d f hld practices or children using - infant hearing...routine: the language of the daily activities...
TRANSCRIPT
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d f h ld
Boys Town National Research Hospital
Auditory Practices for Children Using Sign and Spoken Language
Boys Town National Research Hospital
Catherine Cronin Carotta, Ed.D.Associate Director
Center for Childhood DeafnessBoys Town National Research Hospital
Katie Brennan, M.S., CCC‐SLPAuditory Consultant
Center for Childhood DeafnessBoys Town National Research Hospital
Boys Town National Research Hospital
AUDITORYAUDITORY
TACTILE
TACTILE
VISUALVISUAL
Adaptation of Koch, ACRN 2013
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Adaptation of Koch, ACRN 2013
Communication ContinuumCommunication Continuum
FullyAuditory
Communicator
MostlyAuditory
Communicator
MostlyVisual
Communicator
FullyVisual
Communicator
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McConkey Robbins, 2001; Nussbaum, Scott, Waddy‐Smith, Koch, 2004
A AV AV VA V
Communication ContinuumCommunication Continuum
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(McConkey Robbins, 2001; Nussbaum, Scott, Waddy‐Smith, Koch, 2004)
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Cochlear Implant:
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Implant: Identification
A AV V O OS S W WV V
E’s VocalizationsE’s Vocalizations
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Early Speech Perception TestEarly Speech Perception Test
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Single Word and Multiple ElementsSingle Word and Multiple Elements
ACLC 1 El 88%/58% ACLC 2 El 90%/ 32%
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ACLC 1 Element: 88%/58% ACLC 2 Elements: 90%/ 32%
ACLC 3 Elements: 60% ACLC 4 Elements: 20%
Child E: 4;9 mos.
ACLC Sign/Spoken Spoken
1 Element 88% 58%
2 El 90% 32%
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2 Elements 90% 32%
3 Elements 60% DNT
4 Elements 20% DNT
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E’s ContinuumE’s Continuum
Oral ‐ ‐ ‐ OS ‐ ‐ ‐ OS ‐ ‐ ‐ SO ‐ ‐ ‐ Sign ✓
(McConkey Robbins, 2001; Nussbaum, Scott, Waddy‐Smith, Koch, 2004)
Understanding of Auditory/Visual/Sign
Use of Sign and/or Spoken Language
Auditory ‐ ‐ ‐ AV ‐ ‐ ‐ AV ‐ ‐ ‐ VA ‐ ‐ ‐ Visual ✓
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N/A Picture/Signs ‐ ‐ ‐ P/SG‐ ‐ ‐ GP ‐ ‐ ‐ GP‐ ‐ ‐ Gestures ✓
Words ‐ ‐ ‐WV ‐ ‐ ‐ VW ‐ ‐ ‐ VW ‐ ‐ ‐ Vocalizations ✓
(Waddy‐Smith, Clerc Center, 2004)
(ACRN, 2011)
(ACRN, 2011)
Use of Vocalizations and/or Words
Use of Gestures and/or Pictures/Signs
Expectations Expectations -- PerformancePerformanceName: E Understanding of Auditory/Visual Language
A = Auditory V = Visual
EXPECTATIONS A Av AV VA V
Parents X X
Educational Staff
X X
SLP X X
PERFORMANCE A Av AV VA V
Home X X Classroom X X
Speech session X X
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p
Name: E Use Of Spoken Language and/or SignO = Oral S = Sign
EXPECTATIONS O Os OS So S
Parents X X
Educational Staff
X X
SLP X X
PERFORMANCE O Os OS So S
Home X X
Classroom X X
Speech session X X
AA--V Continuum DiscussionV Continuum Discussion
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AA--toto--V PlanV PlanAuditory Av AV Va Visual
Does not require visual support for clarification
Mostly Auditory:
Needs some visual support for clarification
Equal need for auditory and visual supports
Mostly Visual:Understands some spoken words/phrases
Visual:Does not understand spoken
words/phrasesAdaptation of McConkey Robbins, 2001; Nussbaum, Scott, Waddy‐Smith, Koch, 2004
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• When deciding which strategy to use, consider…what is your desired response?
