The post Lost in the Noise: The Learning Gap for Deaf and Hard of Hearing Children first appeared on Supporting Success For Children With Hearing Loss.

Environmental acoustics should be considered prior to the start of a group learning session. If possible, students with hearing loss should sit with their backs towards a wall or barrier. This allows the students to avoid unnecessary background noise from behind. Visual cues from the speaker can also be very helpful when listening in challenging environments. That being said, lighting should be altered to allow for consistent access to visual cues, and the student with hearing loss should be in a position where he or she has consistent visual access to anyone in the group who may be speaking.  Windows should be avoided, when possible, to reduce the possibility of a glare that would hinder consistent visual cues. Lastly, an Educational Audiologist may be able to assess the environment to determine the extent to which carpets, draperies, or acoustic tiling may help to reduce reverberation and background noise in the learning space.

Utilizing a child’s hearing devices and introducing hearing assistive technologies can also prove beneficial during group listening. Most hearing aids and cochlear implants either automatically manipulate or allow users to manually manipulate microphone directionality. The goal of this would be to have the device microphones focus on picking up the primary signal of interest (e.g., talker) as opposed to background noise. Students can ask their hearing healthcare provider to review these options with them.

Furthermore, assistive listening devices can significantly enhance listening in adverse environments for individuals with hearing loss by sending the primary signal of interest directly to their hearing devices. For instance, if the group is watching a video, the audio signal may be sent directly from the video source to the student’s hearing devices so that effects of distance, noise, and reverberation do not prevent them from hearing it clearly. Many times, hearing aids and cochlear implants have compatible remote microphones that may be useful in group situations. Depending on the microphones’ capabilities, the student may have to ask each individual to hold or wear the microphone as he or she is presenting, or, they may be able to lay the device horizontally on a table in order to capture the voice of whomever is speaking. 

Lastly, optimal communication strategies should always be employed when participating in group activities. Examples of optimal communication strategies include: asking for one person to speak at a time, asking the speaker to face the individual with hearing loss when speaking, asking for clarification and repetition when needed, and asking for other group members to remain still and quiet when someone is speaking. In cases where a single microphone is being used to project a speaker’s voice in a group setting, it is helpful for the speaker to repeat individual questions or comments from group members who may be located further from the microphone. Individuals with hearing loss should also be mindful of reducing background noise as much as possible in their listening environment by sitting farther away from doors and other possible areas associated with noise (e.g., windows facing a busy street or playground).

In summary, group listening is still an area that can present many challenges for individuals with hearing loss. To optimize listening in these situations, the person with hearing loss can manipulate their physical environment, utilize different programming on their devices or introduce assistive listening devices, and implement optimal communication strategies. Success for children with hearing loss in group settings can be achieved with preparation and participation from not only the individuals with hearing loss themselves, but also from their peers and educators!

Author: Tessa Wirt, AuD. DePaul School for Hearing and Speech

Click here to download this article

The post Better Listening in Group Settings first appeared on Supporting Success For Children With Hearing Loss.

We learn language by hearing it from the moment of birth. Even after our language has fully developed, we continue to learn new words and new ways of expressing ideas. This learning happens largely through our sense of hearing. Much of what we know about our world is learned by overhearing the conversations of those around us, or through the myriad of audio streams that follow us through our day. When a child is born with reduced hearing, the development of language, vocabulary, and world knowledge can be affected.

Hearing aids and other devices can provide improved access to spoken language for children with hearing loss. Auditory aids, however, do not fix hearing to the degree that eyeglasses can ‘fix’ a vision deficit. What a student hears through an auditory aid is likely not what you and I hear through the device. A student may hear what is said in the classroom, but may not understand the message due to many factors, such as incomplete access to speech sounds, background noise, unfamiliar vocabulary, delayed language development or a lack of familiarity with the person talking.

Many children can improve their understanding of spoken language as they become familiar with their hearing loss and learn listening strategies. Practice with specific listening skills may further increase the benefit a student receives from hearing aids or cochlear implants.

Information is provided within this section of the website on auditory development, listening skills and more.

Learning to Listen – why is it important?

• A child needs to be able to interpret and attach meaning to information they receive from what they have heard and formulate a response
• Attaching meaning depends on their lexicon (vocabulary ‘dictionary’) helped by their ability to visualize
• Listening comprehension is a key to reading comprehension and written composition
• Listening comprehension = language ability + background knowledge
• Listening Comprehension x Decoding = Reading Comprehension
• It all starts with being able to listen precisely!

Nancy Caleffe-Schenck, well known Auditory Verbal Therapist and Listening and Spoken Language Specialist has given permission to share her Activities for Listening and Learning (ALL).  The ALL is unique in that it provides not only goals in the auditory development area but also for communication, reading and vocabulary.  I also have adapted this into an ALL Goal Bank and Performance Checklist format, with Nancy’s permission, so that it can be easily used for goal-setting during IEP team meetings and to monitor progress.

Auditory Skill Development in Early Childhood

Auditory skills of children who are hard of hearing do not develop at the same rate or in the same way without specific teaching. The following checklists will guide interventionists and family members as they assess and build these important skills.

Sound Foundation for Babies and Toddlers Cochlear Corporation has a suite of resources to assist with listening and language development from birth to 6 years of age. Free download! The Sound Foundation for Babies resources is an awesome resource by Cheryl L. Dickson, that offers week by week activities that can be shared with families as a recommended website, or to augment activities discussed during early intervention. Each week includes a video tutorial and attention specific to audition, receptive/expressive language, speech, songs, rhymes, etc. Sound Foundation for Toddlers was created by Nancy Caleffe-Schenk. Thanks to Cheryl and Nancy for these powerful and easy-to-use materials!

Auditory Skills Checklist  Auditory skills develop sequentially in a hierarchy of increasing complexity. Most children without hearing loss will develop all but the most complex listening tasks by school entry, improving in their ability to listen in noise as their brain matures – until age 13-15 years. Children with hearing loss typically require attention to auditory skill development if they are to learn all of the skills in the hierarchy, especially if they are to compete with typically hearing peers in a classroom. Good technology and consistent use is a critical factor in the natural development of auditory skills, but cannot guarantee progress of skill development without specific attention. Early literacy is primarily based on auditory skills making attention in this area a priority. The Auditory Skills Checklist is a simplified summary of auditory skills, broken into 10 levels, each with 4 skills and examples. It is useful to track progress on auditory development as a part of early intervention over time.

