Chapter 6 & 7 Flashcards
Can children with severe to profound HL develop age-appropriate speech and language skills?
Yes, can learn with normal hearing peers
Consideration when choosing language/communication modality
Match family’s goal for child
Must be familiar with all options
What are the communication options for families of children with hearing loss
3 categories:
Systems Emphasizing Listening and Spoken Language (LSL)
Auditory-verbal
Auditory-oral
Manual-Visual Systems
ASL/ESL
Systems Combining Visual and Auditory Information
TC and Cued Speech
What is the auditory-oral approach
LSL
Uses residual hearing so must have amplification
Goal: educated in settings with peers with hearing loss
Intense therapy targeting speech, language and auditory dev
Home activities to support goals
Speech reading not taught, not discouraged
Auditory verbal approach
Same as oral except:
Auditory skills instead of visual cues
Sometimes restrict visual access
Therapy: teaching parents how to integrate listening and spoken language in ADL
What are Manual-Visual Systems
ASL/ESL
Child must have access to adults fluent in ASL
English is developed later as a second language with emphasis on reading and writing
Bilingual-bicultural approach
Varies from no spoken language to combining some form of speech training
What is total communication
Systems Combining Visual and Auditory Information
Use manually coded English, finger spelling, speech reading, natural gestures, residual hearing and speech
USE OF AMPLIFICATION ENCOURAGED
Families must learn manually coded English and finger spelling to maximize approach
EVERYONE needs to use simultaneous communication at all times
Speech and language development and manually coded English/ASL
What is Cued Speech?
Includes use of residiual hearing
Goal: develop spoken language
EVERYONE INTERACTING WITH CHILD HAS TO CUE
What age does intervention need to start for best results?
6 months
Later identified children (7-34 months) showed lower quotients in language
Why do children need to see a pediatric audiologist?
Specialization
Real ear to coupler difference is critical
Probe tube real ear verification measures
Digital processing strategies
FM/RM systems for school
Hearing aid retention is different
Ear molds are different
Ongoing support
What is a speech map
Graph of the child’s hearing loss for one designated ear in db SPL near the eardrum
Factors affecting speech and language acquisition
Critical period of development is 1st year of life
Late identification causes delay in spoken language dev, academic delay, social difficulty, and vocational limits
With early id, appropriate management, engaged family - comm abilities are comparable to that of normal hearing peers by time they start school
Cognitive effects on communication outcomes
Higher cognitive skills do better
Early-id with lower cognitive skills, did same as late-id higher cognitive skills
Early id with normal cognitive did better than normal cognitive id later
Lower cognitive early id did better than lower cognitive later id
Impact on form, content and use
See slides
Clinical application for form
Focus on opportunities to practice components of language through explicit teaching
As real life as possible
Strategy: recasting - adult recasts or repeats child’s utterance maintaining meaning but appropriate form
Clinical application for content
Word meaning learned in child’s routine - narrate day
Incidental learning
Repeated exposure to new words
Strategy: pre and post teach vocabulary
Thematic units
Clinical application - use
Model communication functions
Bombard with speech and language
Strategy: environmental strategies to practice skills & sabotage
Pre-Literacy and Literacy Issues
Delays in form, content and use lead to weak literacy
Low reading and writing proficiency
Difficulty with spelling, expository writing, and poor phonological skills
Clinical application - literacy
Phonological awareness is key to reading
Exposure to print from infancy
Letters, words, pictures, traffic signs (shapes), toys (feature and function)
Incorporate reading and writing in ADL
Encourage children to draw pictures, trace letters, watch their story be written by parent
Kinds of Language assessment
Formal language measures
Communication checklists or criterion-referenced (informal)
Language sample and narrative analyses
Can use normal hearing tests
What domains of communication dev does formal language assess measure?
Receptive and expressive vocabulary
Receptive and expressive language
Articulation/intelligibility and pragmatics
Communication checklist/criterion-referenced assessment
Checklists of milestones
Does not include normative data
Helpful to track progress over time
Language Sample and Narrative Analysis
Sample done in natural setting
Supplements info from formal evaluation
Done with recordings
Wordless picture books can help to stimulate communication
Speech assessment
Traditional articulation and phonology tests
Measures speech competence or intelligibility
What is speech training
Integrates auditory and speech goals - pay attention to auditory info to maximize listening skills
Use bridging activities to promote real-world carryover
Practice communication sabotage
Use contrasts in perception and production
Hard of hearing considerations
See slide
Speech development in children with HL
See slides
Guidelines for treatment: birth to 3 months
Select and sequence targets based on normal development
Maximize optimal residual hearing - eyes open, ears on
Parents must target spoken language skills as well as
Mild-Moderate HL affects on language & speech
Will have misarticulation of single consonants or consonant blends
Most commonly affricates, fricatives, and blends
Artic test to evaluate
Hearing loss should be ruled out for every child with artic problems
Early Onset Sever-Profound HL on speech and language
Lifelong deficits if not fit with amplification right away
Negatively affects:
the production of vowels and consonants
Speech breathing
Resonance (hyper/hyponasality)
Suprasegmental features
Reduced speaking rate
Excessive or limited pitch variation
What is the Kubler-Ross grief cycle
Denial
Anger
Depression
Bargaining
Acceptance
Characteristics of deaf adults without a mode of communication
Compulsive
Egocentric
Rigid
Deficits in empathy
High levels of anxiety
Primitive personality
Impulse disorder
