Click HERE to download the November Listening and Spoken Language printable calendar from the Moog School. It's provides a daily suggestions that Auditory-Verbal families will find helpful.
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NOVEMBER: Listening and Spoken Language Calendar
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THANKSGIVING: Auditory Verbal Therapy Pinterest Board
THANKSGIVING Auditory Verbal Therapy
Click HERE for ideas for listening and spoken language at home or in parent centered therapy.
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You Are The Boss of Your Hearing Loss Scenario: After the Halloween Party
Characters:
Angela, a girl who is hard of hearing
A group of friends: Amber, Olivia, Mark and Ben
Background Information:
A group of friends are talking about the Halloween party they went to over the weekend in the hall before school.
Angela | The Scenario | Angela’s Friends |
Olivia: Wasn’t the Halloween party at Sam’s house amazing? | ||
Angela: Hi guys! | ||
Mark: It was the most fun party I have ever been too. | ||
Ben: I loved the chili and all the food! | ||
Amber: Too bad the costume contest didn’t go better. Did you hear that Sam’s Mom leg is broken after she tripped over the witch’s broom? Ouch! | ||
Angela: That was great! | ||
Everybody looks at Angela shocked! Angela thinks they don’t like her, gets embarrassed and walks away. | ||
Discussion: How does Angela feel? How would you feel? What would you do? 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: |
Angela | The Scenario | Angela’s Friends |
Olivia: Wasn’t the Halloween party at Sam’s house amazing? | ||
Angela: Hi guys! | ||
Mark: It was the most fun party I have ever been too. | ||
Ben: I loved the chili and all the food! | ||
Amber: Too bad the costume contest didn’t go better. Did you hear that Sam’s Mom leg is broken after she tripped over the witch’s broom? Ouch! | ||
Angela: That was great! | Everybody looks at Angela shocked. | |
(Angela thinks. I missed something.) Angela: What’s wrong? Weren’t we talking about the Halloween party? | ||
Amber: Yes, but I just said, Sam’s Mom broke her leg when she tripped during the costume contest. She’s using crutches. I guess you didn’t hear that. Sorry! | ||
Angela: Oh my! I hope Sam’s Mom get better soon. | ||
Now, I know why you all gave me those funny looks. I’m glad I asked. |
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Thanksgiving: Following Auditory Directions Containing Conditions
Following Auditory Directions Containing Conditions, If..... then... for Thanksgiving!
This printable activity was created by Dana Hagan, MA CCC-SLP Click here to download the printables.
Talk about Thanksgiving traditions, target
auditory processing, auditory memory and following conditional directions
while playing a fun and energetic game.
Ask your child to listen and follow as you read each card.
For example,
"If you watch football on Thanksgiving, then do one jumping jack."
"If you like cranberry sauce on your turkey, then say 'Yipee!' ".
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Listen and Learn with a Thanksgiving Guess Who Game
Thanksgiving Guess Who? can be used for a wide range of listening and language targets such as auditory memory, auditory processing, deductive reasoning and a wide range of receptive and expressive language goals. For the game to work, both players must listen, comprehend and reply to each other’s questions accurately.
To Play: First, you will need to print out the game cards.
Number of players: 2 (more players can compete as teams)
• Description: Each player has a one set of 20 different Pilgrims and Indians. Both players select one small Pilgrim/Indian card. Do not let your opponent see it. Put remaining little cards away.
• Lay out your big cards face up in 4 rows of 5.
• Take turns asking each other questions about the cards to deduce which small Pilgrim/Indian your opponent has. Turn big cards face down when they don’t have characteristics you are asking about (i.e. “Does your person have a hat?” “No”...turn all people with hats face down, etc.).
• Once every card is turned face down but one, you can ask your opponent, “Is your person ______?”
If it is, you win the game!
Suggested Listening and Spoken Language Targets:
1. Describing Salient Features:
If your child often communicates by pointing or uses a lot of non-specific vocabulary like that, this, or thing, playing Guess Who? can contribute to using more specific descriptions. It is a good idea to look at the cards together beforehand and warm up by discussing the characters’ distinguishing features.
2. Question Formation:
Forming yes/no questions involve inverting the subject (e.g., your Pilgrim) with either the main verb (e.g., Is your Pilgrim a girl?) or the auxiliary verb as in (e.g., Does your Indian have a two feathers in his headband?)
3. Is/Does Question Forms:
When using Thanksgiving Guess Who? for this purpose, require the child to ask all questions using one of two forms:
• Is your pilgrim wearing a bonnet_____?
• Does your Indian have a vest _____?
• Expect your child to answer using full sentences, not a simple yes or no.
4. Have/Has as well as Negation and Contractions:
There are four typical forms for an answer:
• Yes, my pilgrim has _____.
• No, my Indian doesn’t have _____.
• Yes my pilgrim is _____.
• No, my Indian is not _____.
5. Using “Clear speech”:
Producing accurate /s/ and /z/ and other speech sounds can be highlighted in spontaneous speech For example: is, has, does, etc. Thanksgiving Guess Who? is a great exercise in self-monitoring and using clear speech.
Have fun!
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Management of Auditory Processing Disorders (APD)
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| http://kidshear.com.au/ |
Research indicates that with appropriate intervention, children with APD can become active participants in their own listening, learning, and communication success. Thus, when auditory rehabilitation is navigated carefully, accurately, and appropriately, an individual’s prognosis is good in spite of being afflicted with APD.
Treatment of APD generally focuses on three primary areas:
1. Changing the learning or communication environment
The primary purpose of environmental accommodations and/or modifications is to improve access to auditorily presented information are often listed in a student’s 504 Plan.
2. Learning and using compensatory strategies
Compensatory strategies teach individuals with APD to take responsibility for their own listening success or failures. The individual uses a variety of active listening and problem-‐solving techniques to be an active participant in daily listening activities.
3. Auditory Rehabilitation for APD
Auditory Rehabilitation targets maximizing auditory processing skills rather than only putting accommodations in place that are usually visual in nature and do not impact the auditory disorder. Research shows that vision is not a good substitute for hearing. If it were, APD would not present with such challenges.
 |
| http://www.gemmlearning.com/ |
Auditory Rehabilitation Therapy involving a systematic program of auditory training
includes two main areas:
1. auditory association abilities.
2. auditory comprehension and direction following abilities.
3. auditory closure abilities.