Auditory Skills Checklist – Cincinnati Children’s Hospital Medical Center is in an interview format that asks parents to rate skills in terms of whether their child often, sometimes or never/rarely displays use of the skill. Examples are provided to make the questions easy to understand. A numeric score is obtained so that use of this checklist over time will show progress in achieving the skills. Thanks to the Cincinnati Children’s Hospital for sharing this resource for use on Supporting Success!

Functional Auditory Performance Indicators (FAPI) was developed in Colorado by Arlene Stredler-Brown and Cheryl DeConde Johnson (2001, 2003) and provides a step-by-step checklist of what to look for, and what to work on next, in developing functional auditory skills. A ‘staple’ in many early intervention and early childhood programs for children with hearing loss.

Go here for Listening Training Resources

Track a Listening Child is one of the Cochlear Corporation suite of resources for 0-36 months. Attractive and engaging for families.

The post Listening (Auditory Skills) Development first appeared on Supporting Success For Children With Hearing Loss.

 

Individuals with hearing loss must put forth more “listening effort” and cognitive resources to attend to auditory information, which can be exhausting. The repeated need for extra listening effort in challenging situations can lead to listening-related fatigue. For children, severe fatigue is associated with increased stress, poorer performance in school, and increased absences. Educators, audiologists, and other hearing health professionals can support students dealing with listening-related fatigue. Read on to learn about how to help your student avoid or recover from listening-related fatigue.

Fatigue is often described as being extremely tired, a lack of energy, and/or a lack of motivation to continue on with a task. Intuitively, we understand that we can get worn out from time to time, from both physical tasks (e.g., running) or mental tasks (e.g., focusing all day at work). It is very common to experience this type of fatigue and healthy individuals can bounce back relatively easily with breaks or recovery periods. However, for some individuals, fatigue can be debilitating, and recovery is difficult. This is concerning as long-term outcomes related to fatigue can be negative, affecting quality of life and work performance in adults. For children, severe fatigue is associated with increased stress, poorer performance in school, and increased absences. It can also be a precursor to mental health problems in adulthood.

What does fatigue have to do with listening and children with hearing loss? Recent research has shown that even the “simple” act of listening and understanding can be exhausting. Individuals with hearing loss must put forth more “listening effort” and cognitive resources to attend to auditory information. The repeated need to expend effort to listening in challenging situations can lead to listening-related fatigue. For children with hearing loss, the school classroom and associated listening requirements can be fatiguing. We know that most modern classrooms can have poor acoustics with significant reverberation times and elevated background noise (challenge #1) and that students have to listen to multiple talkers throughout the day (challenge #2) while multi-tasking by listening and performing other functions, such as note taking (challenge #3). These factors, as well as others, may contribute to a child with hearing loss developing listening-related fatigue.

Of course, not all children experience the same challenges or have the same needs. We are interested in determining which children with hearing loss are most at risk for significant fatigue so that we can help them clinically and educationally. To do so, we have been developing pediatric fatigue questionnaires that specifically target listening-related fatigue in children. First, we wanted to better understand the concept of fatigue from children with hearing loss, their parents, and their teachers by hosting focus groups and interviews. Example quotes obtained from participants in the focus groups follow on the next page. These responses, as well as others provided by the participants, helped us to write items (i.e. questions) for our fatigue scales. While analyses are ongoing, we hope to have the Fatigue Scales available online for widespread use later in 2021.

Educators, audiologists, and other hearing health professionals can support students dealing with listening-related fatigue. Consider signs and symptoms of listening-related fatigue in your students. We found that many children did not realize they were experiencing fatigue throughout the school day. In fact,

several adults with hearing loss told us that they could not articulate their difficulties with listening-related fatigue until young adulthood.

Students may need support to better understand challenging listening situations and how to advocate for themselves, if needed. Discussing this topic with parents, teachers, and administrators is important too. The students who participated in our study felt limited in their abilities to ask for interventions, such as breaks, because of the structure of the school day. It is important for the whole team to strategize best practices to support each student.

What will help your student avoid or recover from listening-related fatigue?  Although no systematic research has been completed on listening-related fatigue interventions, there are several considerations that may be beneficial for your students.

• • Assess the student’s listening environment. Look for ways to improve acoustics by minimizing background noise or reverberation in the space. Participants repeatedly reported background noise as fatiguing.
  • Provide accommodations, such as preferential seating, captioning, or note-taking by a peer. Anything that may help reduce effort while listening could be helpful for your student.
  • Review the student’s amplification use (both personal amplification and school-owned remote microphone technology). Although research on amplification and fatigue reduction is mixed, teachers reported that students appeared less fatigued when utilizing their technology consistently.
  • Employ good communication strategies (and encourage others to do the same). Participants reported that children got fatigued more quickly when others spoke too quickly or had their back turned. Ensure the child can see the person talking.
  • Review the student’s schedule. Many teachers said the students were worn out toward the end of the day/end of the week. If you can, schedule auditory-heavy content at the beginning of the day or at a time when your student can do their best work.

• Schedule “listening breaks” so the student can intentionally turn off from listening. There is no current consensus on the duration, frequency, or type of break required. Needs may vary based on the individual student. Suggestions from participants in our study included allowing the child to rest their head on the desk, take off their device for a short period of time, complete a leisure activity that does not require listening, or complete a movement break.
• Be on the lookout for the Vanderbilt Fatigue Scales! Analyses are ongoing but we hope to have the assessments available online for widespread use later this year. Check our website for links to our publications and to keep up-to-date on the release date for the scales.

Hilary Davis is a pediatric audiologist at the Vanderbilt University Medical Center in Nashville, TN. She sees patients in the Bill Wilkerson Center, provides contract educational audiology services to local school districts, and collaborates on several research studies within the department. Her current interests are fatigue in school-age children with hearing loss and supporting educators as they work with students with hearing loss.

