a separate audiologist).
  • Ensure that there are listening and equipment checks scheduled and all amplification is working properly. Identify the person at each school who will be trained to perform listening checks. Set a date for that training!
  • Identify where the FM will be stored at each school and who will be responsible for charging it. This is often the student’s job but for young children or students with additional needs, an adult may have to oversee this task.


Share Your Contact Information

Be sure everyone at the school knows how to get in touch with you in case problems arise. Find out how they prefer to be contacted. . Relationships matter and first impressions go a long way, so keep it positive and emphasize the collaborative aspects and mutual benefits of this new relationship

.

Set Up A System For Home School Communication:

This can be informal and as simple as identifying whether people prefer to communicate over email or by phone. Some younger students may also have a communication notebook for staff and parents to write in. Especially in the first few weeks, be sure sure you are included in the relevant communication with staff and check in with them regularly. This helps alleviate stress as parents you are in the loop and know what is happening at school.


Perspectives on Deafness When it Coexists with Autism

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Advanced Bionics offered a FREE virtual training course that explores the multidisciplinary perspectives on deafness when it coexists with autism. Each training session is designed to help hearing health professionals gain better knowledge of autism and understand the value of cross-disciplinary collaboration. 

This informative and engaging six-part series is easy to access through Audiology Online.
View each course here:  CEU Courses > 

http://www.advancedbionics.com/us/en/professionals/soundwaves_newsletter/soundwaves_may2014.html

Teaching Mainstreamed Students with Hearing Loss Video for Parents, Teachers and Students, Zina Jawadi

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                           Essential tips and techniques for teaching mainstreamed students with hearing loss (hard of hearing and deaf) in regular schools.
Researched, scripted, organized, and led by Zina Jawadi


                                                              



Advanced Bionics's Global Rehabilitation and Educational Programs Video

Early Board Game for Auditory Verbal Targets

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Well chosen board games model and encourage interactive listening, spoken language and learning skills. When playing board games, child can learn valuable lessons such as listening to the other players, turn taking, asking and answering questions, staying on topic, strategic thinking, manners and being a good sport. 



Many educational board games target answering “WH” questions, categorization, color and letter recognition, counting skills, describing skills, grammar/syntax and increasing sentence length  and expanding vocabulary.

When playing board games you may want to highlight knowledge of basic concepts as they practice good listening skills, following directions, and responding appropriately. Below is one of my handouts from the good ole' days of Auditory-Verbal Therapy you may find helpful.


 This is one of my favorite Fall Themed Games for Home and  in Auditory Verbal Sessions.

http://www.educationalinsights.com/text/EI/downloads/guides/3405-SneakySnacky-Guide.pdf


Click HERE to go to this "SuperDuperInc. Handy Handout"


OCTOBER: Listening and Spoken Language Calendar

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Click HERE to download your own printable calendar for the month of October with ideas for home or your Auditory Verbal Therapy. 



Role Play: I'm the Boss of My Hearing Loss

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Background Situation: Jenna, a girl who is hard of hearing is talking to her friend Joshua on the phone about their class pizza party tonight.
__________________________________

Jenna:“Hello”

Joshua:“ Hi, It’s Joshua.  I’m calling about our class pizza party. Let’s meet at school early tonight about five so we can set up for the party. Can you call Sam and Emma and tell them to come at six? Everybody else is coming then.”

Jenna:“What time did you say for us to meet?”

Joshua:  “Just a minute! (Joshua hollers to his Mom - off the phone.)  “My Mom wants to use her phone so I gotta go!”

Jenna:“But wait…”

Joshua:“See ya!”

Jenna:“Oh man! Just forget it.  I won’t even go!” 


___________________________________________________________

Discussion Time: What was the breakdown? Brainstorm prior knowledge on Boss of My Hearing Loss Strategies.
___________________________________________________________

Let’s try again!

Jenna:“Hello”

Joshua:“Hi, It’s Joshua. I’m calling about our pizza party.  Let’s meet at school tonight about 5:15 so we can set up for the party.”

Jenna:“Joshua, please slow down so I can get the information.”

 Joshua:“ Sure.  Come early, so we can set up for the party around 5:15.  Call Sam and Emma and tell them six okay? Everybody else is coming then.”

Jenna:“Fine. I’ll meet you at school at 5:50 and will call Sam and Emma and them to come at six. Right?

Joshua:  “No, I said 5:15 – a quarter after 5:00.”

Jenna:“A quarter after 5:00, ok.”

Joshua:“Right. See ya! Bye.”
  
http://www.sheknows.com



What is it like to have APD?

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This video is made for anyone who wants an understanding of how people with APD
 deal with the world, and how frustrating it is to just even have a conversation. 

"Each conversation takes my full attention, along with complications such as: background noises, and other distractions. "



Experience first hand the activity demonstrated in the video.



Auditory Activity: Listening to Directions
A child's ability to pay attention and focus on a teacher's instructions can mean the difference between scholastic success or failure.