4. auditory memory ability to retain auditory information both immediately and after a delay.
5. auditory memory sequencing.
6. linguistic auditory processing for higher-‐level language, learning and
communication.
7. auditory processes for auditory integration.
8. ability to attend to important auditory information including attending in the midst of competing background noise and verbal distractions.
9. auditory comprehension/receptive and expressive language including vocabulary, syntax, morphological markers, complex sentence structures, conceptual language, social and pragmatic language.
10. communication repair strategies and clarification techniques
Recruiting higher-order skills to help compensate for the auditory deficit
Examples based on an individual’s needs are targeted and may include such as learning and using:
a) auditory retrieval strategies to improve word retrieval of known but evasive vocabulary
b) synonyms to circumvent word-‐finding blocks
c) categorization or grouping to facilitate auditory memory
d) chunking to aide in recall of sequences of numbers and other types of information
e) mnemonic devices to assist in auditory memory
f) creating and use of a verbal description when referring to concrete items and situations
The degree to which an individual’s auditory deficits will improve with therapy cannot be determined in advance. However, with appropriate auditory rehabilitation, individuals with APD can become active participants in their own listening, learning, and communication success.
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Thanksgiving Guess Who?
Listen & Learn with: Thanksgiving Guess Who?
Reposted from 2012
Thanksgiving Guess Who? can be used for a wide range of listening and language targets such as auditory memory, auditory processing, deductive reasoning and a wide range of receptive and expressive language goals. For the game to work, both players must listen, comprehend and reply to each other’s questions accurately.
To Play: First, you will need to print out the game cards.
Number of players: 2 (more players can compete as teams)
• Description: Each player has a one set of 20 different Pilgrims and Indians. Both players select one small Pilgrim/Indian card. Do not let your opponent see it. Put remaining little cards away.
• Lay out your big cards face up in 4 rows of 5.
• Take turns asking each other questions about the cards to deduce which small Pilgrim/Indian your opponent has. Turn big cards face down when they don’t have characteristics you are asking about (i.e. “Does your person have a hat?” “No”...turn all people with hats face down, etc.).
• Once every card is turned face down but one, you can ask your opponent, “Is your person ______?”
If it is, you win the game!
Suggested Listening and Spoken Language Targets:
1. Describing Salient Features:
If your child often communicates by pointing or uses a lot of non-specific vocabulary like that, this, or thing, playing Guess Who? can contribute to using more specific descriptions. It is a good idea to look at the cards together beforehand and warm up by discussing the characters’ distinguishing features.
2. Question Formation:
Forming yes/no questions involve inverting the subject (e.g., your Pilgrim) with either the main verb (e.g., Is your Pilgrim a girl?) or the auxiliary verb as in (e.g., Does your Indian have a two feathers in his headband?)
3. Is/Does Question Forms:
When using Thanksgiving Guess Who? for this purpose, require the child to ask all questions using one of two forms:
• Is your pilgrim wearing a bonnet_____?
• Does your Indian have a vest _____?
• Expect your child to answer using full sentences, not a simple yes or no.
4. Have/Has as well as Negation and Contractions:
There are four typical forms for an answer:
• Yes, my pilgrim has _____.
• No, my Indian doesn’t have _____.
• Yes my pilgrim is _____.
• No, my Indian is not _____.
5. Using “Clear speech”:
Producing accurate /s/ and /z/ and other speech sounds can be highlighted in spontaneous speech For example: is, has, does, etc. Thanksgiving Guess Who? is a great exercise in self-monitoring and using clear speech.
Have fun!
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Blogroll at the Listening and Spoken Language Knowledge Center
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H-O-L-I-D-A-Y-S Are For Hearing
Tips for Families of Children With Cochlear Implants
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| Source |
People love holidays! Adults busily prepare for the festivities while children are abuzz with excitement. Traditions are passed down as family and friends gather. Below are suggestions so you can enjoy the HOLIDAYS and focus on your child’s listening and spoken language.
Holidays are about listening to joyous music, lively conversations and spending time with family and friends. Encourage your child to be the Holiday Host and greet visitors and take their coats. This will boost your child’s confidence while giving him a chance to talk face to face in a quiet setting. Role-play upcoming holiday situations and practice good listening strategies. Create a secret a signal so your child can notify you when he is having a difficult time hearing. Keep the holiday music off or at a low volume, as your child is likely not the only one bothered by clatter and background music.
Organize an email and send it your family and friends before you gather for the holidays. Write a quick update about your child’s listening and spoken language progress and his cochlear implant technology. Dealing with this before the holidays will allow you to spend time celebrating rather than answering questions of well meaning friends and family.
Large family dinners are noisy so plan accordingly. One suggestion is ensuring your child knows the topic of the conversation. Consider using “conversation starter cards” around the table which are always fun. Also, have someone special seated next to your child who can repeat a joke or summarize a story if your child mishears.
Includeyour child in the holiday preparations and focus on vocabulary that is often specific to the season. What is mistletoe? A menorah? The Nutcracker? A manger? Spend time reading holiday stories, cooking traditional foods and learning the words to holiday songs. You child can create decorations to hang around your home and tell guests about them when they visit.
Devices. Keep your child’s CI accessories charged and ready to use. Role-play so your child is comfortable asking others to wear the FM, Roger system or use their ComPilot and can explain how it helps him hear. At the dining table place the accessory mic in the middle or concealed in the centerpiece. If you attend a holiday performance or a faith-based service, contact the venue to request extra amplification such as a microphone, a hearing loop and captions. Another important device is your phone’s camera. Snap photos to include in your child’s Listening and Spoken Language Experience Book.
Arrange seating with your child’s hearing in mind. Encourage your child to choose a good seat for hearing at dinner and for the gift exchange. Is there a seat away from the bustling kitchen, or the room when the teenagers are playing video games? When opening gifts, suggest sitting in a circle so your child can both listen and watch.
Your traditions are an important way to expand your child’s listening and spoken language skills. If gift giving is your tradition, choose presents that will provide hours of creative play and stimulate conversation. Most of your child’s memories will be about people, not presents.
Simplify. Ask your child what traditions he feels are most important. You may be surprised by his reply. Consider skipping old traditions that have lost appeal or that your family has outgrown. Time spent together rather than on activities will be most remembered. Keep a Joy Journal to jot down moments of triumphs, laughter, inspiration and the “hearing” miracles you enjoy over the holidays.
