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Introduction to Aural Rehabilitation

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Presentation on theme: "Introduction to Aural Rehabilitation"— Presentation transcript:

1 Introduction to Aural Rehabilitation
Lisa Bowers, Ph.D. CCC-SLP

2 Audiologic Rehabilitation Services in the School Setting
Chapter Eight

3 Creation of an Individual(ized) Education Plan (IEP)
Not all children with hearing loss receive an IEP Reserved for children performing below grade level and experiencing speech/language difficulties 504 Plan Child does not need specialized instruction or support No Special Ed Courses Child needs accommodations to have access to education FM System Hearing Aids Preferential Seating Modification vs. Accommodations

4 IEP starts at age 3 and goes through age 21
Early Intervention is from Birth to 3 (IFSP) School-New Multidisciplinary Team Special Ed Teacher General Ed Teacher Administrator must be invited Depending on what services the child is eligible for—different people will be the “Primary” on the IEP

5 Individualized Education Plan (IEP)
Should include the following: Family’s preferred mode of communication Child’s current level of performance Present Level Child’s strengths Always start off with a strength statement Child’s linguistic needs Academic progress Social/emotional needs Appropriate accommodations to ensure learning

6 Outline of an IEP List of things that should be included in a formal IEP
1) Statement of present level of performance 2) Statement of annual goals 3) Short-term instructional objectives 4) Special Education and related services to be provided 5) Extent of participation in the regular educational program 6) Projected date for services to begin 7) Anticipated duration of services 8) Appropriate criteria to determine if objectives are achieved IEP meeting once a year Eligibility diagnostic every 3 years

7 9) Evaluation procedures to determine if objectives are achieved
10) Schedules for review 11) Assessment information 12) Placement justification statement 13) Statement of how special education services are tied to the regular education program Least restricted environment-Placement Justification IEP Forms and Templates differ from county to county

8 Example IEP - includes current status, annual goals and short-term objectives
Domain Status Annual Goal Short-term Objective Audiologic Can discriminate two utterances that differ in syllable length and intonation, such as “Hello” from “How are you?” To achieve closed-set identification of monosyllabic everyday words Will correctly identify a spoken word when presented in the context of four then six alternatives with 80% accuracy Language Does not use bound morphemes such as –ed or -ing To establish consistent use of word endings in expressive and written communication Will demonstrate use of past tense endings in 80% of written samples and in 70% of spontaneous and spoken language samples Speech Neutralizes vowels and omits final word consonants To improve speech intelligibility Will distinguish between /i/, /a/, and /u/ in imitated speech tasks with 80% accuracy, and produce final consonants in at least 50% of words spoken during a spontaneous speech task Psychosocial Does not follow classroom rules To demonstrate grade-appropriate classroom behavior Will receive positive reinforcements for adhering to classroom regulations, and accumulate 100 pts during 3 mo period Educational Reading is delayed by one grade level; can read aloud but has reduced comprehension To improve reading comprehension Will demonstrate comprehension on 85% of grade-appropriate reading samples Written in a way so that another person could come up with a procedure to work on goals/objectives if you’re absent

9 Goals and Objectives REMEMBER, Goal is the desired aim or outcome and objective is a measurable result expected within a particular time period SMART

10 Role of the Audiologist
Test hearing and speech. Maintain listening device and ALDs. Assess central auditory function. Assess classroom acoustics and make recommendations. Provide direct speech perception training. Consult with multidisciplinary team. Serve as educational audiologist in school system.

11 Educator’s Role Provide academic instruction
Provide assessment and diagnosis May or may not have background in deaf education Make modifications to regular education curricula Manage learning environment Manage student behavior and social skills

12 SLP’s role

13 School and classroom placement
Direct services: SLP in Classroom Indirect services: consult with teacher and audiologist Resource: Sp. Ed. Teacher, smaller group setting Self-Contained: moderate to sever intellectual disability for academics; mainstreamed for others (recess, lunch, athletics, etc.) Becoming a thing of the past

14 Equipment every school SLP needs:
1) Hearing aid stethoscope for listening check 2) Hearing Aid Battery tester 3) Air blower to remove moisture and wax from tubing 4)Extra supplies (batteries) Hearing aids/Cis need to be checked on a daily basis

15

16 Strategies Teachers can use with HI children in classroom:
Use visual aids Get student’s attention before speaking Encourage all students to help minimize the noise level in the classroom Face student when talking and avoid covering mouth Providing handouts to provide context cues Preferential seating

17 Segmental Errors with Significant Hearing Loss
Vowels errors Neutralization and nasalization Substitutions Prolongations Consonants errors Voiced/Voiceless confusions Substitutions, omissions, and distortions Consonant cluster errors Visible consonants produced better

18 Assessment of Hearing Impaired Children
Areas of testing by SLP:

19 Speech Assessment Collect speech sample Evaluate intelligibility
Imitation or spontaneous Evaluate intelligibility Rate, record, or transcribe Method of measuring speech influences intelligibility Segmental speech production testing Suprasegmental speech production testing

20 Articulation/Phonology
Articulation: GFTA- 2 (Goldman-Fristoe Test of Articulation) -CAAP(Clinical Assessment of Articulation and Phonology) -Arizona 3 -CID Phonetic Inventory Phonology: KLPA-2(Khan-Lewis Phonological Analysis, Second Edition) HAPP-3 (Hodson Assessment of Phonological Patterns)

21 Language Assessment Language tests according to form, content, or pragmatics Form= Test for Auditory Comprehension of Lang (TACL) or Oral and Written Lang skills (OWL) Content= Peabody Picture Vocabulary Test (PPVT) Function= Pragmatic Content Analysis SKI-HI Language Development Scale The Clinical Evaluation of Language Fundamentals (CELF-4) TOUGH!! IF YOU WANT A CHILD TO QUALIFY USE THIS TEST!! Obtain language sample and analysis Type-Token Ratio (TTR) # of total words used compared to different words Mean Sentence Length (MSL) Mean # of words per sentence

22 Reading Skill Assessment
Develop instructional goals and objectives Few assessments designed for hearing loss May be different for HI students Difficult to compare how doing compared to peers Grade levels compared to hearing children Examine pre-literacy skills Reading readiness Reading and language comprehension Phonology, syntax, semantics Decoding Phonological awareness Alphabetic principles, letter knowledge, concepts about print

23 Auditory Tests Tests that focus on use of audition in language:
TACL (Test for Auditory Comprehension of Language) TARPS (Test of Auditory Reasoning and Processing Skills) TAPS-R and TAPS-UL (Test of Auditory Processing Skills) APT-HI (Auditory Perception Test for the Hearing Impaired) MUSS (Meaningful Use of Speech Scale ) TAC(Test of Auditory Comprehension)

24 Examples of Speech Therapy goals with HI child:
“Increase awareness suprasegmental aspects of speech.” “Improve speech intelligibility in spontaneous communication” “Increase vocalizations that have appropriate speech characteristics.” “Will imitate the suprasegmental variables of loudness, duration, and pitch/intonational contours.”

25 Language Therapy content, form and pragmatics are addressed in development of language intervention plan Increase or improve the following: Parent-child communication Comprehension of complex concepts Vocabulary World knowledge and self-expression Use of syntax and pragmatics Narrative skills


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