The following activity attempts to illustrate what it might be like for a first-grader with an attention disorder to try to concentrate on a set of oral instructions amidst a cacophony of classroom distractions.

This activity requires Flash player.
Get Flash Plugin

You should be sure that your computer's audio is turned on.

When you're ready to begin, select the "Begin" link.

For more info please visit: 
kidshealth.org/parent/medical/ears/centr­al_auditory.html

Therapy for Auditory Processing Disorder: A Parent's Viewpoint

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A kind email out of the blue:





I greatly appreciated Collin's Mom email that shared how well her son is doing in his school. I am thankful that I was a part of his middle school years and a stepping-stone to his success. 

So often, therapy for auditory processing gets a bad rap.
I think it is because Audiologists/SLPs write goals and spend most of the therapy time working on compensatory skills rather than building up and developing auditory skills where the problem originates. Vision is not a good substitute for hearing in any context.

The Little Red House - Fall Interactive Listening Activity

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Listening, developing auditory memory, auditory sequencing, retelling
 and more with the interactive story, 

"The Little Red House With No Door, No Windows,
 A Chimney On Top And
 A Star In The Middle."



My Mom shared this story with me, and I told it to my daughters
 and many children over the years who have
 learned to listen and talk in Auditory Verbal Therapy.
It is always timely.



This is one of many version of the folktale.

Once upon a time there was a little boy who was tired of playing with his toys.  He said, “Mother, I have nothing to do. What can I do?”

His mother said, “Go outside and find a little red house with no doors or windows and a star inside!”

So the little boy went outside to search for the house.  There he met a little girl.  He asked the girl, “Do you know where I can find a little red house with no doors or windows and a star inside?”

“No I don’t!” said the girl, but my father may know.

So the little boy asked the girl’s father, “Sir, do you know where I can find a little red house with no doors or windows and a star inside?”

The girl’s father laughed!  “No boy, I have never seen anything like that!  Go ask Grandmother.  She has lived a very long time and is very wise.  Maybe she will know.”

So the little boy asked Grandmother, “Please can you tell me where I can find a little red house with no doors or windows and a star inside?”

“No!” said Grandmother, “but I would like to find that house myself.  Go ask the wind; he knows everything!”

The wind blew by the little boy and the little boy asked, “Oh wind, do you know where I can find a little house with no doors or windows and a star inside?”

The wind said, “Yes boy, I will show you the way.”  The little boy followed the wind up a grassy hill.  At the top of the hill was an apple tree.  The wind blew the apple tree and an apple fell off.  “Look on the ground, boy, and you will find your house,” said the wind.

The boy looked to the ground and picked up the apple.  “It is a red house with no doors or windows, but where is the star?” asked the little boy.

The wind replied, “Take it home and ask your mother to cut it in half.”  The little boy hurried home to his mother.

“Mother, I have found the little red house with no doors or windows.  Please cut it in half so that I might see the star.”  The little boys mother took a knife and very carefully cut the apple in half.  Inside was a star holding tiny brown seeds. 

You Are The Boss of Your Hearing Loss Scenario: At the Ice Cream Shop

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You Are The Boss of Your Hearing Loss Scenario: At the Ice Cream Shop

Characters:
Nathan, a boy who uses cochlear implants
A second boy

Background Information/Scene:
Nathan was parking his bike in front of Dairy Queen. Another boy rides up and is parking his bike also.



Person # 1- The Boy
The Scenario
Person # 2 - Nathan

A boy who Nathan doesn’t know is parking his bike nest to Nathan in front of Dairy Queen.

You say: Cool bike



Nathan didn’t hear him.


The Boy stands in front of Nathan and looks at him.


Nathan looks at the Boy.                   It’s awkward.


The Boy thinks, What’s wrong with this kid?

 The Boy gives Nathan a dirty looks and mumbles something that sounds mad.

You say: You’re weird!
The boy walks away to order his
 ice cream.



How does Nathan feel? How would you feel? What would you do?

Discussion:
What was the communication break down?
What would you do in this situation?
Use your boss of your hearing loss strategies.

Now, let’s try again:

Person # 1- The Boy
The Scenario
Person # 2 - Nathan
You say: Cool bike



Nathan didn’t hear the boy.


The Boy stands in front of Nathan and looks at him.


Nathan looks at the boy.
It is sort of awkward.
Then, Nathan thinks, that kid is looking right at me.
He’s standing right in front of me and waiting for something.
I wonder if I didn’t hear something he said?




You say: Hey, were you talking to me?
You say: Yea, I said, that’s a cool bike.




You say: Thanks man.

You Are The Boss of Your Hearing Loss Scenario: At School In the Noisy Hallway

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Characters:
Ally, a girl who wears hearing aids
Brandon, Ally’s classmate

Background Information/Scene:
At school in the busy hallway.


Person # 1- Brandon
The Scenario
Person # 2 - Ally

Ally is walking in the busy hall at school right before morning bell rings.