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Protocol for Audiological Assessment, Hearing Aid and Cochlear Implant Evaluation, and Follow-up
Today’s blog is from the Alexander Graham Bell Association
and can be read at the Listening and Spoken Language Knowledge Center website.
Share With Each of Your Child's Audiologists
This audiological protocol is intended to support programs for early detection and management of hearing loss in infants and children.
This protocol also is a guide to appropriate and ongoing audiology services recommended for children participating in listening and spoken language (LSL) programs.
Alexander Graham Bell Association’s Recommended Protocol for
Audiological Assessment, Hearing Aid and Cochlear Implant Evaluation, and Follow-up
Table of Contents
- Contributors and Reviewers
- I. Introduction
- II. Overview of Audiological Management
- III. Recommended Elements of the Initial Audiological Diagnostic Assessment
- IV. Recommended Procedures to Assess Amplification
- V. Recommended Audiological Management for Children with Cochlear Implants
- VI. Recommended Audiologic Management Regarding FM Systems
- VII. Disclaimer and Copyright
Contributors and Reviewers
Contributors: Carol Flexer, Ph.D., LSLS Cert. AVT; Jane Madell, Ph.D., LSLS Cert. AVT; Joan Hewitt, Au.D., CCC-A
Reviewers: Elizabeth Fitzpatrick, Ph.D. (with collaboration Carmen Barrieru-Nielsen, Au.D.); Stacey Lim, Ph.D., Au.D., CCC-A; Johnnie Sexton, Au.D., CCC-A; Don Goldberg, Ph.D., CCC-SLP/A, FAAA, LSLS Cert. AVT
Adopted June 2014
Reviewers: Elizabeth Fitzpatrick, Ph.D. (with collaboration Carmen Barrieru-Nielsen, Au.D.); Stacey Lim, Ph.D., Au.D., CCC-A; Johnnie Sexton, Au.D., CCC-A; Don Goldberg, Ph.D., CCC-SLP/A, FAAA, LSLS Cert. AVT
Adopted June 2014
I. Introduction
This audiological protocol is intended to support programs for early detection and management of hearing loss in infants and children. This protocol also is a guide to appropriate and ongoing audiology services recommended for children participating in listening and spoken language (LSL) programs.
The Alexander Graham Bell Association for the Deaf and Hard of Hearing (AG Bell) recognizes and recommends an audiological protocol that includes the test battery approach as an optimum means to access spoken language. No single test should be used in isolation to define and describe the nature and extent of a hearing loss. Ideally, every listening and spoken language program will have onsite audiological services. But regardless of setting, close collaboration of parents, audiologists, therapists, and educators is essential. Parents should be present and participate in all assessments. Whenever possible, the Listening and Spoken Language Specialist (LSLS®) certified professional also should be present at audiological assessments or communicate his/her questions or concerns regarding the child's hearing or technology.
The recommended procedures and elements in this document are consistent with the following guidelines and position statements:
The Alexander Graham Bell Association for the Deaf and Hard of Hearing (AG Bell) recognizes and recommends an audiological protocol that includes the test battery approach as an optimum means to access spoken language. No single test should be used in isolation to define and describe the nature and extent of a hearing loss. Ideally, every listening and spoken language program will have onsite audiological services. But regardless of setting, close collaboration of parents, audiologists, therapists, and educators is essential. Parents should be present and participate in all assessments. Whenever possible, the Listening and Spoken Language Specialist (LSLS®) certified professional also should be present at audiological assessments or communicate his/her questions or concerns regarding the child's hearing or technology.
The recommended procedures and elements in this document are consistent with the following guidelines and position statements:
- Joint Committee on Infant Hearing (JCIH) (2007).Year 2007 position statement: Principles and guidelines for early hearing detection and intervention programs. Pediatrics, 120(4), 898-921.
- American Speech-Language-Hearing Association (2004a). Guidelines for the audiologic assessment of children from birth to 5 years of age. Available at http://www.asha.org/policy/GL2004-00002.htm
- American Speech-Language-Hearing Association (2006). Roles, knowledge, and skills: Audiologists providing clinical services to infants and young children birth to 5 years of age. Available at http://www.asha.org/policy/KS2006-00259/
- American Academy of Audiology (2013). Clinical practice guidelines: Pediatric amplification. Available at http://audiology-web.s3.amazonaws.com/migrated/PediatricAmplificationGuidelines.pdf_539975b3e7e9f1.74471798.pdf
II. Overview of Audiological Management
- Initial screening, diagnosis, and confirmation should be completed within the first three months of life—as soon as possible after birth—in order to ensure that appropriate amplification and habilitation is underway prior to age 6 months. JCIH (2007) recommends that screening be accomplished by age 1 month, diagnostic testing be accomplished by age 3 months, and intervention begin by age 6 months.
- When hearing loss is diagnosed, routine evaluation should occur ideally at four- to six-week intervals until full audiograms are obtained, and at three-month intervals through age 3 years.
- Assessment at six-month intervals from age 4 years is appropriate if progress is satisfactory and if there are no concerns about changes in hearing.
- Immediate evaluation should be undertaken if parent or caretaker concern is expressed or if behavioral observation by parent, therapist or teacher suggests a change in hearing or device function.
More frequent evaluation is appropriate when middle ear disease is chronic or recurrent, or when risk factors for progressive hearing loss are present.
III. Recommended Elements of the Initial Audiological Diagnostic Assessment
The following section is based on the Joint Committee on Infant Hearing 2007 position statement.
Audiological Evaluation
Comprehensive audiological evaluation of newborns and young infants who do not pass newborn hearing screening should be performed by experienced pediatric audiologists. The initial audiological test battery to confirm a hearing loss in infants must include electrophysiological measures and—when developmentally appropriate—behavioral methods. Confirmation of an infant's hearing status requires a test battery of audiological test procedures to assess the integrity of the auditory system in each ear, to estimate hearing sensitivity across the speech frequency range, to determine the type of hearing loss, to establish a baseline for further monitoring, and to provide information needed to initiate the fitting of amplification devices. A comprehensive assessment should be performed for each ear even if only one ear did not pass the screening test.