Click here to download this article

The post Fatigue from Listening with Hearing Loss in School first appeared on Supporting Success For Children With Hearing Loss.

What is the first step for developing auditory skills with remote techniques?

Starting any session with LING sound test is a smart idea to yield information about how the child is hearing across the speech spectrum. Conceptually, LINGs are done in order to map the stability of a student’s access to sound over the course of a treatment, between sessions and for troubleshooting. Keeping the structure of a LING check at the beginning of a session can be a good checkpoint that ensures the student is wearing devices and they are powered on.

There are multiple factors that affect audibility in the remote learning environment, such as: speaker fidelity, internet bandwidth, distraction, distance from the speaker and noise/reverberation in the listening environment. Due to these factors outside of the child’s behavior, doing the LINGs in a virtual session may produce unpredictable or inaccurate outcomes. If the child misses a LING during a virtual session it may be that the volume of the computing technology is not appropriate orbackground noise is interfering and needs to be addressed.

If the student doesn’t have anyone facilitating the session with them, educators can do the LINGs virtually with the understanding that the outcome may not be a true indicator of access to sound. Otherwise, empower the caregiver(s). This is a great time to build caregiver capacity for doing the LINGs at home, to obtain caregiver feedback on the student’s access to sound, and to talk to the caregiver about optimal acoustics. Educators may send the CID quick tip video on LINGs, spend a session (or part of one) coaching the caregiver(s) on how to do the LINGs in person with the child or, if you can, demonstrate as a first step.

Can auditory training be done via remote instruction?

Auditory skills teaching programs are offered widely by device manufacturers and other sources to encourage computer-based learning (visit your student’s device manufacturer’s website to see what they offer).  These remote learning programs are valuable tools, and they are designed and validated for computer-based learning.

Other auditory skills curricula were designed to be done face-to-face given the inherent advantage of being in the same space with the student. The purposeful engagement between the learner and the teacher toward auditory goals can be somewhat challenging during remote instruction. When we engage students in auditory skills tasks, we typically have control over a variety of factors (e.g. background noise, proximity of the student, integrity of the auditory signal). The control over these factors helps make the training verifiable. Working with students remotely takes away our control of these factors, which makes engaging in formal auditory skills teaching a challenge with non-computer-based curricula.

While using non computer-based curricula, educators should note on the rating forms that skills were worked on during virtual learning, as a referent that the skills may develop in a modified timeline. It may be useful, in the time of a pandemic, to pause the goal of formal skills training, and to consider this a great time for auditory practice.

What is auditory practice and how does it fill the need typically carved out for auditory skills learning?

Auditory practice is a way in which students can still be encouraged to practice their listening skills while in a less than optimal listening environment. It is a way to practice new listening strategies, encourage self-advocacy skills and determine what methods are effective for your student. The goal of auditory practice is to enhance listening and discriminating skills regarding the student’s own auditory environment. While we use captions throughout our lessons as a support for our students, during auditory practice, you might consider pausing them. Remember to turn them back on before transitioning to the next subject.

Auditory practice can include:

• Introducing or re-familiarizing strategies for listening and self-advocacy skills.
• Planning auditory lessons with students, including detection or hearing in noise (based on skill level).
• Identifying sounds in the student’s environment and localizing sounds.
• Using the time to build on the depth of auditory skills for one ear at a time.
• Teaching the student (and caregiver) to find a quiet listening spot. Small rooms with little reverberation are best. This includes carpeted rooms or those with soft furnishings/curtains.
• Reminding the student to ask for repetitions if needed or to use other repair strategies such as repeating what they heard (e.g., “I heard you say …,” “Could you repeat what you said after ‘___’”) and asking for specific clarification.
• Building strategies for supplementing listening with devices, such as streaming via Bluetooth.

Are there elements of formal auditory skills curricula we can use with remote learning auditory practice?

The goals and objectives within auditory skills curricula (such as CID’s SPICE and SPICE for Life) can be used to develop goals, and many of the activities within the manuals can be adapted to a remote platform by using the curricula’s resources and rating forms to track progress.

If a child is doing well following along in the session, providers could use parts of SPICE/SFL as auditory practice. Providers typically have previous knowledge of the student’s present levels. Keep in mind that error patterns, especially unusual ones from the provider’s perspective, may be a biproduct of the remote learning environment and should be taken into consideration. Elements of these curricula, however, could be coached and practiced in a remote learning environment, perhaps with the help of a caregiver.

Some skills that can be practiced from these curricula include:

• listening to a story and answering questions about it
• engaging in a conversation (practice communication repair strategies)
• recalling a set of spoken words (avoid working on plural s/z and past tense d/t as these morphemes are especially difficult to perceive through technology)
• following directions to draw a picture (e.g., “draw a round face with two blue eyes.”)

Remember, any summaries or statements about the skill or activity would need to include a caveat that these were observed during remote learning. It is feasible that the provider could encourage the caregiver(s) to find props, pictures and/or supplies in the home (or send via email as a link, PowerPoint, or GoogleDoc) that are relevant to the child’s skill level. The provider could then coach the caregiver toward eliciting student practice. The CID SPICE for Life, for example, does include Home Practice pages in the Resource Manual that may be shared with parents.

What are some ways that we can ensure students have optimal access to sound when engaging in remote leaning?

• Identify what technology is available to the student and if there are options for setting the student up with other equipment (e.g., Bluetooth speaker, streamers, direct connections or a hard-wired speaker to plug into the technology for louder, clearer sound).
• Contact an audiologist with any sound-related questions.
• Strategize for a device-listening check at the start of the day – either via LINGs (see above) or having the caregiver use monitor earphones/stethosets to listen
• Make sure fresh batteries are in place. Using technology for wireless connectivity drains device batteries faster than usual.
• Charge streamers or FM/DM systems nightly.
• Use dehumidifiers for the devices so that they are working optimally.
• Maximize the volume on computing technology as needed for best sound. There may be enhancements to download to increase the volume. The caregiver or student may be able to use a free sound-level meter app on a mobile phone to check if volume is increased. These are great skills to develop for self-advocacy.