You say: Hi Ally.



Ally didn’t hear him.

You say: HEY ALLY!



Ally still doesn’t hear Brandon
so says nothing.


Brandon thinks, What’s wrong with Ally? She is not very friendly


Later at lunch they meet again.



Hi Brandon. Are you getting hot lunch or did you pack today?
So now you’re going to talk to me? Well I’m not talking to you!




What?
Well, you didn’t talk to me this morning. You just ignored me.




When did you talk to me?  I didn’t hear you.
Stop pretending.

Oh my gosh! You are really mean!

Ally gives a dirty look to Brandon and walks away.




How does Ally feel? How would you feel? What would you do?

Discussion:
What was the communication break down?
What would you do in this situation?
Use your boss of your hearing loss strategies.

Now, let’s try again:

Person # 1- Brandon
The Scenario
Person # 2 - Ally

Ally is walking in the busy hall at school right before morning bell rings.

You say: Hi Ally.



Ally didn’t hear him.

You say: HEY ALLY!



Ally still doesn’t hear Brandon
so says nothing.


Brandon thinks, What’s wrong with Ally? She is not very friendly


Later at lunch they meet again.



You say: Hi Brandon. Are you getting hot lunch or did you pack today?
You say: So now you’re going to talk to me? Well I’m not talking to you!




You say: What?
You say: Well, you didn’t talk to me this morning. You just ignored me.




You say: When did you talk to me?  I didn’t hear you.
You say: Stop pretending.

You say: No really, it’s hard for me to hear and understand when it’s noisy. Remember, I wear hearing aids. I told you that before
You say: Oh yeah.” I totally forgot. I thought you were just being rude. It’s cool then I guess. No worries!




You say: So, I brought leftover pizza. What are you having for lunch today?



You Are The Boss of Your Hearing Loss Scenario: Phone Conversation and a Pizza Party

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Characters:
Jenna, a girl who is hard of hearing
Joshua, Jenna’s classmate

Background Information/Scene:
Jenna receives a call from Joshua. They are both in charge of setting up for their class pizza party tonight.


Person # 1- Jenna
The Scenario
Person # 2 - Joshua

Jenna is at home when the phone rings. It’s Joshua calling.

You say: Hello.




You say: Hi, It’s Joshua.  I’m calling about our class pizza party. Let’s meet at school early tonight about 5:15 so we can set up for the party. Can you call Sam and Emma and tell them to come at six? Everybody else is coming then.
You say: I didn’t get all that. What time did you say?




You say: Just a minute!

Joshua hollers to his Mom while on the phone with Jenna.



You say: wawawawawa


You say: My Mom wants to use her phone so I gotta go!
You say: But wait!




You say: See ya
Well, you didn’t talk to me this morning. You just ignored me.



Jenna is frustrated and gets angry.

You say: Oh man! Just forget it. I won’t even go to the party!” 




How does Jenna feel? How would you feel?  What would you do?

Discussion:
What was the communication break down?
What would you do in this situation?
Use your boss of your hearing loss strategies.

Now, let’s try again:

Person # 1- Jenna
The Scenario
Person # 2 - Joshua

Jenna is at home when the phone rings. It’s Joshua calling.

You say: Hello.




You say: Hi, It’s Joshua.  I’m calling about our class pizza party. Let’s meet at school early tonight about 5:15 so we can set up for the party. Can you call Sam and Emma and tell them to come at six? Everybody else is coming then.
You say: Joshua, please slow down so I can get the information.




You say: Sure.  Come early, so we can set up for the party around 5:15.  Call Sam and Emma and tell them six okay? Everybody else is coming then.”

Joshua hollers to his Mom while on the phone with Jenna.



You say: wawawawawa


You say: My Mom wants to use her phone so I gotta go!
You say: But wait!




You say: See ya

Jenna is frustrated but decides to call Joshua back in a few minutes.




You say: Hi Joshua, I’m calling you back because I didn’t hear all the information about setting up for the party tonight.




You say: OK. I said for us to meet at school about 5:15 so we can set up for the party. Did you call Sam and Emma and tell them to come at six? Everybody else is coming then.
You say: Joshua, please slow down so I can get the information.”

You say: Sure.  Come early, so we can set up for the party around 5:15.  Call Sam and Emma and tell them six okay?
You say: Fine. I’ll meet you at school at 5:50 and will call Sam and Emma and them to come at six. Right?





You say: No, I said 5:15 – a quarter after 5:00.”
You say: A quarter after 5:00. OK.




You say: Right. See ya soon. Bye!
You say: Bye!




"What is An Auditory Verbal Therapist?" - A Real Conversation Starter!

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Today’s blog is written by  Elizabeth Rosenzweig MS CCC-SLP LSLS Cert. AVTwho is a speech language pathologist and a certified auditory verbal therapist in private practice. You can read more of her work at http://auditoryverbaltherapy.net

Elizabeth answers many of the same questions that I am frequently asked about Auditory Verbal Therapy and Hearing Loss. So, rather than reinventing the wheel...