Evaluation: Birth to Age 6 Months
For infants from birth to a developmental age of approximately 6 months, the test battery should include a child and family history, an evaluation of risk factors for congenital hearing loss, and a parental report of the infant's responses to sound. The audiological assessment should include:
- Otoscopic inspection
- Child and family history
- Auditory Brainstem Response (ABR) testing using air-conducted click and tone burst stimuli and bone-conducted stimuli when indicated. When a hearing loss is detected, frequency-specific ABR testing is needed to determine the degree and configuration of hearing loss in each ear for fitting of amplification devices.
- Click-evoked ABR testing using both condensation and rarefaction single-polarity stimulus, if there are risk indicators (e.g., hyperbilirubinemia or anoxia) for neural hearing loss (auditory neuropathy spectrum disorder or ANSD) to determine if a cochlear microphonic is present.
- Auditory Steady State Response (ASSR) testing may be used as another means of assessing ear and frequency specific thresholds. ASSR testing can also be used to assess auditory nerve function when no ABR is present.
- Distortion product or transient evoked otoacoustic emissions (OAE) testing
- Tympanometry using a 1000-Hz probe tone, and acoustic reflex testing
- Parent and clinician observation of the infant's auditory behavior as a cross-check in conjunction with electrophysiologic measures. Behavioral observation alone is not adequate for determining whether hearing loss is present in this age group, and it is not adequate alone for the fitting of amplification devices.
Evaluation: Age 6 to 36 Months
For subsequent testing of infants and toddlers at developmental ages of 6 to 36 months, the confirmatory audiological test battery includes:
- Otoscopic inspection
- Child and family history
- Parental report of auditory and visual behaviors and communication milestones
- Behavioral audiometry (either visual reinforcement or conditioned-play audiometry, depending on the child's developmental level), including pure-tone audiometry across the frequency range for each ear and speech detection, speech audibility (e.g., using the Ling 6-sound test) or speech recognition measures
- OAE testing
- Acoustic immittance measures (tympanometry and acoustic reflex thresholds)
- Electrophysiological testing as described above, if responses to behavioral audiometry are not reliable.
For children of all ages, AG Bell recommends that all results, questions, and recommendations are discussed with the parents in a culturally sensitive manner and in the family’s native language.
Parents should leave the audiology appointment understanding the management plan. They should know when to return for follow-up appointments and what their responsibility is in the process (including monitoring full-time use of amplification technology and monitoring what the child hears with the amplification technology). Parent questionnaires such as the IT-MAIS (Infant-Toddler Meaningful Auditory Integration Scale) and ELF (Early Listening Function) may be useful in the monitoring process.
Written reports should be provided and include:
- Descriptions of test procedures, conditions of testing, and reliability estimate
- A complete audiogram (if available at the initial diagnosis) with symbol key, calibration, and stimuli identified, as well as an explanation of results using tools such as a "Familiar Sounds" audiogram to support parent/teacher counseling
- Copies to parents, as well as to primary care provider, Listening and Spoken Language Specialist, and other health/education providers as requested in writing by parents
- Referral to medical, otolaryngological, or other resources (e.g., genetic counseling, social services, psychological counseling, occupational therapy) as appropriate.
IV. Recommended Procedures to Assess Amplification
Identify the hearing instrument, including manufacturer, model, output and response, compression or special feature settings, earmold specifications, and quality of fit. In addition, earmolds need to be well made and acoustically tuned (e.g., tubing, venting, bore size to match the child’s hearing loss in order to maximize the child’s access to sound). The audiologist should listen to the hearing aids at the start of every test session, and should confirm that parents know how to perform a listening check of hearing aids.
- Electro-acoustic analysis of hearing aids to document hearing aid performance at the following times:
- At initial fitting
- At regular intervals (e.g., at follow-up appointments)
- Upon return from repairs
- If parental concerns arise from behavioral observation or listening check.
- Real-Ear-to-Coupler Difference (RECD) measures
- Used with prescription method such as DSL (Desired Sensation Level ) or NAL (National Acoustic Laboratories) to establish target gain and output
- To convert hearing aid performance in 2cc coupler to real ear hearing aid performance
- To convert hearing levels in dB HL to ear canal SPL (Sound Pressure Level)
- To assess change in earmold style and fit.
- Cortical-evoked response testing to validate hearing aid fittings, where available.
- Sound Field Aided Response
- To demonstrate the child’s response to speech for parent education purposes
- To monitor the child’s auditory progress
- To assess speech perception at soft (e.g., 35 dB HL) and at average conversational levels (e.g., 50 dB HL) in quiet and in the presence of noise to evaluate the effectiveness of amplification technology. Each hearing aid should be evaluated separately and then both tested together.
- Assessment of speech audibility using the Ling 6-Sound Test at varying distances (e.g., through 6 meters or approximately 20 feet)
- Comparison of Ling results with NAL speech-o-gram if available to evaluate hearing aid fitting
- Functional auditory assessments (e.g., PEACH [Parents' Evaluation of Aural/oral performance of Children], LittlEARS Auditory Questionnaire) to validate hearing aid fitting.
NOTE: Functional gain measure is an appropriate verification procedure for bone conduction hearing aids and cochlear implants. Verification of amplification requires a RECD measure for children wearing hearing aids.
V. Recommended Audiological Management for Children with Cochlear Implants
- If adequate access to the full spectrum of acoustic information of spoken language cannot be achieved for an infant or child through conventional amplification, information should be provided to the family regarding cochlear implant (CI) technology, including benefits and risks as documented in published, peer-reviewed literature along with referral to a pediatric cochlear implant center.
- Upon parental consent, the cochlear implant team will review the audiologic information obtained to date and perform further assessments to evaluate the child’s suitability for cochlear implantation. Speech perception testing should be included in the pre-CI evaluation and used both in determining candidacy and to compare to post-CI evaluations.
- The LSLS should participate in the cochlear implant candidacy process.
- Following initial mapping of the cochlear implant speech processor(s), re-mapping should be conducted on the schedule recommended by the cochlear implant team given the child's age, device(s) implanted, number of electrodes activated, and additional individual considerations such as a bilateral or bimodal fitting.
- Once the speech processor is programmed to provide optimal access to the speech spectrum, ongoing evaluation at regular intervals is recommended (e.g., at three-month intervals for the first year). After this period, routine assessment of performance with the cochlear implant continues to be recommended at six- to 12-month intervals if progress is satisfactory.
