Kristina M. Blaiser, PhD, CCC-SLP Assistant Professor, Utah State University Director, Sound Beginnings

Transcription

1 Kristina M. Blaiser, PhD, CCC-SLP Assistant Professor, Utah State University Director, Sound Beginnings

2 Objectives Discuss changes in population of children with hearing loss: Impacts on speech production Current speech production assessment practices Overview of three intervention models

3 Background/History Changing population of children with hearing loss Increases in early identification Average age of identification has gone from 2 ½ years to 2 ½ months (White, Forsman, Eichwald, & Muñoz, 2010) Increases in hearing technology Digital hearing aids Cochlear implants

4 Access to sound

5 NBHS = Developmental Synchrony With early identification and access to advanced hearing technology, children can reach speech and language milestones more similar to their NH peers Developmental rather than remediation approach (Robbins, et al., 2004; Cole & Flexer, 2011)

6 Speech production: Then Centralized vowels Limited production of fricatives/high frequency sounds Syllable reduction Resonance issues

7 Speech production: Now Able to develop typical speech production over time Common developmental patterns also occur in children with hearing loss Non-developmental error patterns: initial consonant deletion, vowel substitution Similar non-developmental patterns of children with HAs and CIs. (Flipsen & Parker, 2008; Connor, Craig, Raudenbush, Heavner, & Zwolan, 2006)

8 Factors that impact speech production Access to technology Age at identification Age at implantation Duration of deafness Maximized amplification/technology

9 Ling, 2002

10 Objectives Discuss changes in population of children with hearing loss: Impacts on speech production Current speech production assessment practices Overview of three intervention models

11 Assessment of speech production Standardized assessments Goldman Fristoe (GFTA) Arizona Test of Articulation Intelligibility ratings Sentence repetition* Reading sentences* Intelligibility rating scales * Difficult to give to very young children

12 Intelligibility Intelligibility ratings based on sentence repetition or reading tasks Challenges with sentence tasks for younger children with HL (Ertmer, 2010, 2011)

13 15 children in preschool program All use Listening and Spoken Language Cross-disciplinary team (audiologists, speech language pathologists, deaf educators)

14 Articulation/Intelligibility GFTA administered to all children at the beginning of the school year Intelligibility scales completed by: Classroom teacher Graduate student (SLP) Parents Audiologist Unfamiliar listeners

15 Results: GFTA Average Standard Score: (sd= 21.30) Standard Score by Participant Standard Score

16 Percentage of Consonants Correct 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 67% 60% 57% 20% Initial Initial blends Medial Final

17 Intelligibility Scale Adapted from the Colorado Home Intervention Program (CHIP)

18 Intelligibility Scales Parents (4.92, range: 4-6, sd=.73) Audiologist (4.53, range: 2-6, sd= 1.18) Graduate students (3.93, range: 1-6, sd= 1.73) Classroom teacher (3.6, range: 2-5, sd=.98) Unfamiliar Listener (3.2, range: 1-6; sd= 1.69)

19 Interpreting results Compare information found on both standardized and non-standardized assessments Use this as a tool for communicating to parents and graduate students Look at error patters (developmental, acoustic)

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22 Communication with Audiologist Use of most recent/up-to-date technology is one of the most important factors SLPs need to be able to understand the role that acoustics play in speech production- work together to get access. Feedback and communication with audiologists is key!!

23 Objectives Discuss changes in population of children with hearing loss: Impacts on speech production Current speech production assessment practices Overview of three intervention models

24 Intervention Models 1. Ling method: Structure based on auditory development Formal and informal strategies to access a variety of vowels and consonants (including manner, voicing, placement) 2. Intelligibility method: Using words which get multiple opportunities for practice Targeting a wide variety of consonants in meaningful contexts 3. Developmental method: Using speech production milestones Encouraging parent-child interactions and vocalizations

25 In summary Changes in population of children with hearing loss: Impacts on speech production Current speech production assessment practices should include a combination of standardized and non-standardized assessments Overview of three intervention models: Vary by provider and child/family

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