Elizabeth writes, "When you meet someone new, one of the first questions we tend to ask is, “What do you do?”  When I tell people that I teach children with hearing loss to listen and speak, it’s a real conversation starter.  Here are some of my most frequently asked questions about hearing loss, hearing technology, and Auditory Verbal Therapy.  What are yours?

What do you do?
I’m a Listening and Spoken Language Specialist, Certified Auditory Verbal Therapist.  The LSLS Cert. AVT designation means that I’m a speech-language pathologist* who has training above and beyond basic SLP certification specializing in guiding and coaching parents and caregivers to teach children with hearing loss to listen and speak without the use of sign language.  Here is more information about the Principles of Auditory Verbal Therapy.
*Members of other speech and hearing science-related professions (audiologists, teachers of the deaf) can also apply for LSLS certification.  I just happen to be an SLP by training.

So… you teach lipreading?
No, I don’t teach lipreading.  Here’s why.

So… you use sign language?
No.  The families I serve have chosen listening and spoken language for their children’s communication mode.  In fact, more than 85% of parents of children with hearing loss choose for their children to learn to listen and talk (Brown, 2006).  Oral communication gives their children access to the broader world, independence, improved literacy and phonological awareness, and even the ability to learn to communicate orally in more than one spoken language.  Learning to listen means a person with hearing loss — even profound hearing loss — can enjoy music, learn to use the telephone, and understand speech without visual cues.

What causes that [hearing loss]?
There are many different reasons that a person could be deaf or hard of hearing.  Some hearing loss is genetic — it can occur on its own or be part of a larger syndrome that causes other symptoms as well.  (For example, Connexin 26 deafness is caused by a mutation of the GJB2 protein which effects the hair cells of the inner ear but causes no other issues, while Usher Syndrome causes hearing loss but is also associated with vision loss).  Other hearing loss is the result of illness, injury, or age (age-related hearing loss is called presbycusis and is a natural part of the aging process).  There are genetic tests available to determine the cause of hearing loss, but remember that even if the genetic testing does not determine a cause for your/your child’s hearing loss, that does not necessarily mean it is not genetic in nature, just that we have not yet identified that particular genetic variant.  While we are often able to identify the cause of hearing loss, there are times that the cause is idiopathic (basically, medical speak for “we don’t know”).

But how do you teach a deaf person to listen if they can’t hear?
Access to hearing is crucial for learning to listen and speak naturally.  We [people with typical hearing] learned to talk because we spent our first months of life (even in utero, starting 20 weeks before we were born!) listening to the sounds of language around us.  Helping children with hearing loss gain access to sound is the first critical component of our task if we want to help them learn to talk as well.  This is why it is so, so important for people with hearing loss to be fitted immediately with the appropriate technology (hearing aids, Baha, or cochlear implant, depending on their level and type of hearing loss).  Unlike glasses, though, you don’t just put the hearing device on and your hearing issue is suddenly corrected.  It takes time and therapy to train the brain to listen.  It’s all about the brain.  

How old are the children you work with?
Thanks to newborn hearing screening, the majority of the children on my caseload were identified with hearing loss at birth.  Because I serve families from around the world, though, where newborn hearing screening may not be possible, I do have some children whose parents only discovered their hearing loss as toddlers when they were not meeting the expected speech, language, and listening milestones.  Other children on my caseload were born with hearing but lost it as a result of illness or injury.  I also work with teens and adults — either those who have had hearing loss their whole lives or those who lost their hearing after learning language and are looking to get back up to speed with new hearing technology (a hearing aid, Baha, or cochlear implant).

They’re identified at birth?  How can you tell that a baby can’t hear?
Newborn hearing screening is done one of two ways, either ABR (Auditory Brainstem Response) or OAE (OtoAcoustic Emissions) testing.  Both of these tests measure physiological responses to sound stimuli that do not require the baby to do anything to respond.  By measuring the brain’s response to sound (ABR) or the natural sounds emitted by a typically functioning ear (OAE — and yes, your ear is emitting sounds, even if you can’t hear them!), we can determine whether or not an infant (or any other unresponsive patient) is in need of further hearing testing.

But how do you do therapy with a child that young?
Early intervention is the key to success for children with hearing loss.  Here’s why.  The bulk of my work focuses on guiding and coaching the parents, supercharging their interactions with their child to help them facilitate the growth of language and listening skills from the very start.  If the child sleeps through the entire session, the parents and I are still learning together.  I just love working with infants and young children and their parents, helping them to build the foundation for a lifetime and language and listening success!

How do you work with clients around the world?
I use videoconference technology to provide teletherapy services to clients from all over the globe.  It’s like Skype or FaceTime, but more advanced to be compliant with HIPPA and other patient-privacy laws.  Curious about what atypical teletherapy session looks like or the benefits of teletherapy?  Check out my Teletherapy FAQs!