- Sound Field warble tone or narrowband noise thresholds and speech perception testing should be performed whenever the speech processor is programmed and may be helpful along with other troubleshooting techniques whenever problems are suspected. Additional purposes of sound field testing are:
- To demonstrate the child’s response to speech for parent education purposes
- To monitor the child’s auditory progress
- To assess speech perception at average (e.g., 50 dB HL) and at soft (e.g., 35 dB HL) conversational levels in quiet and in the presence of noise, to evaluate the effectiveness of the cochlear implant, or of each cochlear implant in the case of bilateral fitting
- Subjective assessment of distance hearing using the Ling 6-Sound Test to demonstrate the range of audibility provided by the technology. In a quiet environment, the child should be able to detect all of the Ling sounds at close distances (e.g., one meter or approximately 3 feet) and at substantial distances (e.g., approximately 12 meters or approximately 40 feet).
- Immediate evaluation is recommended if parent, caregiver, or educator/therapist observe behaviors suggesting a negative change in performance or express concern regarding device function.
- Functional auditory assessments (e.g., PEACH, LittlEARS) to validate hearing aid fitting.
VI. Recommended Audiologic Management Regarding FM Systems
- Every child with hearing loss will benefit from the use of an FM system to reduce the negative effects of distance and competing noise.
- All technology selected for children should be FM compatible.
- Validation and verification should be included in evaluations for children using FM systems. See Clinical Practice Guidelines for Remote Microphone Hearing Assistance Technologies for Children and Youth Birth-21 Years (American Academy of Audiology, 2008; available at http://www.audiology.org/publications-resources/document-library/hearing-assistance-technologies).
RECOMMENDED UNAIDED AND AIDED AUDIOLOGIC PEDIATRIC ASSESSMENT PROTOCOLS BY AGE* OF CHILD
0-6 months | 6-12 months | 12-24 months | 24-36 months | Over 36 months | |
UNAIDED TESTING | |||||
ABR | x | x | X if not performed previously | ||
Immittance testing | X 1000 Hz probe tone | x | x | x | x |
OAE testing | x | x | x | x | x |
Behavioral testing 250-8000 Hz | X BOA | X VRA | X VRA with transition to CPA | X VRA until child can perform CPA | X CPA |
SAT-Ling Sounds | x | x | x | ||
SRT testing Speech Perception testing at 40 dB above threshold if possible. This test may be useful for helping families understand what the child is hearing. | X Body parts, familiar objects | X Body parts, familiar objects Begin standardized tests | X Standardized tests | ||
TESTING WITH TECHNOLOGY | |||||
RECD | x | x | x | x | x |
Cortical Responses | x | x | x | x | x |
SAT-Ling Sounds | x | x | x | ||
SRT Testing | x | x | x | ||
Aided thresholds – 250-8000 Hz | x | x | x | x | x |
Aided Speech Perception 50 dB HL – Quiet | X Right, Left, Binaural | X Right, Left, Binaural | X Right, Left, Binaural | ||
Aided Speech Perception at 35 dB HL – Quiet | X Right, Left, Binaural | X Right, Left, Binaural | |||
Aided Speech Perception 50 dB HL- /+5 SNL | X Binaural | X Binaural |
Note 1: The purpose of all auditory technologies is to deliver the most complete sound possible to the child’s brain, where actual “hearing” occurs. The task of technologies is to access, stimulate, and develop neural pathways that are the basis for listening, talking, reading and learning.
*Note 2: The age levels presented represent a child’s developmental levels as well as chronological age. A child (or adult) with developmental delays should be assessed with tests appropriate to his/her developmental level, not chronological age.
Note 3: Aided testing refers to whatever technology the child is using. This may be hearing aids, cochlear implants, osseointegrated devices, FM systems, and other. Each ear should be tested separately with technology, as well as binaurally.
Abbreviations used in the chart:
“X” means the test should be performed
*Note 2: The age levels presented represent a child’s developmental levels as well as chronological age. A child (or adult) with developmental delays should be assessed with tests appropriate to his/her developmental level, not chronological age.
Note 3: Aided testing refers to whatever technology the child is using. This may be hearing aids, cochlear implants, osseointegrated devices, FM systems, and other. Each ear should be tested separately with technology, as well as binaurally.
Abbreviations used in the chart:
“X” means the test should be performed
BOA - Behavioral Observation Audiometry
VRA - Visual Reinforcement Audiometry
CPA - Conditioned Play Audiometry
ABR - Auditory Brainstem Response Testing
SAT - Speech Awareness Threshold
SRT - Speech Recognition Threshold
RECD – Real-Ear-to-Coupler Difference
OAE - Otoacoustic Emissions Testing
RECOMMENDED AUDIOLOGIC SPEECH TEST PROTOCOLS BY AGE* OF THE CHILD
RECOMMENDED AUDIOLOGIC SPEECH TEST PROTOCOLS BY AGE* OF THE CHILD
Birth-6 months | 6-12 months | 12-18 months | 18-24 months | 24-36 months | 3-5 years | 6-8 years | 8+ years | |
SAT | x | x | x | x | ||||
SRT | x | x | x | x | x | x | ||
ESP | x | x | x | |||||
NU CHIPS | x | x | x | |||||
WIPI | x | x | ||||||
PBK | x | x | ||||||
NU 6 CNC | x | x | ||||||
HINT -C or A | x | x | ||||||
Baby's Bio | x | x | ||||||
AzBio | x |
Note 1: The purpose of all auditory technologies is to deliver the most complete sound possible to the child’s brain, where actual “hearing” occurs. The task of technologies is to access, stimulate, and develop neural pathways that are the basis for listening, talking, reading, and learning.
*Note 2:The age levels presented represent a child’s developmental levels as well as chronological age. A child (or adult) with developmental delays should be assessed with tests appropriate to his/her developmental level, not chronological age.
Note 3: Speech tests are to be presented in unaided and aided conditions. Aided testing refers to whatever technology the child is using. This may be hearing aids, cochlear implants, osseointegrated devices, FM systems and other. Each ear should be tested separately with technology, as well as binaurally.
*Note 2:The age levels presented represent a child’s developmental levels as well as chronological age. A child (or adult) with developmental delays should be assessed with tests appropriate to his/her developmental level, not chronological age.
Note 3: Speech tests are to be presented in unaided and aided conditions. Aided testing refers to whatever technology the child is using. This may be hearing aids, cochlear implants, osseointegrated devices, FM systems and other. Each ear should be tested separately with technology, as well as binaurally.