Daily computer-based learning is now a reality for students. Although this may not be ideal for students with hearing loss, it is an opportunity to build their capacity for listening with technology. Teaching them ways their device(s) can be tiered with technology, focusing on self-advocacy skills and engaging them in real-world listening situations are skills that will be beneficial, even when typical classroom learning resumes.

Click here to download this article, including author information

The post Teaching Auditory Skills via Remote Learning first appeared on Supporting Success For Children With Hearing Loss.

Too often, however, teachers who work with these students don’t feel they have enough knowledge about which auditory skills are appropriate to practice and how those skills develop. New information recently added to the Supporting Success website can answer many of your questions: Listening (Auditory Skills) Development pages.

Why practice auditory skills?

Listening is essential to communicating. Many who write about the contribution of listening skills to school success cite a study by Wilt², which analyzed how time spent communicating is broken into different activities. Wilt found that people listen 45% of the time they spend communicating, 30 % of communication time was speaking, 16%  reading, and 9 % writing.

Listening practice can improve listening skills.   Sweetow³ reviewed dozens of studies of auditory training and found that improvements in communication strategies—and often in sentence recognition—can be expected. When using a synthetic training approach, participants listen to spoken language, often at the sentence level, and learn to use visual cues, context and knowledge of language to understand the information.

Listening practice is underrepresented in most general education curricula. Listening can be challenging for many students, and even more difficult  for students with hearing loss.  If our students are to have improve their access to communication in the classroom, discussing listening challenges and practicing listening skills must happen during their time with professionals who understand hearing loss.

Q: How can we find time to assess and practice auditory skills?

A: Apply the Speech Perception Lens to every lesson.       

Auditory speech perception is the set of skills needed to understand spoken language through listening. Improvement of speech perception can lead to better comprehension and production of spoken language. If you wonder where to find the time in your daily schedule to add auditory practice, each month the Listening Strategies article in Teacher Tools provides new ready-to-use cross-curricular activities for auditory practice while also addressing common curriculum goals.

Four abilities⁴ comprise speech perception. Listed in order of complexity:

• Detect or hear sounds
• Discriminate, or recognize how spoken utterances (e.g., phonemes, words, sentences) are different from each other
• Identify, or attach meaning to, spoken utterances, and
• Use all that auditory information to comprehend discourse such as phrases, sentences and conversations

If a teacher examines the task being asked of a student in a given lesson, she can determine what listening skills will be required for successful completion of the task. Taking this perspective can be likened to looking at the lesson through a “speech perception lens.”

Use the Speech Perception Lens for Error Analysis

Step One: Analyze the auditory task. To examine auditory tasks, looking at the first column of this table to find the complexity level of the spoken message to which the student will listen. For an early reader, a lesson on sound-letter matching will ask the student to listen to a phoneme. In a small group or partner discussion, the student will be listening to discourse.

Next, determine how the student will be responding. If the student is simply indicating that she heard something, a rare task in an educational setting, the task is one of detection. If the student is expected to repeat what was heard, the task is identification. Most educational tasks require the student to demonstrate comprehension by making a choice. The choice may be within a given set of possible answers, or it may be an open choice based on information learned. The student who hears the phoneme /m/ and is expected to point to the letter m or write it,  is showing comprehension of a phonemic relationship. The student who listens to a classmate’s opinion and then responds to show agreement or disagreement is showing comprehension of a sentence or discourse, depending on the length of the classmate’s statement.

Step Two: Know the essential features of vowels and consonants.  Vowels vary from one another based on the location in the vocal tract in which they resonate.  Vowels which resonate near one another sound similar. Consonants, however, vary based on the way in which they are produced – whether they are nasal (like /n/), require a stopping of breath (like /t/), or produce a sound caused by friction of air passing through a restricted space (like /s/).  Errors are more likely to happen when listening to sounds that are produced in the same way, like /s/ and /z/.  Read more here.

The Bottom Line: Do Something!

Professionals who work in a one-to-one or very small group session with students who have hearing loss can provide guided practice using materials from the student’s academic curriculum. In these sessions, the adult will be able to determine the possible reasons for an error and help the student find strategies to avoid that type of error in the classroom. New lessons and strategies for listening success can be found in the monthly Teacher Tools magazine.

References:

1. 1. Ferguson, M. A., & Henshaw, H. (2015). Frontiers in psychology, 6, 556.
2. 2. Miriam E. Wilt(1950) A Study of Teacher Awareness of Listening as a Factor in Elementary Education, The Journal of Educational Research, 43:8, 626-636, DOI: 1080/00220671.1950.10881817
3. 3. J Am Acad Audiol.2005 Jul-Aug;16(7):494-504. Efficacy of individual auditory training in adults: a systematic review of the evidence.
4. 4. Erber, N.P. (1982). Auditory training. Washington DC: AG Bell Association for the Deaf

The post Auditory Skill Practice – a MUST for Hard of Hearing Students first appeared on Supporting Success For Children With Hearing Loss.

Speech perception and listening accuracy cannot be assumed by looking at the audiogram – it must be assessed. Teacher’s voices, room acoustics, and classroom management vary so identifying listening challenges – and specific accommodations – needs to be done for students who are hard of hearing each school year. New information about the Listening Inventory For Education – Revised will help guide consideration of what typical listening challenges look like for students with normal hearing, so that we can better quantify these challenges for students who are hard of hearing.

Why challenged listening?

The primary difference between students with hearing loss and their typically hearing peers is that they do not access speech as fully. This reality is often unrecognized by school staff who ‘know’ that the child can hear them just fine. While all children under the age of 15 years have an immature auditory cortex, and therefore greater challenges listening as accurately as adults, those with hearing loss are more impacted.

Classrooms are often noisy and the person the child needs to hear is often more than 3 feet from the hearing aid microphones. While individuals can detect sound occurring beyond 3 feet, to truly perceive sounds like s, f, t, p (as in cat, cap, cast, calf) speech must be within the student’s listening bubble, or the range of hearing within which speech can be fully heard. 