How do you do therapy without being physically present?
Many people think that “speech therapy” involves hands-on treatment (put your lips here, but your tongue here, etc.).  Auditory Verbal Therapy focuses on learning to listen and talk using a developmental, not remedial, approach.  My job is to coach the parents in how to infuse everyday activities and interactions with opportunities for listening, language, speech, and cognitive growth.  Not being present for teletherapy can actually be an advantage over in-person treatment because I can’t jump in.  I have to empower the parents to be their children’s first and best teachers, and that is key!  One hour of therapy a week is not enough.  For children to truly succeed, parents need to have the skills and confidence to implement AV techniques throughout the week.

How long does this therapy take?
There are many factors that affect a person’s outcome with a cochlear implant.  Let’s take a child who is identified early, fitted with appropriate technology, and has access to a Listening and Spoken Language Specialist and strong family support and commitment to the AV lifestyle.  For the children like this on my caseload, they usually don’t need me by the time they are 3-5 years old.  Basically, if everything goes well, they’re reading to mainstream from day one of preschool or kindergarten, with age-appropriate skills and minimal support.  For other children, perhaps those identified later or who have additional disabilities, progress may be slower and the timeline extended.  For teens and adults, therapy usually is shorter-term in nature, focused on building specific skills or re-learning how to hear with a new device.
Success is not an accident.  It takes lots of hard work, but incredible results are achievable.

What’s the difference between a cochlear implant and a hearing aid?
Here’s my simple explanation on hearing loss and hearing technology:
Sensorineural hearing loss (sometimes called “nerve deafness”) occurs when the cilia (hair cells) of the inner ear (the cochlea) do not function properly.  In an undamaged ear, the pressure from sound waves goes into your pinna (the outer ear, the part you can see), makes the eardrum move back and forth, is passed along the small bones of the middle ear (the smallest bones in your body!), and then transfers to the middle ear, where those sound waves cause actual waves in the fluid-filled cochlea.  The waves of fluid cause the hair cells to move.  This sets off a beautiful chemical chain reaction, which ultimately causes stimulation of the auditory nerve (cranial nerve VIII), which sends the sensation of “sound” to the brain.  The hair cells in the cochlea are tonotopically arranged, meaning that each region corresponds to different tones, going from high frequency sounds at the basal end to low frequency sounds at the apex of the cochlea, which looks like a snail shell.  Think of a piano keyboard that has been rolled into a spiral, except that the keys go from high to low, unlike a regular piano.
A hearing aid simply pushes more (louder) sound into this system.  If the sound is louder, it makes bigger waves in the cochlear fluid and stimulates those hair cells to say, “I heard that!”  It’s pushing more sound through the damaged system.  For some peoples’ degree of hearing loss, a hearing aid is enough to provide access to the full spectrum of speech sounds.
A cochlear implant replaces the damaged system altogether, and works for patients when a hearing aid is not enough to give adequate access to sound.  A cochlear implant consists of an internal electrode array (like a wire with various electrodes, points of contact, that is threaded through the cochlea to take the place of the damaged hair cells), and an external processor.  Sound goes into the CI microphone, then the processor (think of it as the “brain” of the CI) says, “Okay, to replicate this natural sound coming in with our electrical system, we need to stimulate electrodes #1, #5, and #12 in this order, in this pattern, at this rate.”  That message travels up the wire to the magnet/headpiece/coil on the outside of the CI users’s head, and FM waves transmit that information to the internal implant.  The proper electrodes of the internal array in the cochlea) are fired, and this message stimulates the auditory nerve, and the brain hears.
This is all a very simplified explanation of an exquisite process, but I think it gives enough information for a layperson to have a good working knowledge of the system — not too simple (so it seems like magic), not too complex (so it seems like mystery).

Can everyone benefit from a cochlear implant?
For some people with hearing loss, a hearing aid is enough to give them access to sound needed for brain development and the development of speech, language, and listening skills.  When a hearing aid is not providing enough access, it’s time to consider a cochlear implant.  In almost all cases of sensorineural deafness that is severe-profound (and we’re even creeping up to moderate loss in the case of borderline candidates), the patient can benefit from a cochlear implant.  Cases where a person who has sensorineural hearing loss severe enough to need a CI but cannot have one would include: lack of a cochlea (a very rare anatomical anomaly), lack of an auditory nerve (also very rare, in which case the person would be more of a candidate for an ABI, Auditory Brainstem Implant), ossified cochlea (for example, someone who had had meningitis years ago, and the cochlea has ossified [basically, "turned to bone"] to the extent that an electrode array cannot be put in), or other health conditions that preclude surgery.
There are also people who have conductive, not sensorineural hearing loss.  Here, the issue is not with the hair cells of the cochlea but with the outer or middle ear.  The cochlea works, we just can’t get the sound in.  These people benefit from bone conduction devices, like the Baha (or, in some cases, a traditional hearing aid).
HERE is more information on the cochlear implant process.

