A Road Map to Listening and Spoken Language ELIZABETH GAFFNEY, LSLS CERT. AVED
Disclaimer Elizabeth Gaffney, M.E.D, LSLS Cert AVEd is co-author of Auditory Verbal Strategies to Build Listening and Spoken Language Skills hosted online at www.auditory-verbal-mentoring.com. This presentation is not produced or owned by Cypress-Fairbanks ISD. This presentation is the property of Elizabeth Gaffney, LSLS Cert. AVEd.
Learner Outcomes Participants will be able to describe the principles and goals of the Listening and Spoken Language approach. Participants will be able to describe and demonstrate some Auditory Verbal strategies. Participants will be able to describe how listening and spoken language can be integrated into daily routines.
Please remember Words are powerful and need to be chosen carefully. I have tried to use the most current terminology commonly accepted in the field and hope to continue that in our discussion today.
What is your perception of Listening and Spoken Language? Sign language is looked on with indifference or disfavor, since it isn t a "hearing" means of communication. Speech is "normal," signing is not. The hand cue The child is cheated of a real education while forced to endure a tedious and unproductive regimen of speech therapy and listening-skill training. It helps children integrate auditory information and increase their auditory processing and spoken language. The eradication of sign language is important to oral mission. Oralists make money by mis-educating the parents of Deaf children and making them get cochlear implants.
Overall, choice of communication opportunities is the choice of the family and the individual.
Common Terms Auditory-oral: teaches deaf children to use their residual hearing in combination with speech reading and contextual cues to better comprehend and use spoken language. (Jean Moog) Aural-oral: leads to oral language or speech by developing the child's usable hearing to understand spoken language and by developing speech to express spoken language. (Geri Nelson) Auditory Verbal: developmental approach which follows developmental milestones by introducing skills at the ages and stages when children s brains are primed to learn. (Hearing First)
What is the bottom line? Listening and Spoken Language is the development of spoken language through audition supported by hearing technologies.
Timeline of the development of Listening and Spoken Language 1868: Alexander Graham Bell begins teaching children with hearing loss in London, England 1895: Victor Urbantschitsch wrote "Auditory Training for Deaf Mutism and Acquired Deafness 1898: the first electric hearing aid was created by Miller Reese Hutchison 1937: first wearable hearing aid available in the United States 1939: Max Goldstein published his "acoustic method" 1953: Doreen Pollack began developing her "acoupedic program" published in 1970 1972: the first single channel cochlear implant was introduced 1978: the International Committee on Auditory Verbal Communication was formed 1984: Cochlear Corporation introduced the first multi channel cochlear implant 1994: the certification exam for Auditory Verbal Therapists was created 1995: Oticon developed the first digital hearing aid
Listening and Spoken Language Today 2 of every 1,000 babies born in the US is born with a detectable hearing loss in one or both ears. https://www.nidcd.nih.gov/health/statistics/ quick-statistics-hearing 95% of babies born with hearing loss are born to hearing parents. https://report.nih.gov/nihfactsheets/viewf actsheet.aspx?csid=104
Who benefits from Listening and Spoken Language? Many children with hearing loss benefit from instruction in listening and spoken language skills, regardless of primary communication mode. Intrinsic Factors Age Duration of hearing loss Medical findings Cognition Extrinsic Factors Functional use of amplification Communicative intent Availability of services Parental involvement MHL/UHL Late identified
Dismiss? Discharge: the treatment or intervention has produced the intended results of the specific treatment is inappropriate. Child has: Age-appropriate language Skills to listen in noise Skills to listen to a rapid rate of speech with little visual support
So what is the Listening and Spoken Language approach? Includes both AVT (therapy) and AVEd (classroom instruction). Professionals agree that no one system or approach is right for all children. The primary goal of the Listening and Spoken language approach is for children to learn to listen and talk with conversational competence.
Sessions are diagnostic to evaluate progress and skills of both the child AND parents. Goals for the child are set by professionals and parents and should be considered functional in the real world environment. Children learn language most easily when they are actively engaged in relaxed meaningful interactions with supportive caregivers.
The Principles of Listening and Spoken Language These principles are standards for Certified Auditory Verbal Therapists and Auditory Verbal Educators across the world AG Bell Academy, 2012.