For most classroom communication students who are hard of hearing must work harder to listen, resulting in fewer cognitive resources available to process what was said so that it can be comprehended and remembered. Because they expend more effort to listen and pay attention, they experience greater listening fatigue as compared to typically hearing peers. Greater effort for less comprehension, at a higher level of fatigue, all play a role in reducing the pace of learning and an increasing gap in achievement across school years. Refer to the Cascading Impact of Hearing Loss handout for more information.

How well a student is able to perceive speech in a classroom will impact educational performance. These impacts are often overlooked or misunderstood by school staff as they review whether it is necessary to evaluate a student with hearing loss to determine eligibility for sufficiently intensive specialized services and accommodations.

Almost 5 years ago (November 2014) the US Department of Education and US Department of Justice clarified that, under Title II of the ADA, schools are required to ensure that communication for students who are deaf and hard of hearing “are as effective as communication for others” [ADA Title II 28 C.F.R. 35.160 (a)(1)] through the provision of appropriate aids and services “affording an equal opportunity to obtain the same result, to gain the same benefit, or to reach the same level of achievement as that provided to others” [ADA Title II 28 C.F.R. 35.130 (b)(1)(iii)]. (Read more about ADA.)

Functional Assessment

Performance under typical school conditions is necessary to assess either directly with the Functional Listening Evaluation (FLE), or indirectly, with checklists like the Children’s Home Inventory of Listening Difficulties (CHILD) or the Listening Inventory For Education-Revised (LIFE-R).

The Functional Listening Evaluation has become a mainstay in the field of DHH education and is commonly performed by educational audiologists and teachers of the deaf/hard of hearing. The FLE is a means to estimate how well a student is able to access verbal instruction, and to what degree speechreading, distance and noise effect performance.

The FLE can be performed with a variety of age-appropriate stimuli including single words, phrases, nonsense phrases and sentences depending upon if the desired information is about the precision of speech perception (words/nonsense material) or to estimate access to classroom communication (phrases for young children, sentences for grade 1 and above). A steady source of background noise and a means to control the loudness of the noise in comparison to the presenter’s voice is needed to perform the FLE in a valid manner. The Recorded FLE Using Sentences was created to simplify and add consistency to FLE administration. See the 2-minute video demonstration of using the Recorded FLE Using Sentences on YouTube. A free 10-minute classroom noise file can be downloaded from this Supporting Success webpage for instructional use or to aid in assessment. Collected data (1999)¹ on children age 3 to 17 with typical hearing listening in quiet and noise found that the typical score listening in quiet averaged 95+% and in noise 90+%, regardless of age and without the use of visual cues.

The Listening Inventory For Education was revised in 2012 (LIFE-R) resulting in a suite of checklists for students, classroom teachers and parents. Most frequently used is the LIFE-R Student Appraisal which is a self-report measure for students grade 3, or age 8, and above. Students must consider each of the 15 school listening situations and decide the how difficult it is for them to hear and understand. Via this rating, a potential score of 100% is possible on the LIFE-R Student Appraisal.

Two recent research studies provide helpful insight into interpretation of LIFE-R results. In 2018¹, researcher in Belgium translated the LIFE-R verbatim into Dutch and it was completed by 187 secondary students with normal hearing. Even though a score of 100% is possible, the typical listening situations in a classroom can be challenging for students with normal hearing as well as those with hearing loss. The average score for students with normal hearing was 72% with the most difficult listening situations being when classmates were noisy or when listening to responses during class discussion. The first ten questions on the LIFE-R relate directly to instructional classroom situations, in which students score significantly higher than the five questions related to social or group listening situations.

A second study² analyzed the data collected from use of the online LIFE-R over a period of 4 years (no identifying information), resulting in 3500-5000 responses, depending on the question analyzed. In every listening situation, students with severe to profound hearing loss showed greater hearing difficulty than all other groups, including cochlear implant users. The total average score for all 15 listening situations across students of different grades, hearing technology and hearing levels was 57%. Of the data analyzed, 509 had grade level indicated. Students in grades 3-6 reported poorer listening (53%) than those in grade 7-9 (61%) for all 15 situation responses. The most challenging situation was trying to listen to the teacher when other students were making noise, while difficult for all respondents, was even more so for the younger students. The second most difficult scenario was listening in a large room or school assembly.

If a student with hearing loss scores less than 90% on the FLE, or less than 72% on the LIFE-R it is evidence that communication is not as effective as peers and that auxiliary aids and services MUST BE PROVIDED to close this gap.

Formal Assessment

When students are present in classrooms it is assumed that they will hear and understand instruction. Hearing loss impacts this basic assumption and the question “to what degree is this student impacted” must be addressed. Although it is expensive to purchase norm-referenced tests, it is necessary to have the ability to collect data that is relevant to children with hearing loss in both a norm-referenced and functional performance (informal) format. The following are felt to be the best tools available to gather this information to identify areas of weakness, which make results advantageous to eligibility discussions and planning.

• Developmental Test of Auditory Perception (DTAP): age 6-18. Takes 30 minutes to administer via CD. Results in language and non-language auditory perception index scores and background noise and no background noise index scores. The DTAP and FLE are a powerful combination to provide evidence of the impact of hearing loss on access to communication.
• Assessment of Story Comprehension (ASC): Pre-K and K, age 3-5 years. Takes 3 minutes to administer and 1 to score. Teacher reads a story and student answers literal and inferential questions.
• Oral Passage Understanding Scale (OPUS): age 5-21 years. Takes 10-20 minutes. Teacher reads a passage and student answers questions. It identifies knowledge and use of words, word combinations, syntax, and use of language in which meaning is not directly available from the words used. Yields more information than simply whether the individual can comprehend; deeper processing abilities.
• Listening Comprehension Test – 2 / Listening Comprehension Test – Adolescent: ages 6-11 and 12-18 years. Takes 35 minutes to administer. Results are a good predictor of how well a student will be able to function in the mainstream classroom. Subtests are listening for the main ideas, details, reasoning, vocabulary and understanding messages. Results can readily be used to develop intervention goals.