How much does that cost?
There is no set “off the shelf” price for a cochlear implant.  The cost varies based on a number of factors: the insurance system (does the patient have private insurance or do they live in a country with nationalized healthcare?), the surgeon and hospital fees, etc.  Most nationalized healthcare systems do include cochlear implants in their coverage.  In the United States, cochlear implants are covered by most private insurers as well as Medicare and Medicaid.  Unfortunately, coverage for hearing aids seems to lag behind, and though some families are able to receive hearing aids through early intervention or
See these articles for information on how to successfully argue for cochlear implant surgery or processor upgrades.  You can also find more information on sources of funding for hearing technology and sources of funding for auditory verbal therapy.

Is it as good as real hearing?  What does it sound like to them?
Asking what a cochlear implant sounds like to a person with hearing loss is like asking, “What does red look like to you?”  We are all limited by our own perceptions, and any simulation that we hear is just that: a simulation, based on our best knowledge of how the device’s algorithm processes sound, and then re-filtered through our own ears and brain as the listener.  This is not to say, however, that hearing loss simulations are inaccurate (learn more about why this is so, and how to understand hearing loss research, HERE).  We hear as well as we speak, and the fact that cochlear implant users are able to achieve very natural-sounding speech shows the remarkable capability of the brain to take electronic sounds and make them into clear, usable hearing.  For more on how hearing loss sounds, see this article.
Audiological results show that it is very possible for a person with hearing loss (who is appropriately amplified and has received good listening and spoken language instruction), to have hearing thresholds from 15-20dB across the board to 6000Hz and speech discrimination scores (in quiet and loud speech and speech in noise) in the 90% range.  This is comparable to how someone with unimpaired hearing might score.  Of course, even thousands of dollars of the best hearing equipment available cannot match the priceless gift of natural hearing, but in terms of actual results in practice, people with CIs and HAs can do remarkably well.  Why?  The brain is incredible.  

Does it work?
Again, the outcomes literally speak for themselves.  Decades of research on the outcomes of children with cochlear implants and/or those raised with Auditory Verbal Therapy show that, by and large, these children are learning to listen, talk, and read at levels commensurate with their hearing peers.  They are thriving in the mainstream, attending college, gainfully employed, and living lives that are as “normal” as anyone else.  For a great overview of research on this topic, see this collection from Utah State University.

How do the children do socially?
Social competence is often predicated on language success.  If you have the language and listening skills to keep up with your peers, socialization will be that much easier.  All children go through bumps in their development, butresearch shows us that children with cochlear implants generally report levels of self-esteem comparable to their hearing peers. 

How well do they hear music?
When cochlear implants were first developed, the external device was called a “speech processor,” not a “sound processor” like they are sometimes called today.  Why?  In the beginning, just the thought that a profoundly deaf person would be able to hear speech seemed too fantastic for words.  If that could be achieved, any access to additional sounds would just be icing on the cake.  Speech — and the communicative independence that came with it — was the goal.  Now, cochlear implant users can hear speech, music, and more!  Though cochlear implant users’ enjoyment of music varies (as does typically hearing peoples’, I might add), research shows us that cochlear implant users do have the capability to hear the difference between a wide range of pitches, and that practice and exposure can significantly increase CI users’ music enjoyment.  People with hearing loss who have good amplification and a strong AV foundation can even learn to play an instrument, participate in a choir, or take dance lessons.  HERE is more information on the latest research on CI/HA users and music.

How well do they hear in noise?
Hearing in noise can be tricky for anyone, but even more so for a person with hearing loss.  Our brains are trained to pick up the important signal (the person talking to us) and filter out the rest (the background noise), while still being attentive to certain sounds in the environment (a siren, an oncoming car, or someone calling our name from across the room).  It’s pretty impressive!  If a person with hearing loss has not had that auditory experience (and remember, this experience starts before you even take your first breath), it’s tough!  Auditory training, combined with the ability to today’s hearing technology to use a “computer brain” to identify and filter out background noise, can help a lot.  So can adaptive technology like FM and soundfield systems, and smart communication techniques.

Can people with hearing loss drive a car?  Talk on the phone?  Go to college?  Get married?  Listen to music on an iPod?  Learn a foreign language?  Play sports?

These questions may sound silly, but remember, most people have little to no everyday interaction with people with hearing loss.  The answers to all of these questions?  YES!
Yes, people with hearing loss can drive a car.  Yes, they can talk on the phone.  Yes, they can go to college (check out the Ultimate College Guide for Students with Hearing Loss for more info and tips!).  Yes, they can listen to music on an iPod (often linking it right to their hearing device, or, with even newer technology, streaming via bluetooth!).  Yes, people with hearing loss get married (to partners with and without hearing loss, read some stories HERE).  Yes, people with hearing loss can learn multiple oral languages.  Yes, people with hearing loss can play sports.  So much is possible!"






