#1 Promote early diagnosis of hearing loss in newborns, infants, toddlers, and young children, followed by immediate audiologic management and Auditory-Verbal therapy. The earlier intervention starts, the better. Universal Newborn Hearing Screening Parents should receive accurate, unbiased information about their child's hearing loss as soon as possible 1:3:6 http://www.jcih.org/execsummfinal.pdf
1:3:6 is only possible if there is successful collaboration between Government Agencies CDC Health Resources and Services Administration (HRSA), and USPSTF) jurisdictional EHDI programs SACHDNC 1:3:6 Professional Organizations the American Academy of Audiology the American Academy of Otolaryngology- Head and Neck Surgery the American Academy of Pediatrics the American Speech-Language-Hearing Association Families Service Providers Teachers of the Deaf, ECI Providers Speech-Language Pathologists Audiologists Pediatricians ENTs Without the timely receipt of recommended follow-up services, the benefits of newborn hearing screening can be severely diminished.
#2 Recommend immediate assessment and use of appropriate, state-of-the-art hearing technology to obtain maximum benefits of auditory stimulation. Simply having technology does not mean it is appropriately set or worn. Cannot assume that a child's listening age corresponds to the length of time the child has had technology.
#3 Guide and coach parents to help their child use hearing as the primary sensory modality in developing listening and spoken language. Focus on learning to understand spoken language without sign or formal speechreading training. Visual Cues are appropriate when a child is without optimal access to all sounds of speech. Rule of Thumb: three attempts at understanding an auditory cue, then "sandwich" with auditory-visual-auditory input.
Does a Listening and Spoken Language program advocate the complete absence of visual input? No! It advocates the use of natural gestures, body language, and touch as part of a natural communication system. The emphasis is on audition as the primary sense for learning spoken language.
#4 Guide and coach parents to become the primary facilitators of their child's listening and spoken language development through active consistent participation in individualized Auditory-Verbal therapy. Children naturally learn language from the people around them. Every day and every experience can be an opportunity for language learning.
#5 Guide and coach parents to create environments that support listening for the acquisition of spoken language throughout the child's daily activities What does a "good" listening environment look like? Is the team using the FM system reliably? Does the child know how to get support in difficult listening environments?
A Good Listening Environment Optimal Position Classroom Acoustics Background noise Access to speaker s face if necessary
Use of FM School, home, outings Increases SNR Teach independence and advocacy
Difficult Listening Environments Family celebrations General education, large group, programs Field day, Boosterthon Zoo, park, pool, field trips, grocery store
#6 Guide and coach parents to help their child integrate listening and spoken language into all aspects of the child's life Listening and Spoken Language is a lifestyle! Strategies should be used throughout all aspects of daily life by all people the child interacts with.
#7 Guide and coach parents to use natural developmental patterns of audition, speech, language, cognition, and communication. Emphasis is on the developmental appropriateness of target skills. Children learn best through play based, every day activities.
#8 Guide and coach parents to help their child self-monitor spoken language through listening. What is an auditory sandwich? What is acoustic highlighting? What is the auditory feedback loop?
Auditory Sandwich 1) Auditory input is given first to ensure the focus is on listening to gain meaning 2) Visual/tactile input is added, when appropriate (may be eye gaze, pointing, showing a toy, etc.) 3) Auditory input is repeated again without the visual input
Acoustic Highlighting can be done in several ways: speak the target with more emphasis pause slightly before saying the target whisper the target add duration to a target
Auditory Feedback Loop Strategies that help build this skill: Repetition Whisper
#9 Administer ongoing formal and informal diagnostic assessments to develop individualized Auditory-Verbal treatment plans, to monitor progress and to evaluate the effectiveness of the plans for the child and family. Parents should be consulted frequently, with open dialogue. Have parent-only sessions. Ask parents open ended questions.
#10 Promote education in regular schools with peers who have typical hearing and with appropriate services from early childhood onwards. There are a variety of educational opportunities that vary by location. The trend in Deaf Education is turning towards mainstreaming in general education.