References

1. 1. Bodkin, K., Madell, J., & Rosenfield, R. (1999). Word recognition in quiet and noise for normally developing children. American Academy of Audiology Convention, Miami, FL – Poster session.
2. 2. Krijger, L. DeRaeve, K. L. Anderson & I. Dhooge (2018). Translation and validation of the Listen Inventory for Education Revised into Dutch. International Journal of Pediatric Otorhinolaryngology, 107, 62-68. Online article.
3. 3. Nelson, K. Anderson, J. Whicker, T. Barrett, K. Munoz, & K. White (2019). Classroom Listening Experiences of Students who are DHH using LIFE-R. Submitted manuscript.

The post Determining Listening Challenges first appeared on Supporting Success For Children With Hearing Loss.

Auditory Comprehension:

Speech perception is the set of listening skills that are essential for communicating by spoken language.  Speech perception skills can be described in four categories: awareness, discrimination, identification and comprehension. Each skill set is described on web pages in  the Listening (Auditory Skills) Development section.

These listening skills do not develop sequentially from one category to the next. Rather, a child might simultaneously be developing skills in two, three, or even all four categories, but at varying levels of complexity.
The best 10-day exercise plan at home | Very Fitness pharmatest e 300 shakira, pharrell williams and the beatles land on apple’s fitness.
Speech perception training also requires attention to the complexity of the listening task, or the amount of acoustic information in the message.  Generally, levels of complexity are described as the sound/phoneme level, word level, phrase/sentence level, and discourse/connected speech.

Auditory comprehension is understanding what one hears through listening. The student demonstrates  auditory comprehension of a message by responding to it using language that usually “references the stimulus but is unique in its content.”  (Estabrooks, 2000).

Two examples can illustrate how comprehension differs from identification.

Example of a Response that Demonstrates Auditory Comprehension

Adult: Hi. What’s your name?

Student: Norman! What’s yours?

Example of a Response that Demonstrates Auditory Identification

Adult: Hi. What’s your name?

Student: Hi. What’s your name?

Auditory comprehension of a message is dependent upon successfully performing ALL of these auditory response tasks:

Attention
Detection
Discrimination
Identification
Memory
(possibly localization)

It is ALSO dependent upon these characteristics of the message:

– Acoustic information (vowels, consonants, intonation, etc.)

– Vocabulary

– Word usage (e.g., idiomatic phrases)

– Grammar (passive voice, indirect objects, etc.)

AND on these characteristics of the student:

Auditory processing abilities                                           Motivation

Linguistic processing abilities                                          Cognitive abilities

Physical condition (hunger, sleep, fatigue)                     Mental State

We must also consider the characteristics of the talker:

Volume
Rate of speech
Clarity of expressing thoughts Clarity of articulation (accent, idiosyncrasies)
Accent or dialect
Ease of speechreading (moustache, etc.)
Familiarity

Finally, comprehension is affected by the environment in which the communication takes place:

Background noise                                     Reverberation

Auditory and visual distractions              Distance from the talker

Comprehension is where listening meets the real world in an attempt to engage in successful communication. Many of the characteristics listed are out of our control as educators and beyond the scope of this discussion. The professional who is mindful of the complexity of asking a student with hearing loss to demonstrate comprehension will nevertheless be better able to guide that student toward success.

Selected Component Skills of Auditory Comprehension

Tasks that require auditory comprehension typically occur at the phrase or sentence level through extended discourse such as conversation, small group or class discussion or listening to audio text.

Sustained Attention was discussed in the Auditory Awareness section. LINK. When students are asked to listen to and recall longer messages and greater amounts of information, they are practicing sustained attention and hopefully improving their stamina for listening.

Memory  Auditory Memory is the processing, storing and recalling of what one hears. Auditory memory is not a single entity, but has several facets, including memory for:

– words

– for phonemes

– for digits

– for rules

– for information heard in extended discourse

Scientists also study sequential memory and memory for numbers. All of this becomes auditory memory if the information was received through listening alone, with little or no visual support.

Informal Assessment of and Practice with Auditory Memory

Auditory memory is formally evaluated within cognitive assessments. These formal evaluations  should be administered by a professional, such as a psychometrist, speech language pathologist or audiologist.

Miller (1956) established that auditory memory of an individual has a limited capacity. Successful recall can be affected by the length and complexity of the message. It is generally accepted that the  number of objects an average adult can recall from short term memory is “seven, plus or minus 2”. Rhodes (2011) reports that by 6 years of age, a child “imitates a 16-syllable sentence, based on short-term recollection …. Remembers six items of a story … (and) repeats three numbers backwards.” Students with hearing loss often do not meet these milestones before entering school.

The criteria listed by Rhodes can be used to

– establish a baseline for each student

– identifying goals for progress

– determine a starting point for practice

Some suggested methods for checking and practicing auditory memory skills are offered here.  It is not necessary to use an auditory hoop for these tasks.

Memory for Words (or numbers)

1. Select 9 picture cards of objects (or numbers) within the student’s vocabulary. Explain the task to the student – you will list some words, and the student should remember and repeat them in the correct order. Encourage the student to give his or her best effort.

2. Choose 5 cards to start. Without showing the pictures to the student, name the objects one a time, with a 1- or 2-second pause between words. When you have read the 5^th word, have the student repeat the list.

3. Increase or decrease the number of words for the next set, based on the student’s success.

When a student’s baseline for recall of words is established, add one more word and practice three different sets each session. It is important to use different categories of words within one session to avoid ‘spillover’ from previous trials. Although recalling the order of the words is ideal (English grammar is sequential!), it is not essential in the beginning.  As the student builds memory skills, continue increasing the length of the list, up to the “Magic 7”.  Teachers of students with hearing loss have noticed that words with more than one syllable increase the difficulty of recalling the entire list, so one-syllable words are preferred for this task in the beginning.

Some students may need visual ‘markers’ for the words. If this is the case, after saying each word, place its picture face down in a row in front of the student, proceeding from left to right. The student can point to each picture and say the word. Turn over the pictures at the end of the student’s list to show which were correct. To reduce the visual support, after naming the picture, place it face down in a stack rather than a row.

Memory for Sentences

The context of a sentence aids in recall of the words within it. As with memory for words, counting syllables may be a more accurate way to predict the length of text a student can recall.