Abbreviations used in the chart:
“X” means the test should be performed
“X” means the test should be performed
SAT - Speech Awareness Threshold
SRT - Speech Recognition Threshold
ESP - Early Speech Perception Test. Available at http://www.cid.edu/ProfOutreachIntro/EducationalMaterials.aspx
NU-CHIPS - Northwestern University Children’s Perception of Speech. Available at http://www.advancedbionics.com/content/dam/ab/Global/en_ce/documents/libraries/AssessmentTools/Test%20Reference%20for%20Cochlear%20Implants.pdf
WIPI - Word Intelligibility by Picture Identification. Available at http://www.auditec.com/cgi/Auditec2013Catalog.pdf
PBK - Phonetically Balanced Kindergarten Word Test. Available at http://www.asha.org/eweb/OLSDynamicPage.aspx?title=Childrens+Spondees+PBK-50A&webcode=olsdetails
CNC - Consonant Nucleus Consonant Test. See Mackersie, C. L., Boothroyd, A., & Minnear, D. (2001). Evaluation of the Computer-Assisted Speech Perception Assessment Test (CASPA). Journal of the American Academy of Audiology, 27, 134–144.
AzBio - See Spahr, A. J., Dorman, M. F., Litvak, L. M., Van Wie, S., Gifford, R. H., Loizou, P. C., … Cook, S. (2012). Development and validation of the AzBio sentence lists. Ear and Hearing, 33(1), 112-117. doi: 10.1097/AUD.0b013e31822c2549
Baby Bio - See Spahr, A. J., Dorman, M. F., Loiselle, L., & Oakes, T. (2011). A new sentence test for children. 10th European Symposium on Pediatric Cochlear Implantation. Athens, Greece, May 12-15.
Disclaimer: The protocol outlined in this document is not prescriptive for professionals who hold the Listening and Spoken Language Specialist (LSLS®) certification to utilize in their scope of practice and is not required by Alexander Graham Bell Association of the Deaf and Hard of Hearing or the Alexander Graham Bell Academy for Listening and Spoken Language. This reference contains guidelines and recommendations for use at the professional’s discretion. AG Bell disclaims any liability to any party for the accuracy, completeness, or availability of this documents, or for any damages arising out of use of this document and any information it contains.
Listening and Spoken Language Specialist (LSLS®), Auditory-Verbal Therapist (LSLS Cert. AVT®) and Auditory-Verbal Educator (LSLS Cert. AVEd®) are trademarks of the AG Bell Academy for Listening and Spoken Language.
© Copyright 2014 Alexander Graham Bell Association for the Deaf and Hard of Hearing. All rights reserved. Alexander Graham Bell Association for the Deaf and Hard of Hearing (2014).
© Copyright 2014 Alexander Graham Bell Association for the Deaf and Hard of Hearing. All rights reserved. Alexander Graham Bell Association for the Deaf and Hard of Hearing (2014).
Recommended protocol for audiological assessment, hearing aid and cochlear implant evaluation, and follow-up. Washington, DC: author.
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DECEMBER: Listening and Spoken Language Calendar
Here is a month's worth of language suggestions that you can incorporate into
AUDITORY VERBAL THERAPY activities with your child.
Click HERE to download your own printable copy.
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Potato Heads to Encourage Listening and Spoken Language Skills
Santa Spud was given to be by a family who knew Potato Head was a treasure for encouraging listening and spoken language skills.
Their daughter was a preschooler at the time and today a Senior in High School.
There are many articles on using Potato Head for listening and spoken language development. Below are links:
How to use potato heads to encourage language skills by Expressly Speaking
The Many Faces of Mr. Potato Head by Playingwithwords36510 ways to Play with Potato Head by SpeechRoomNews
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Holiday Baking and Cookie Toys for Listening, Spoken Language and Fun
Include your child in holiday baking for rich listening and spoken language experiences. There are many toys to carryover the activity with a cookie theme. Many of are great Christmas gift ideas.
Go to HomemadeSpeech to view many more cookie suggestion for listening and learning.
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Go to HomemadeSpeech to view many more cookie suggestion for listening and learning.
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AV Center of Wheaton's Graduate Bryn Spejcher featured in Hearing Our Way magazine.
Look who is featured in the current Hearing Our Way magazine.
Bryn Spejcher who is an AV Graduate from the Auditory Verbal Center of Wheaton.
I remember Bryn:
- eager to listen and learn and sitting up to the table in the booster chair and her Mom's commitment to listening and spoken language.
- not wanting to attend AGBELL’s LOFT program that I “made” her go to in Milwaukee.
Later Bryn shared LOFT was a life changing experience.
Later Bryn shared LOFT was a life changing experience.
- observing AV therapy for a summer a few years ago and getting choked up when seeing a little girl with pink hearing aids and remembering her own days in AVT.
Way to go Bryn – as you are pursuing your dream while working
on your doctorate in audiology!
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10 Ways to Target Listening and and Spoken Language at Christmas
Today’s blog is from a post by Maria Del Duca, MA CCC/SPL - a Mom and a Therapist at www.communicationstationspeech.com
You can be read her original article HERE
1. Elf on the Shelf - one of our favorite holiday traditions in the Del Duca household is our Elf on the Shelf. As a parent it is fun to see the wonder and excitement in my son’s eyes each morning as he searches for “Buddy” (yep…that’s our elf’s name…thank you Will Farrell)! But as a speech pathologist I LOVE this activity because for 24 days (or more if you start right after Thanksgiving) you are focusing on “Where” questions and teaching prepositions (location words, e.g. “in, on, behind, under, above,” etc.) through a real-life fun activity.
2. Decorating the Christmas Tree - this activity is great for vocabulary development as you can talk about the different Christmas ornaments. You can teach descriptive words and even focus on answering “Who?s” by labeling who may have given you the ornaments in the past. Its also a great sequencing activity talking about what you do 1st (cut down, or buy/unpack and assemble tree), 2nd (put on lights if not decorated with lights already), 3rd (put on ornaments), 4th (garland/tinsel/ribbon, whatever), 5th (candy canes?). Whatever your typical process is to decorate your tree. You can use words like “first, next, last, before, after”…great sequential words!
3. Cookie Making, Baking, & Decorating! - Oh so fun! I love this activity because it is language-rich, sequential and ALSO focuses on math within measurements. Again you can talk about sequential words (examples above), use self-talk and parallel-talk (find further explanations of what these are here) to describe your actions, and use descriptive words when decorating cookies.
