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69 Cards in this Set
- Front
- Back
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Hearing Impaired
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refers to being deaf or hard of hearing.
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The Greater The Loss
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the greater the difficulty the child will have with verbal communication and understanding auditory information.
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Hard of Hearing
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a loss between 16 and 75 decibels. It is associated with varying degrees of speech and language impairment
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deaf
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hearing impairment greater than 75 dB. People who are categorized as deaf can't understand conversational speech. they can't hear it.
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Deaf (capital D)
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refers to identity in the deaf culture. Considering yourself a member of the deaf culture. The community is proud of who they are, don't want to hide their impairment or be condescended to. Don't assume someone in the Deaf community has cognitive impairments. Treat them like a normal individual.
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Congenital
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the hearing loss was present at birth.
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Acquired
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contracted or gained after birth
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Prelingual Deafness
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the hearing loss occurs before you acquire language and speech
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postlingual deafness
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the hearing loss occurs after the age of five
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Could you have an acquired prelingual hearing loss?
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Yes
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Could you have a congenital postlingual loss?
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No
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Prognosis
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factors that can predict becoming a successful verbal speaker and developing language skills (receptive and expressive). this will decide where we can get in therapy.
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Cognitive
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children who have a congenital loss do not have as good a prognosis for developing speech and language skills. An acquired loss provides some exposure to language.
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prelingual
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has a poorer prognosis than post lingual
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Quality of Services
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Akron/Canton is great. Other areas in Ohio are not as good. Quality of intervention varies throughout the United States.
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Support From Parents
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some parents are able to embrace their child's disability, and do whatever it takes to support their children to help them develop speech and language skills. Some parents do not make the effort, which makes communication for the child very difficult. This support is critical.
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Visual and Hearing Impairment
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this will make it very difficult to gain speech/language skills.
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Presence of Other Disabling Conditions
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will make things more difficult
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Universal Newborn Hearing Screening
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when children are little they don't do very much. it is very difficult to identify a hearing loss. if this is a first child, parents won't know that the child is not performing in ways they should expect. many children are not identified until they enter school at the age of five.
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HL Articulation and Phonology
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varying degrees of speech impairment.
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HL Difficulty With Frequency of Sounds
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high frequency sounds are harder to hear. the intensity is less, and certain sounds are omitted or distorted. /s, f, sh, z/
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Vowel Distortions
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vowels are distorted
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Unique Prosody
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can be monotone or flat; highly variable
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HL - General Characteristics of Speech and Language
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Articulation/Phonology
Difficulty with High Frequency Vowel Distortions Unique Prosody |
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Hypernasality
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this can indicate hearing impaired.
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HL - Semantics
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Limited Vocabulary
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HL - Syntax
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Fewer sentence types
shorter and less complex sentences difficulty comprehending complex syntax |
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Morphology
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omission or inconsistent use of bound morphemes (can't hear them)
plurals, possessives, verb-tenses-markers at ends of words |
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HL - Reading and Writing
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reading abilities are depressed
writing reflects oral expression |
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HL - Pragmatics
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difficulty with communication repair
difficulty with slang, recognizing nuances of conversation |
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HL and Language Impairment
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therapy techniques will e very similar to those for children with LI. If may be like working with a CLD student; we are going to make accommodations.
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Intervention for Hearing Loss
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we have to expose the child to sound. refer the child to audiologist, ENT, or surgeon to help them.
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The Ideal (children with HL)
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Identification through UNBHS before one year of age.
Fit for hearing aid for first 12 months and early intervention Cochlear Implant about about 1 year (not always possible) The earlier you identify the better |
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Cochlear Implant Outcomes
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children successfuly implanted early will achieve near identical speech and language skills to children with normal hearing.
the earlier the implant the better the outcome for reading ability. nonverbal intelligence ability contributes to successful outcome |
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Not Every Child is a Candidate for Cochlear Implants
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some will have to rely on hearing aids, and some will rely on a different philosophy. This means there will be residual difficulties with language skills.