So the emphasis is on coaching the parent why? Over a period of three days, learning retention is as follows: % of what one reads % of what one hears % of what one sees % of what one sees and hears % of what one discusses % of what one experiences % of what one teaches to others
So the emphasis is on coaching the parent why? Family is one of the most influential forces in human life. How the family is nurtured and supported by professionals significantly affects the child's entire development. Active parent engagement should be a CORNERSTONE of a Listening and Spoken Language program.
Coaching Model 1) Explain strategy/target and rationale 2) Model and demonstrate the target strategy 3) Invite the parent to participate and demonstrate with the child 4) Provide feedback and validation to the parent 5) Plan for carryover to daily routines An Inter-Disciplinary Model To Offer Babies Early Auditory Habilitation, Education, and Development- Illinois State University
So the emphasis is on coaching the parent what do we coach them to do? Model and stimulate language Integrate targets into daily routines Partner with professionals Inform team of child's interests and abilities Interpret the child's early communication Manage behavior Record and discuss progress Make informed decisions Advocate for their child and family Be knowledgeable about child development Use Auditory Verbal Strategies
Auditory Verbal Strategies What? Why? How? Not only does the LSLS need to have knowledge of the what, how, when and why of strategies, but they need the ability to transfer their own knowledge to the parents through coaching.
Auditory Verbal Strategies to build Listening and Spoken Language Skills Auditory Closure Motherese Auditory First Repetition Auditory Sandwich Self Talk/Parallel Talk Expectant Look Wait Time Joint Attention Whisper Positioning Expand Model language Sabotage Auditory Bombardment Ask What did you hear? Acoustic Highlighting Open Ended Questions
Remember listening and spoken language skills are developed through natural interaction about things that are meaningful and interesting to the child.
Why should listening and spoken language be integrated into daily routines? 95% of what a child learns is learned at home. Armstrong, T. (1991) Intervention time Waking hours at home
How can listening and spoken language be integrated into daily routines? Use the zone of proximal development. Model strategies and use role release with parents. Ask open ended questions about implementing targets in other environments "How might you do this at home?. View every activity as a language opportunity.
Let s review What is the Listening and Spoken Language approach? Who can benefit from Listening and Spoken Language? What are some Auditory Verbal strategies and how are they used? How can listening and spoken language be integrated into daily routines?
References Fickenscher, S., & Gaffney, E. Auditory Verbal Strategies to Build Listening and Spoken Language Skills. Retrieved from http://www.auditory-verbal-mentoring.com Beck, D. L., & Flexer, C. (2011). Listening is where hearing meets brain... in children and adults. Hearing Review, 18(2), 30-35. Cole, E. B., & Flexer, C. A. (2011). Children with hearing loss: Developing listening and talking, birth to six. Plural Pub.. Crandell, C. C., & Smaldino, J. J. (2000). Classroom acoustics for children with normal hearing and with hearing impairment. Language, speech, and hearing services in schools, 31(4), 362. Dunst, C.J., & Trivette, C.M. (1997). Early intervention with young at-risk children and their families, In Ammerman, R., and Hersen, M. (eds.), Handbook of prevention and treatment with children and adolescents: Intervention in the real world (pp. 157-180). New York, NY: John Wiley & Sons. Estabrooks, W. (2006). Auditory-verbal therapy and practice. Washington, DC: Alexander Graham Bell Association for the Deaf and Hard of Hearing, Inc Easterbrooks, S. R., & Estes, E. L. (2007). Helping deaf and hard of hearing students to use spoken language: A guide for educators and families. Corwin Press Flexer, C., Hewitt, J., Madell, J. (2014) Alexander Graham Bell Association Recommended Protocol for Audiological Assessment, Hear Aid and Cochlear Implant Evaluation, and Follow Up. Retrieved from: http://www.agbell.org/protocol.audiological.assessment/ Listen, Learn & Talk (2005). Babies Babble. Cochlear Ltd. http://www.cochlear.com/wps/wcm/connect/in/home/support/rehabilitationresources/earlyintervention/listen-learn-and-talk Simser, J. Auditory-Verbal Techniques and Hierarchies. Retrieved from First Years Professional Development Through Distance Education: http://firstyears.org/c4/u2/avtsimser.pdf
Elizabeth Gaffney, M.E.D., LSLS Cert. AVEd elizabeth.r.gaffney@gmail.com