4. Reading Christmas Books - some of my personal favorites are How the Grinch Stole Christmas, the Polar Express, as well as Twas the Night before Christmas (of course). What great vocabulary in these books! Also rhyming (phonological awareness), making predictions and inferences, etc can be targeted and practiced. If you are religious, reading stories about the Nativity lends itself to a whole new set of vocabulary words children don’t typically hear in school (unless in a Christian school) such as “wise men, frankincense, myrrh, manger, shepherds, etc.”.
5. Making a gingerbread house - who doesn’t love to make gingerbread houses? Especially when you get to eat the candy as you work! I love this activity because you can talk about all the different foods and candies you are putting on your house. Its a great sequencing activity. Your child can problem solve how to keep the candy from falling off the house. You can talk about patterning of red and green (or whatever colors you are using)candies, count out the number of candies or foods you are going to use, use self-talk and parallel talk to describe your actions. So many wonderful language skills in this one activity!
6. Catalog Shopping - going through store catalogs and/or circulars and spending time cutting out pictures of what toys your child wants and pasting the pictures onto a piece of paper (making a collage or booklet) is a GREAT activity! You get to practice cutting and pasting as well as talk about all the cool toys your child wants and why your child would like them. Some parents get nervous with this activity because they feel that if their child asks for the toy, they must then go buy it for them. But you can just explain that this is just a “wish list” and that Santa (or mom and dad if you don’t do Santa in your house) will get what he/she/they think is best. IF that is not an option for your family, you can still do this activity. Just spend some time before the activity picking and choosing the circulars that have only the toys you have or are getting your child and have your child cut pictures out of those certain circulars.
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7. Singing Christmas Carols - you don’t realize how many new and different vocabulary words are in Christmas songs until you start to sing them. Really! What other time of year would your child talk about a “partridge in a pear tree” or that the “horse was lean and lank”? Another great thing about singing songs together is you can sing as fast or slow as you want if you are singing without music accompaniment.
8. Writing a letter to Santa - a perfect activity to practice creating complete sentences with correct use of vocabulary, grammar and organization. You can do this in writing if your child is old enough (great to practice spelling as well) or if your child is young you can still focus on these skills by having your child verbally tell you what he/she wants to write and you can use modeling and rephrasing to demonstrate how to create complete sentences. Plus its so fun to watch them as they are talking about the things they are hoping Santa will bring them!
9. Looking at Christmas Lights - depending on what opportunities you have in your area, you may be able to go to a light display that has many different kinds of lights and Christmas character displays. If not, you can do what we used to do (and still do to this day), make a thermos full of hot chocolate, get in the car, and drive around looking at Christmas lights. What does this have to do with language? Think about all the different adjectives you can use when talking about light displays (bright, beautiful, colorful, simple, tremendous, etc.) as well as great vocabulary when looking and naming Christmas icons you see! Maybe you can even play “I spy” or some other game to target listening, following directions, memory recall and even receptive comprehension (especially if you are using descriptive words to describe an object you see rather than naming the object). Such a fun holiday activity to do with family!
10. Christmas Scavenger Hunt - this is one of my very, very, very favorite activities to do focusing on vocabulary, modifiers, direction following, problem solving and so many more language and cognitive skills. I like to print out the Christmas Scavenger Hunt from Speakingofspeech.com (click the link above find your copy) and take my son to the mall or numerous stores and we use Bingo markers or stickers and mark off every time we find an object pictured! It really is a fun time! You could also drive around your neighborhoods and find these items as well if you wanted to!
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Christmas Actions and Targeting Verbs
Click HERE to grab your Santa Actions freebie.
Santa is here and he's busy getting ready for Christmas! Use these Santa action cards to practice auditory comprehension and spoken language skills related to the holidays!
It is easy to fall into a rut of labeling vocabulary.
Talk about actions, functions, descriptions, locations… in connected speech using acoustic highlighting techniques such as lots of melody.
Christmas is the perfect time for entries in your child's Experience Book or you may choose also to make a:
Great listening and spoken language lessons are learned with example Experience Book pages shown below.
Dependent on your child's language level you will need to target morphological markers which are unstressed, uttered quickly and tend to be concentrated at the high frequency end of the speech spectrum.
For example:
• plural morphological markers |s|, |z|, and |es|,
• possessive |s|
• past tense verb forms (irregular, regular, |d|, |t|, and |ed|)
Remember to use your Experience Book pictures to also target past tense verbs such as:
"Mommy baked Christmas cookies."
"The carolers sang Christmas songs."
Merry Christmas!
Merry Christmas!
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Listening, Learning and Spoken Language with New Events, Activities or Holidays
This blog post was adapted from the http://www.medel.com article entitled,
Helping Your Child Enjoy New Events with Their Cochlear Implant
by Donna Sperandio, Head of Rehabilitation at MED-EL
You can be read the original article HERE
For any child a new activity or event is an experience, and especially for a child with hearing aids or cochlear implants each new event means new sounds and experiences that may seem overwhelming. But don’t worry, there are a few ways that you can help to make their listening experience, and the whole event, comfortable and enjoyable.
The Key Word: Preparation
Involving your child in preparing for the event in an age-appropriate way is the best method to make everything enjoyable.
First, just introduce them to the general idea of what the event is about. This way they can develop an overall understanding of what to expect.
How should you do this? An easy way would be to explain the big steps that might occur by just talking about them in order. Or, you could get a bit more creative. If you have pictures from similar events, or if it’s a recurring event maybe from the last time it happened, then you can show these to your child to give them an idea of what they might see or be around. Younger children might enjoy acting out the activity with toys or dolls, and this can be especially useful in structured events like a wedding where there’s a clearly defined routine to the whole event.
Then, you can get more into the details. What are specific activities that happen at this event? Will someone be standing up to give a speech, and if this happens how should your child behave? If there will be songs or music, maybe your child would enjoy hearing them in advance so that he or she can better enjoy them during the actual event.
Here are some basic questions that you can think about what to tell your child:
- Why is this event happening?
- What will happen at the event?
- Who will be at the event?
- Will there be any surprises, like unexpected events or noises, for which he or she can prepare?
- How should your child behave? Is it formal or informal?