We do know that once a person receives a cochlear implant you have to be taught to hear and listen, and how to recognize sounds. |
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Children With Higher Nonverbal Intelligence
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will have a more successful outcome
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Intervention Approaches for HL
Auditory/Verbal |
Use amplification to tap residual hearing. This says that even children with very significant hearing loss, we are going to try to tap the auditory information they can receive. Our plan is for them to be able to function in society; listening and speaking as typical children do. GOAL: verbal communication Integration into mainstream culture |
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Intervention Approaches for HL
Manual |
the focus will be on nonverbal signed communication.
Integration into deaf culture American Sign Language |
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So the Intervention Approaches for those with Hearing Loss is
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Auditory/Verbal
Manual OR Total Communication |
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Total Communication
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the best of both worlds; a little bith of everything could help, so let's find out what works.
combination of auditory/verbal, and manual. |
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Signing Exact English
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not sign language; this is a communication system that follows the rules of our language. This focuses on meaning and expressing meaning.
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Augmentative and Alternative Communication
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Augmentative: to supplement
Alternative: to find a different path |
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AAC
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this is used by people who some or all of the time can't rely on their speech. Its best thought of as a replacement for those who can't rely on their speech output.
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An AAC System
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integrates speech, gestures, symbols, and maybe a device. It will incorporate all of these items.
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Partner Assisted Scanning
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this is very difficult for those who don't know how to use the board.
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Are there pre-requisites to using AAC?
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NO pre-requisites. This should be tried out with people who are unable to communicate. You're going to give them a chance.
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Unaided
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nonverbal, natural, manual signs, and American Sign Language. No device.
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Aided
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require additional external support. Picture cards, computer, electronic advice, etc.
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Low (Light) Tech
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cards on a velcro board, picture symbols, photos, written word, anything non-electronic. yo might have a battery operated device. Inexpensive. You are creating what the person is going to say.
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High Tech
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this will involve a computer, or a dedicated AAC advice (bubbles.
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Direct Selection
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pushing the button, and the device will say what you want it to say. You have to be able to do this with a finger, eye gaze, or with a pointer attached to the arm.
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Scanning
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alternative access method, when direct selection is not possible. this is much slower. By sound/light. User would use a switch, and click when it was a row that has the picture wanted.
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How do I know when AAC is right for a student?
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AAC is an option; not a primary means. You will not have hundreds of kids on your caseload using AAC. Being verbal along with AAC is very important.
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How many people using AAC?
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About 2 million children/adults (total) use AAC devices in the U.S.
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When do we suggest AAC?
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when the child presents wish a severe expressive language impairment that he or she can't express their basic needs and wants, or if they have such a significant problem that its interfering with their ability to develop language.
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Team Approach AAC
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a team or group of professionals make the decision. A physical/occupational therapist may be involved with the decision.
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How should I approach the parents about an AAC device?
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the use of AAC encourages children to be verbal.
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Respect Hopes and Dreams
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if the parents hope that their child is going to talk someday, we are going to tell them that this is the first best choice.
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Development is a Process
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we can't expect for children to start with immediate language; we have to give the parents a realistic expectation as far as how a child will follow typical guidelines.
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Positive Prognosticators
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normal cognition, vision and hearing are okay, physical ability, direct select.
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Negative Prognosticators
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impoverished environment, don't attend when their name is called, or to things in the environment. no interaction.
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Share Existing Research Support
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telling the parents about studies that have been done in parent-friendly language. Encourage them to talk with other families who have a child using AAC. This can make all the difference.
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Medicaid
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will cover the cost of an AAC device every seven years.
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Low Tech Advantages and Disadvantages
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Inexpensive
Tailored to individual/situation Limited vocabulary |
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High-Tech Advantages and Disadvantages
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Voice output
the child can access the computer for reading and writing Expensive Training and Integration; adults will be hardest to train. |
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Purpose of Intervention Adolescents
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teaching compensatory strategies
accommodating and modifications BOTH |
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Basic Approaches Adolescents
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Functional; academically, socially, or vocationally related.
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Factors to Consider; Adolescents
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will depend on the type of model used.
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Type of Reinforcement: Adolescents
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Secondary
Specific Information Natural Reinforcement |