– Input/imprint (receptive)
Imitation (receptive/expressive)
Auditory Learning Strategies Auditory Learning Strategies
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– Imitation (receptive/expressive)
– Comprehension (receptive)
– Use (expressive)
• Direct child’s auditory attention (“Listen”)
• Auditory Sandwich
• Tell, then show
• Use parentese
Auditory Strategies Auditory Strategies -- InputInput
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• Acoustic Highlighting
• Low‐lighting
• Auditory space
• Modeling
• Repetition
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Auditory SandwichAuditory Sandwich
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Auditory SandwichAuditory Sandwich
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Auditory SandwichAuditory Sandwich
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• Model, then WAIT
• Ask, “What did you hear?”
• Use a partner as a model
• “Tell mom…”
Auditory Strategies Auditory Strategies -- ImitationImitation
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• Auditory closure
• Give target in the form of a question (Did he jump?)
• “Can you say…?”
• Give a choice
• Give a direction and pause in natural context/routines
• Ask a variety of questions
A id ki t !
Auditory Strategies Auditory Strategies -- ComprehensionComprehension
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– Avoid asking too many!
• Sabotage/change a familiar routine
Checking ComprehensionChecking Comprehension
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Checking ComprehensionChecking Comprehension
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• Stop talking!
• Look expectantly and WAIT
• Sabotage the situation
Auditory Strategies Auditory Strategies –– Encourage UseEncourage Use
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• Role reversal
• Obligatory context
Encouraging Expressive CommunicationEncouraging Expressive Communication
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Encourage UseEncourage Use
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Auditory Chain / SupportAuditory Chain / Support
Natural Cues
Indirect
DirectVisual/Verbal
DirectVisual Language
Cues
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Cues Cues
• Routine• Repeat Phrase• Say With Facial Expression• Say With Speech Reading• Point To The Word Or Picture
• Say With An Eye Gaze• Say With Natural Gesture• Say Shorter Phrase
• Say With A Point To Object• Ask Child To Repeat
• Say Phrase OrWord With Sign
Adapted from DynaVox Systems LLC
1. What’s the auditory content & level?
2. What’s the set type & size?
3. What’s the A‐V plan?
Focused Auditory ProcessFocused Auditory Process
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4. What’s the auditory strategy?
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6. What’s the auditory chain/support?
7. What’s the visual support?
8. Did it work?
Focused Auditory ProcessFocused Auditory Process
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9. How will you modify?
Modify: Auditory Skill LevelModify: Auditory Skill Level
Identification Identification
ComprehensionComprehension
Identification
Comprehension
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DetectionDetection
DiscriminationDiscrimination
Detection
Discrimination
Modify: Set Size or TypeModify: Set Size or Type
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Less Challenging
MoreChallenging
New: Language and concepts being presented for the first or second time
Review: Language and concepts that h b t d t dl
Modify: Content/ContextModify: Content/Context
More Challenging
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have been presented repeatedly over a period of at least 2 weeks
Routine: The language of the daily activities of the classroom: transition, snack, instructional routines, etc.Less
Challenging
Modifications: CueingModifications: Cueing
Natural Cues
Indirect
DirectVisual/Verbal
DirectVisual Language
Cues
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Cues Cues
• Routine• Repeat Phrase• Say With Facial Expression• Say With Speech Reading• Point To The Word Or Picture
• Say With An Eye Gaze• Say With Natural Gesture• Say Shorter Phrase
• Say With A Point To Object• Ask Child To Repeat
• Say Phrase OrWord With Sign
Adapted from DynaVox Systems LLC
• Erber, N. (1982). Auditory Training. Washington DC: Alexander Graham Bell Association for the Deaf & Hard‐of‐Hearing.
• McConkey Robbins, A. (2001). A sign of the times: Cochlear implants and total communication
ReferencesReferences
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Cochlear implants and total communication. Advanced Bionics Loud & Clear (4)2, 1‐7.
• Nussbaum, D., Scott, S., Waddy‐Smith,B., & Koch, M. (2004). Spoken language and sign: Optimizing learning for children with cochlear implants. Paper presented at Laurent Clerc National Deaf Education Center, Washington, DC.
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Katie Brennan, MS, CCC‐SLPCathy Carotta, Ed. D., CCC‐SLP
Boys Town National Research Hospital555 N h 30th S
Boys Town National Research Hospital
555 North 30th StreetOmaha, Nebraska 68131
[email protected]@boystown.org
Boys Town National Research Hospital
A production of the Lied Learning & Technology Center at Boys Town National Research Hospital
©2014
Boys Town National Research Hospital