Are You Teaching Your Child with Hearing Loss Commitment or Compromise?

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Today’s blog is written by Krystyann Krywko, who is a hearing loss educator
 and writer who provides resources and support for families 
who are raising children who are deaf or hard of hearing. 

You can read more of her work at www.kidswithhearingloss.org. 
Receive a free copy of her free mini eBook, Five Emotional Sticking Points of Parenting a Child with Hearing Loss, when you subscribe to her site.

The Great Compromise Hoax: How it Doesn’t Help Our Kids with Hearing Loss

Photo by: National Assembly for Wales

Krystyann writes, 

I had an interesting conversation with a friend the other day about commitment versus compromise. We were talking about how important it is to look after ourselves and that we had a choice either to commit to our health or to compromise it.



  • The classroom is too loud at the end of the day and your daughter can’t hear the homework assignment and so she falls further behind.
  • Your son mishears a key word as the teacher is writing on the board and while he pauses a moment to try and figure it out he falls behind in his note-taking.
  • The substitute teacher is not sure how to use the FM system so it remains off for the entire day.
  • The noise in the cafeteria is too loud and your daughter doesn’t hear that her friends are meeting in the library for recess. She goes outside and can’t find anyone.
  • Asking the teacher to write the homework assignment on the board.
  • Making sure the teacher knows that it’s hard for you to hear when they are facing the board, and could they please try to face the class. Other solutions could include having an assigned note taker, or having access to the teacher’s notes.
  • Showing the substitute teacher what they need to do to use the FM unit.
  • Telling your friends to make sure they have your attention before they make plans.


Our discussion centered on the idea that…
A commitment is an action of the mind; a promise that is based on knowledge. Making a commitment is hard at times. It is never the easy way in the heat of a tempting moment.
And…
A compromise is an action of the emotions; based on feelings, excuses, and rationalizations. Making a compromise is easy. Any little thing is an excuse to give into the impulses of the moment.
Later I took this thinking one step further and began to think about my son’s hearing loss and realized that part of my role as a parent is really about teaching him to commit to his hearing loss and his needs, rather than compromising them.
The word compromise has a warm and fuzzy feel about it. It’s that win-win situation that parents and educators love – where everyone is happy.
But, when a child with hearing loss makes a compromise in the classroom or in a social situation, a lot more is at stake.
These are all situations where your child needs to commit to their hearing loss. They need to be able to say “Hey, wait a minute. This isn’t working for me. Here is what I need.”
Teaching your child to commit to his hearing loss means helping him take the responsibility for what he needs to ask for to get his needs met.
And sometimes it’s a real bummer that your child always needs to be the one to put herself out there and ask for something, but others aren’t going to know what she needs unless she tells them.
Commitment looks like:
 Commitment is about honoring yourself and your needs and there is nothing wrong with teaching your child to take ownership about those needs.
How have you helped your child commit to their hearing loss? Would love to hear from others…




INSTAGRAM USERS: Follow #auditoryverbaltherapy

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 If you're an Instagram user — and I know a few of you are —  follow: 

#auditoryverbaltherapy 


See you over there. Remember to share all your posts with the hashtag: #auditoryverbaltherapy



Auditory Verbal Tips for Preparing Your Child for Trick-or-Treating and Halloween

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I love these suggestions for targeting listening, vocabulary, social skills when preparing  your child for Halloween. Today's blog post is from Donna Sperandio, a Listening and Spoken Language Specialist who currently works as Head of Rehabilitation for MED-EL. Read more of her work at http://www.medel.com/blog/

Improve Your Child’s Hearing this Halloween!



It’s almost Halloween! If you’ve got a child hearing implant recipient and want to celebrate today by trick-or-treating or dressing up, here are some tips that you can use to get the most out of the day.

Start Planning Early!

Just like at school, talking with your child in advance will help him or her to build an understanding of what Halloween is about and what will happen on Halloween day. That way, once Halloween gets closer they’ll be able to talk with their teachers and friends with confidence.
Here are some suggestions for how you can use Halloween to help child learn or develop speaking and listening skills:

Learning Halloween-Specific Vocabulary

Like many holidays, Halloween has its own specific vocabulary. While your child might have heard some of these words before, there are also some words that might be completely new.
By introducing these to your child you can help build his or her knowledge of Halloween, as well as his or her vocabulary.
  • Read books about Halloween. Focus on words specific to the holiday, like “trick-or-treat”, “pumpkin”, “ghost”, “witch”, and “bat”.
  • Make Halloween crafts to use as decorations in and around your house, and talk with your child about what you’re making like “masks”, “spider webs”, “skeletons”, and “costumes”.
  • Don’t just say the word and then move on, but rather expand on the names by using lots of descriptive words. Calling it a “scary” mask, a “haunted” house, the “wicked” witch, and the “hairy” spider are all ways to engage your child more and improve vocabulary.

