Speech and Language: General Information for the School Clinician

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Speech and Language General Information for the
School Clinician

• Pathways to Success Fall 2007
• Sarah J. Burke, M.A., CCC-SLP

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Presentation overview

• General information
• Evaluation/Assessment
• Auditory Skill Development
• Speech Skill Development
• Oral Language Development

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General Information
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Definitions, some views

• Hearing loss can be described as an invisible
  acoustic filter that distorts, smears, or
  eliminates incoming sounds
• Cole Flexor, 2007
• Hearing impairment- any type and degree of
  hearing loss
• Deaf and hard of hearing are used functionally
• Ross, Maxon, Brackett, 1991

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Demographic overview

• As many as 12,000 new babies are identified with
  hearing loss every year
• In that same year another 4,000-6,000 children
  who passed the newborn screening acquire or are
  identified with a hearing loss
• Each year 16,000-18,000 infants and toddlers are
  identified
• National Institute on Deafness

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Additional demographics

• Approximately 1 in 1,000 children are born with a
  hearing loss
• Approximately 90 of deaf children are born to
  hearing parents
• In the next 10 years, over 90 of students with
  hearing loss will be placed in public schools

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Developmental considerations

• Neuroplasticity is greatest in the first
• 3 ½ years of life
• The highest auditory neural centers are not
  developed until approximately age 15
• Cole Flexor, 2007

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Amplification considerations

• Age at initial amplification
• Type of amplification
• Consistency and use of amplification
• Benefit from amplification
• If a child is amplified 4 hours a day it will
  take 6 years to have the same exposure to
  auditory information that a typically hearing
  child has in 1 year- Stovall, 1982

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Other considerations for speech/language
development

• Etiology
• Parental support
• Language experience/exposure
• Cognition/Intellect
• Structural/Physiological
• Social/Emotional
• Other neurological factors

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A few more notations

• .

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Incidental Learning

• What one overhears
• Access to information that is not directly
  addressed to you
• Important for the acquisition of speech and
  language
• Problematic when a child has a hearing loss

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REMEMBER

• Each child is an individual
• Treat the whole child

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Evaluation/Assessment

• Audiological Information/Interpretation
• Reference List of Suggested Testing Materials

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Auditory Skill Development
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Developing Auditory Skills

• Detection
• Discrimination
• Identification
• Comprehension
• Eber, 1982

• Detection
• Pattern perception
• Segmental identification
• Comprehension
• Chute Nevins, 2002

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Detection

• Most basic auditory skill
• Necessary for processing spoken language

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Discrimination vs. Pattern Perception

• Same vs. different

• Select from a closed set
• Different patterns
• Different syllables
• Ex., single vs. bi- vs.
• polysyllabic

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Identification vs. Segmental Identification

• Label what is heard

• Same patterns
• Recognition through consonant/ vowel information
• Ex., equal number of syllables, differences are
  in the syllables

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Comprehension

• Most complex level of auditory skill development
• Demonstrate understanding via response
• Encompasses all language forms (semantics,syntax,m
  orphology,pragmatics, etc)

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Tips

• To optimize auditory signal
• Make sure amplification is working
• Reduce background noise
• Use preferential seating
• Reduce signal to noise ratio (ALDs)
• To avoid auditory distortion
• Use normal conversational volume and rate
• To reduce visual interference
• Avoid backlighting
• Speak clearly- do not over or under articulate

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Tools

• HELP for Auditory Processing
• CAST (Contrasts for Auditory and Speech Training)
• No Glamour (APD, listening)
• Internet
• http//www.hearingjourney.com/listening_room/index
  .cfm?langid1

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Speech Skill Development
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Developing Speech Skills

• Developmental hierarchies
• Traditional models
• Ling- 1976
• The 8s- Shriberg, 1993

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Traditional developmental speech models vs.
phonological processes

• Templin, 1957
• Sander, 1972
• Prather, Hedrick, Kern, 1975

• Kahn, 1982
• Stoel-Gammon, Dunn, 1985
• Hodson Paden, 1991

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Ling for use for children with hearing aids

• Consonants are divided into three steps
• Step I /p, b, f, v, w, m, h/ and th voice
• Step II /t, d, l, n, s, z/, y, sh, and zh
• Step III /k, g, r/, ng, j, and ch
• Based on viseme, not phoneme

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The 8s proposed for use with children with
CIs

• The Early 8 /m, b, r, w, d, p, h/ and y
• mastery clustered around 3.0
• The Middle 8 /t, k, g, f, v/, ng, ch, and
  j
• mastery clustered around 3.0-4.0, 5.6-7.0
• The Late 8 /s, z, l, r/, sh, th( voice),
  zh
• mastery clustered around 5.6-8.0
• Lof, 2004

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Tips

• Use visual information
• Use tactile cues
• Use multimodalities
• Focus on functional words- social, high value
  (gets or gives information)

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Tools

• HELP for articulation
• LiPS
• Webber cards
• Internet
• http//www.uiowa.edu/7Eacadtech/phonetics/

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Developing oral language

• Common areas of deficit
• Semantics
• Morphology
• Syntax
• Abstract Language

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Vocabulary

• Focus on abstract words/concepts
• Teach function words
• Pre-teach vocabulary
• Expand with multiple meaning words- learn new
  meaning for known words/concepts
• Expand with synonyms/antonyms

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Morphology

• Focus on elements that are not stressed in oral
  production
• Word endings- plurals, verb tenses
• Prefixes, suffixes (teach meaning)

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Syntax

• Acoustic highlighting- non-stressed words that
  provide information
• Focus on language expansion- key words/concepts
• Work on increasing complexity of sentence
  structures- relative clauses, passive voice

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Abstract Language

• Idioms, Metaphors
• Implied/Inferred Meaning
• What is not stated

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Tools

• HELP series
• No Glamour series

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REMEMBER

• Each child is an individual
• Treat the whole child

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References

• Cole, E.B. Flexor, C. (2007). Children with
  hearing loss developing listening and talking
  birth to six. San Diego, CA Singular Publishing
• Ross, M., Brackett, D. Maxon, A. (1991).
  Assessment and management of mainstreamed
  hearing-impaired children. Austin, TX Pro-Ed.