1. Select text within the student’s receptive language level. Based on the student’s auditory memory for words, break the text into meaningful phrases. Each phrase should contain the number of syllables (plus or minus one) corresponding to the student’s recall for words, as established in the previous task. Do not break up syntactic phrases (e.g., prepositional, adverbial, etc.).

2. Explain the task to the student. Read the first chunk, and have the student repeat it verbatim. The student should repeat each morpheme (e.g. prefixes and word endings).

3. If there are no errors, repeat Step 2. If there are errors in repetition of words, address them as described here.

– If a word is omitted, repeat the entire phrase. If it is omitted again, say, “You skipped a word,” and repeat the phrase again. If it is omitted a third time, say the omitted word, then repeat the entire phrase, adding emphasis to the omitted word. The student should repeat the phrase correctly. If not, note the error and continue with the next piece of text.

– If a morpheme (such as final -s or past tense marker) is omitted, repeat the entire phrase. If it is omitted again, say, “Listen carefully to the [word endings, prefixes, etc.],” and repeat the phrase again. If it is omitted a third time, say the erroneous word, highlighting the missed morpheme, then repeat the entire phrase, adding emphasis to the omitted morpheme. The student should repeat the phrase correctly. If not, note the error and continue with the next piece of text.

– If a word is substituted (e.g., have for has) or inserted (e.g., adding a word not in the text), repeat the entire phrase. If the error occurs again, say, “Not [incorrect word],” and repeat the phrase again. If the error occurs a third time, say “There is no [inserted word]”, then repeat the entire phrase, slowing at the point of the incorrect insertion. The student should repeat the phrase correctly. If not, note the error and continue with the next piece of text.

– If the student repeats with incorrect word order, repeat the entire phrase. If the error is repeated, say, “You switched some words,” and repeat the phrase again. If the error is repeated a third time, say only the affected words. The student should repeat the affected words correctly. If not, note the error and continue with the next piece of text.

Memory for Information

Memory for spoken information is a more typical academic task, and requires a more global comprehension of the message, rather than a word-by-word recall.

To assess or practice memory for information, select a text within the student’s receptive language level. Choose a text about which you can ask wh- questions as well as higher level questions. The wh- questions will establish basic recall of what was heard. Successfully answering higher order questions, however, is essential for success in school.

Write down your questions prior to the activity.  You will use this paper to record what occurs during the activity.

1. Explain to the student that you will be reading a selection and then asking questions to find out what the student remembers about what you read.

2. Read the text naturally.

3. Ask your first question. If the student answers correctly, note that next to the question and ask the next question. If the student does not answer correctly, suggested responses are provided here. Note your responses next to the question.

– Ask the student to repeat your question back to you. Clarify the question if needed.

– Repeat the question then re-read the portion of the text that contains the correct answer. Include one or two sentences before and after the sentence containing the answer. Repeat the question.

– Address any vocabulary that may be unfamiliar.

– If the student is unable to answer correctly after two or three attempts, note the error, quickly explain the correct answer, and move to the next question.

The Impact of Language on Auditory Comprehension

If the content to which the student is listening uses language structures, vocabulary or background information beyond the student’s skills, the best of listening skills cannot produce a successful communication task.

Therefore,  one strategy for improving auditory comprehension is to build the student’s range of syntax, vocabulary, and background knowledge. Those tasks are beyond the scope of this text. Auditory memory and speech perception in general, however, is one set of  skills that can improve with instruction and practice and can contribute to better comprehension of spoken language.

More Auditory Comprehension Resources

Strategies for Improving Auditory Memory and Speech Perception Skills for Connected Speech – two free webinars from CID – Central Institute for the Deaf

Auditory Memory for Quick Stories – from Super Duper Inc.

ASSESSMENT

Assessment of Story Comprehension

OPUS – Oral Passage Understanding Scales

Listening Comprehension Test – 2 (elementary)

Listening Comprehension Test – Adolescent

TAPS-4  – Test of Auditory Processing Skills (memory, auditory discrimination, comprehension, phonological awareness)

CURRICULA

No Glamour  Memory

Look Who’s Listening Game

Spotlight on Listening Comprehension 4 book set (details, story comprehension, making inferences, reasoning and problem solving

SPICE – Speech Perception Instructional Curriculum & Evaluation

SPICE to Life Auditory Learning Curriculum

References

Estabrooks, W. (2000). Auditory Verbal Practice. The Listener, Summer, pp 6-29.

Miller, G. A. (1956). “The magical number seven, plus or minus two: Some limits on our capacity for processing information”. Psychological Review. 63 (2): 81–97.).

Rhodes, Ellen. 2011. Auditory Developmental Scale: 0-6 Years.

Posted August 2019. This information was authored by Julia West, teacher of the deaf/hard of hearing who has taught students with hearing loss in private and public schools for over 20 years. She is co-author of the CID SPICE for Life Auditory Learning Curriculum and authors the Listening and Self-Advocacy sections of the Teacher Tools e-Magazine.

The post Auditory Comprehension first appeared on Supporting Success For Children With Hearing Loss.

Auditory Discrimination:

Speech perception is the set of listening skills that are essential for communicating by spoken language.  Speech perception skills can be described in four categories: awareness, discrimination, identification and comprehension. Each skill set is described on web pages in  the Listening (Auditory Skills) Development section.

These listening skills do not develop sequentially from one category to the next. Rather, a child might simultaneously be developing skills in two, three, or even all four categories, but at varying levels of complexity.

Speech perception training also requires attention to the complexity of the listening task, or the amount of acoustic information in the message.  Generally, levels of complexity are described as the sound/phoneme level, word level, phrase/sentence level, and discourse/connected speech.

A discrimination task requires a student to perceive differences and similarities between two sounds, words or longer utterances. The properties being judged can be volume or intensity, duration, pitch, stress pattern or other feature. Discrimination tasks require a student to report whether two stimuli (never more) are “the same” or “different”.

Discrimination tasks are often confused with identification tasks. Some examples can clarify the two categories of listening tasks.

