CSD 5400 REHABILITATION PROCEDURES FOR THE HARD OF HEARING Auditory Training

This can be a child’s or an adult’s major component to an aural (re)habilitation program What is it??

Some Definitions of Auditory Training Goldstein (1939) Auditory training involves a development and/or improvement in the ability to discriminate various properties of speech and nonspeech sounds Carhart (1960) Auditory training is a process of teaching hearing impaired listeners to take full advantage of all available auditory cues Erber (1982) Auditory training is helping kids to acquire many of the auditory perception abilities that normal hearing kids acquire naturally without intervention

Primary Objectives of Auditory Training Learning to maximize the use of acoustic cues available for speech perception Adjusting to and making maximum use of amplification These objectives are especially critical with cochlear implant recipients

Some Additional Comments… Auditory training is not designed to change sensitivity, but rather to make maximal use of audible sounds Accurate assessment of speech understanding is important Adults NST, CCT, W-22, NU-6, SPIN, SIN, CID Everyday Sentences Kids WIPI, PB-50, NU-CHIPS, Sound Effects Recognition Test Ling Six Sound Test Procedure using the 6 sounds /a/, /u/, /i/, /sh/, /s/, /m/

Some Additional Comments… Specific goals and procedures may vary depending on whether the client is an adult or child, but these three things are common to all 1. Appropriate amplification is basic to the process 2. Residual hearing is maximized, either as a primary means of reception or as a supplement to visual communication 3. Auditory training must involve the use of meaningful dialogue representative of the messages the client will encounter in their academic, work, home, and social environment

Auditory Skill Development in Children Most traditional approaches to auditory training use this hierarchy of auditory skill development Awareness--is a sound present? Discrimination-are sounds the same? Identification-recognizing and identifying sounds Comprehension- understanding the message on a cognitive and linguistic level

Auditory Training Activities for Children Auditory training activities that are appropriate for each stage of auditory skill development

Popular and Current Auditory Training Approaches for Kids DASL II SKI-HI SPICE

DASL II (1994) Developmental Approach to Successful Listening (II) Sequential, highly structured auditory training program Can be used with any age Most often used with preschool and school-age kids using hearing aids or cochlear implants

Auditory Hierarchy of the DASL II Sound awareness Basic skills (detection, discrimination) of both environmental and speech sounds Phonetic listening Exposure to the fundamental aspects of speech perception Duration, intensity, pitch, rate Discrimination and identification of vowels and consonants in isolation and in words Auditory Comprehension Discrimination of common words to the comprehension of complex verbal messages in everyday settings

SKI-HI (1985) SKI-HI is a comprehensive identification and home intervention treatment plan for hearing impaired infants and young children and their families Many SLPs and audiologists use the developmentally based auditory stimulation and training program that is included in the treatment plan

SKI-HI The program moves the child through these eleven auditory skills in four phases Notice that as you move through the different skill levels, the auditory behavior becomes more complex

Sample SKI-HI Lesson Here’s a sample lesson plan for Skill 3, recognizing objects and events from a sound source

Speech Perception Instructional Curriculum and Evaluation Goals and Objectives for: Detection Awareness and responsiveness to speech Suprasegmental perception Gross variations in duration, stress, intonation Vowel and consonant perception Connected Speech Activities include combined auditory and visual cues and auditory cues alone Popular as a cochlear implant auditory training program

Summary Remarks of Auditory Training with Children Auditory training philosophies and methodologies have enjoyed a resurgence through the advancement of conventional hearing aids and cochlear implants Before implementing any one plan, you need to consider the child’s language development stage and characteristics of their hearing loss (audibility) This should be a multi-sensory approach Visual cues should be emphasized as well as auditory cues

Auditory Training With Adults Major difference in goals Auditory training with kids has a developmental goal Auditory training goal for adults is remediation Two general types of activities Drill on auditory or auditory/visual stimuli Adjustment to use of amplification

Activities for Reinforcing Auditory Discrimination Minimal pairs-- sets of words that differ by only one phoneme Discriminating (same or different) Identifying (pointing) Producing (saying aloud) Auditory memory drills Closed-set lists (numbers, days of the week, months of the year, names) Exercises in intonation “when will it open” Adjust the accent word and talk about any change in meaning

Listening Experiences With Hearing Aids It’s useful to proceed gradually in adjusting to hearing aid use and to discuss with your clients their ability to assess the relative complexity of everyday listening situations using this kind of hierarchy

Guidelines for Adjusting to Hearing Aid Use The adjustment period should take 2-4 weeks