- Will there be speakers, and where will the speakers be located? (This is important because it might influence where your child should sit or stand to hear best.)
- Will there be induction loop or FM systems? (If yes, then your child could connect wirelessly to the systems for better hearing.)
During the Event: Enjoy
Depending on your child, you may want to either stay close or give them lots of space. Make sure to talk with them in advance and, if they’re old enough, make a choice that both of you can agree upon. Remember, the goal is to make it enjoyable for them as well as for you. If your child likes to be independent, that’s great! Encourage his or her independence, but also let them know that you’ll always be nearby if needed.
If your child uses any assistive listening devices make sure to grab them before leaving, and don’t forget any other accessories or extra batteries just in case. Again, it’s better to be prepared.
Talking with the event organizers can also help, whether it’s just informing them that your child will be present with his or her cochlear implant or asking about any assistive listening devices they have.
Example questions could be like:
Afterwards: Relax
If you want to reflect afterwards, you could ask your child if they have any questions about what had happened at the event or just ask them how they felt. If you took any photos at the event you could also look through them now.
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Suggestions When Talking to Others About Your Child's Hearing Loss
This blog post was adapted from an article by Mark Watychowicz the father of Julia, a six year old with hearing loss.
It was contributed by Debbie Clason, staff writer for Healthy Hearing
You can be read the original article HERE
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How to talk to Adults About Your Child’s Hearing Loss
Julia Watychowicz is a six-year-old girl who loves to play tennis and compete in Irish dance competitions. She also happens to have a severe hearing loss, a condition for which she wears hearing aids.
Mark shares:
Julia’s diagnosis “came out of nowhere," accepting her hearing loss wasn’t nearly as difficult as dealing with perceptions from family and friends.
“Most have been supportive, but some family members were not as accepting,” he said. “To this day, some still believe that she could be fixed by herbal remedies and magic potions by a witch doctor. Maybe I am exaggerating, but the notion that family feels the need to fix Julia, suggests that Julia is broken. Some even think that the hearing treatment will make her hearing worse.”
Julia is part of the 14.9 percent of American children between the ages of 6 and 19 who have hearing loss. Julia’s hearing loss was detected by her preschool teacher who noticed she wasn’t always responding to her name when it was called. Shortly thereafter, she was fit with hearing aids– and her parents started fielding questions from other adults.
“A very common question would be, will she grow out of it? Is it permanent?”
Mark said “There are many scientists and universities that offer the hope of a cure, but that is not an option right now. We can't sit around and wait for a cure. For children, there is a small window of opportunity for early intervention that will give them the tools they need to manage their hearing impairment in the best way that they can.”
Mark is right. According to the American Speech-Language-Hearing Association (ASHA), early intervention is the key to helping children like Julia keep pace with their peers when it comes to speech and language development.
Untreated hearing loss affects children in four ways:
- It causes delays in speech and language development.
- The language deficit causes learning problems that affects academic achievement.
- Communication difficulties lead to social isolation and poor self esteem.
- It can ultimately impact vocational choices.
The Individuals with Disabilities Education Act (IDEA) ensures that children who are deaf or hard of hearing receive free intervention services throughout their school years. Although these intervention services help children with hearing loss keep pace academically with their normal hearing peers, the stigma associated with hearing loss can be frustrating for their parents.
“When people found out about Julia's hearing impairment, most felt sorry or sad for her,” Mark said, “but there is nothing to be feel sorry or sad about. Julia is a happy and healthy girl that has achieved amazing accomplishments. Not just accomplishments for a child with a severe hearing impairment, but accomplishments that are amazing for any first grader.
Children are very capable of adapting when given the opportunity.”
Mark said it’s sometimes difficult to convince family and friends a child who is deaf or hard of hearing can accomplish the same things as a normal hearing child. “I feel that people have trouble understanding how someone with a hearing impairment could adapt to still live an amazing life in the mainstream world,” he said. “The explanation is simple: a disability is merely a state of mind. We all have disabilities that we have learned to manage. A child that is deaf or hard of hearing is no different.”
Mark’s advice to other parents of children who are deaf or hard of hearing is simple: be their advocate.
He suggests using these statements when having conversations with other adults about your child’s hearing loss:
- My child is not broken. He/she is a happy and healthy child that will rock this world one day.
- You don't need to treat my child differently. Include my child in every conversation. There is only one simple rule: have proper speaking etiquette. When communicating, face your audience; don’t speak from a different room; don't speak over one another; and offer visual cues (we all like to speak with our hands sometimes, right?)
- Don't feel sorry for my child.
- Don't feel the need to fix my child. It is an amazing journey that parents go through with their child, and only the parent, their child and their treatment team will know what is best.
“Having a hearing impairment just means your life has a detour, but you still could reach your goals at the end of your journey,” Mark said. “There are rock stars, politicians, movie stars and major league baseball players that have accomplished greatness while being treated for a hearing impairment. Just last year, a Super Bowl player, Derrick Coleman, played with hearing aids. With the right tools (technology), support, education, team and opportunity, a person with a hearing impairment could accomplish anything.”
Recently, Julia’s Irish dance team placed seventh in the Mid-America region – a significant accomplishment for such a young team. Her hearing aids allow her to hear the music and dance brilliantly; however, it’s her parents who’ve given her the confidence to chase her dreams, teaching her that her hearing loss does not define her.
“Not having the family's support can very discouraging, but as a parent, one of the most important roles is to give your child the opportunity to be all that he/she can be,” he said. “You can't let the discouragement overwhelm you.”
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Focus on Self-Advocacy Self-concept, Self-esteem and Identity with Hearing Loss.
The November/December 2014 Volta Voices issue is devoted to self-concept, identity and self-esteem with hearing loss. Preparing your child or your students with appropriate advocacy skills from an early age will address self-concept and help ensure resilience.
Hereis a link to read a digital copy of this issue.
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Christmas Taboo Game for Listening, Language and Learning
Taboo is a vocabulary word game that relies on listening, auditory memory and auditory integration.![]()
Take turns describing the word or phrase at the top of the card to your partner without using five common additional TABOO words also on the card.
The monitor looks at the card and LISTENS to ensure that the player does not use any of the taboo or illegal words
This activity expands Christmas vocabulary and concepts and also targets listening to each new clue word while holding the last ones in short term memory while auditory processing and comprehending to solve the answer.
HEREis the link to: www.Holidayzone.com to get your free printable cards.
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