Learning Everyday Vocabulary

In addition to Halloween-specific words, there are lots of words that you can teach your child to use throughout the year.
  • Colors: Halloween is full of colors, and pointing out the “orange” pumpkin, the “white” skeleton, or the “black” witch’s hat is a practical way to help build your child’s knowledge of colors.
  • Textures: The “furry” spider, the “sticky” spider web, and the “shiny” pumpkin skin are all examples of different textures that you can emphasize while making decorations or costumes.

Learning About Sequences and Time

Halloween has lots to do with events happening in a fixed and routine order, so it can be a great way to teach your child concepts that have to do with progression and correlations.
  • Use words like “first we will…” and “then this will happen” to show that separate events are related. When you’re explaining what will happen during trick or treating, you can tell your child, “First we’ll knock on the door, and then when the door opens we’ll say ‘Trick or Treat’!”.
  • You can also use this to explain events that happen over an extended period of time, especially in the weeks leading up to Halloween. So, when you’re preparing your costumes you could say, “This week we’ll get our costumes ready, and then next week we’ll carve the pumpkins so that they look good on Halloween.”
  • Take pictures as you prepare and celebrate Halloween. You can then use these as a sort of memory game where you lay them all out on a table and make a game out of putting them in order of what happened first, what happened next, what happened last.

Learning Memory and Math Skills

That’s just one way to build memory skills, and here are a few more:
  • If you’re making your own costume or mask, talk your child through all the parts that you’ll need: “first we’ll need paper, then crayons, and then scissors, and finally glue”. Then have your child repeat back to you all the supplies you need, to see if they’ve understood and remembered everything, and make a game out of finding all of these supplies in the house.
  • It’s also easy to incorporate math into these exercises. By asking your child questions like “We’ve already made two masks, but three of your friends will come over later. How many more masks do we need?”
  • And, as you’re making decorations you could ask questions like “How many legs does the spider need”, or “How many wings does the bat have?”

Learning Social Skills

Since trick-or-treating is all about going out into public and interacting with people, it can be a great way for your child to learn about social skills.
  • Remind your child to say “thank you!” every time someone gives him or her a treat.
  • If he or she is going out with a group of children, emphasize the importance of taking turns and being nice to other children.
  • More generically, you can explain to your child the cultural aspects or significance of holidays in general. Depending on where you live, Halloween may either be a lighthearted night of candy collecting or a very important night of remembrance for ancestors. It’s a great opportunity to explain a little bit about your own culture to your child, in age-appropriate ways.

Learning About Safety

Even more than social skills, going out in public is a way to learn about safety and how to behave with (or without) parents around.
  • Remind your child to always stay nearby, and not run off from their group unexpectedly.
  • Show the importance of staying with an adult while crossing roads, as well as looking both ways before crossing.
  • If there are animals around, remind your child to always ask if it’s okay to pet or get near them.

Be Prepared, Have Fun!

If you’ve helped your child prepare for and learn about Halloween, it should be easy for them to enjoy the night. But how can you prepare?
  • Make sure that your child has spare batteries, or any necessary spare parts, with them.
  • If you won’t be around, for example if another parent will be leading a group of children including your child, make sure that there’s someone who knows how to help change the batteries—just in case.
  • Take lots of photos! This way you can talk about what happened afterwards, and maybe even play a memory game later.
While some of these tips are specific to Halloween, there are lots that you can use here to help your child prepare for holidays or events in general. 

Knock, Knock Trick or Treat Song For Listening and Singing

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Song: Knock Knock, Trick Or Treat?

CD: Super Simple Songs - Halloween
Music: Super Simple Learning
Animation: Tinman Creative Studios

Vocals: Devon Thagard


Lyrics: 


Knock knock, trick or treat? 
Who are you?
I'm a ghost. I'm a little ghost. 
Knock knock, trick or treat?
Who are you?
I'm a ghost. I'm a little ghost.



Knock knock, trick or treat?
Who are you?
I'm a cowboy. I'm a little cowboy.
Knock knock, trick or treat?
Who are you?
I'm a cowboy. I'm a little cowboy.



Knock knock, trick or treat?
Who are you?
I'm a witch. I'm a little witch. 
Knock knock, trick or treat?
Who are you?
I'm a witch. I'm a little witch.



Knock knock, trick or treat?
Who are you?
I'm a monster. I'm a little monster. 
Knock knock, trick or treat?
Who are you?
I'm a monster. I'm a little monster.



Knock knock, trick or treat?
Who are you?
I'm a ballerina. A little ballerina. 
Knock knock, trick or treat?
Who are you?
I'm a ballerina. A little ballerina.



Knock knock, trick or treat?
Who are you?
I'm a pirate. I'm a little pirate. 
Knock knock, trick or treat?
Who are you?
I'm a pirate. I'm a little pirate.



Knock knock, trick or treat?
Happy Halloween. Happy Halloween. 
Knock knock, trick or treat?
Happy Halloween. Happy Halloween.





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