Comparisons of Discrimination and Identification Tasks

A Discrimination Task

Teacher: Tell me if these sound the same: shhh (pause)   ch .

Student: No, they sound different.

An Identification Task

Teacher: Point to the card that shows the sound you hear. (pause): shhh.

Student: (points to card) [Note: it is recommended that student also repeat the sound.]

OR

Teacher: Please tell me what you  hear: sheep.

Student: (optional: points to picture) sheep.

Teacher: Cheep.

Student: (optional: points to picture) cheep.

Although “Are they the same or different?” seems like a clear question, students can become confused about what the teacher is asking. Children who are often asked to identify the first sound or first letter of a word might say mop and mat are the same because they have the same first letter. An older student who is asked whether single and solo are the same might respond yes because they have similar meanings. When a teacher is asking a student to make an auditory discrimination it might be necessary to clarify what property the student should be comparing: the component sounds? number of syllables? stress pattern?

Auditory Discrimination and Students With Hearing Loss

Erber (1982) notes that professionals working with students who have hearing loss often use an auditory discrimination task to determine the cause of an erroneous response to a different auditory task.

A phonics lesson, for example, might ask a student to identify the letter associated with the phoneme -e- (as in bed) – an auditory identification task. If the student points the letter a rather than e, the teacher might check to see if the student perceives the acoustic differences between the short e vowel sound and the short a vowel sound.

During a discussion about farming wheat, a student who comments, “My mom doesn’t like wheat. She pulls it out and throws it away,” may be unfamiliar with the wheat plant and not hear the subtle difference between wheat and weeds.

In the above examples, the identification errors likely occurred because the phonemes -a- and -e-  and the words wheat and weed are acoustically similar and difficult to discriminate. The teacher could respond by asking, “What did you hear?” That question will prompt the student to produce a vowel or word that may not (due to an error in his speech production) match what he heard. Instead, the teacher can check the student’s ability to discriminate. Here are two examples of checking discrimination during the identification tasks described above.

Examples of Discrimination as Error Analysis and Remediation

                  Example A.

Teacher: Listen. Which vowel do you hear:  bed? (an identification task)

Student: (points to letter a)

Teacher: Oh. That says /-a-/. Are these two sounds the same or different?

Listen:  /-e-/ (pause) /-a-/?

      Example B.

Student (thought the teacher said “weed” when she actually said “wheat – an identification error)

Teacher: Those words are almost the same, but the last sound is a little different. Listen: wheat (pause) weed. Do they sound the same to  you?

In Example A, if the student says the phonemes sound the same, the student has made an auditory error. The teacher can give the student feedback like, “Yes, those sounds are very close to each other. They are almost the same. But they are a little different. Listen again.” The sounds can then be produced slightly elongated to highlight the differences. If the student is asked to say the sounds, he will likely produce two sounds that sound very, very similar to each other. This may be a task for the speech specialist. The teacher, however, can spend one or two valuable minutes saying the sounds as she points to the letters, then 1 or 2 minutes more having the student listen and decide which sound he hears, with the teacher giving immediate feedback.

In Example B, many students with hearing loss will not hear the difference between wheat and weed. The teacher can check the vocabulary by pointing to a picture of wheat and asking the student to name the plant. If the student is unable, the teacher can a quick explanation of the word, the differences between wheat, a product farmers sell and the weeds they kill or throw away.  She would then draw attention to the final letter and sound and move on with the lesson. Auditory practice may not be necessary because if this student had been familiar with the wheat plant as a farming product, the auditory error would probably not have occurred.

Improvement of Auditory Discrimination

Improving auditory discrimination may not be an objective on a student’s IEP, but as shown above, teachers can use targeted discrimination practice to improve auditory identification, an essential speech perception task. Here are some guidelines for quick and effective uses of discrimination practice in the course of an academic lesson.

– When the teacher first asks the student to discriminate between two stimuli , the teacher should produce the vowels (or words) as naturally as possible, without elongating them.

– Always let the student know if her response is correct and emphasize that the two sounds are very similar.

– The discrimination task should be presented at least three times, with one trial presenting the same vowel (or word) twice.

– If the first response was incorrect, the second and third trials can use a slightly exaggerated production to support better discrimination.

– If the student had difficulty discriminating the two items, provide additional practice in brief (3 minute) lessons. If the student’s accuracy continues to be lower than 80%, inform the audiologist. Difficulty in discriminating a pair of acoustically similar phonemes might indicate difficulty with other phonemes that are similar to each other, which should be evaluated.

More Resources for Auditory Discrimination

Free PD Webinars from CID – Central Institute for the Deaf

References

Erber, N. 1982 Auditory Training. A.G. Bell Association for the Deaf. Washington D.C.

CURRICULA

Learning to Listen Sounds Kit

CAST – Contrasts for Auditory and Speech Training

SPICE – Speech Perception Instructional Curriculum & Evaluation

SPICE to Life Auditory Learning Curriculum

Posted August 2019. This information was authored by Julia West, teacher of the deaf/hard of hearing who has taught students with hearing loss in private and public schools for over 20 years. She is co-author of the CID SPICE for Life Auditory Learning Curriculum and authors the Listening and Self-Advocacy sections of the Teacher Tools e-Magazine

The post Auditory Discrimination first appeared on Supporting Success For Children With Hearing Loss.

Awareness:
Detection – Localization – Auditory Attention

Speech perception is the set of listening skills that are essential for communicating by spoken language.  Speech perception skills can be described in four categories: awareness, discrimination, identification and comprehension. Each skill set is described on web pages in  the Listening (Auditory Skills) Development section.

These listening skills do not develop sequentially from one category to the next. Rather, a child might simultaneously be developing skills in two, three, or even all four categories, but at varying levels of complexity.

Speech perception training also requires attention to the complexity of the listening task, or the amount of acoustic information in the message.  Generally, levels of complexity are described as the sound/phoneme level, word level, phrase/sentence level, and discourse/connected speech.

Auditory awareness can be described as a combination of three subsets of skills:  detection, localization and auditory attention.

DETECTION

Detection is the most basic of listening tasks, as it requires the listener to determine the presence or absence of sound, or of a particular sound. For children who have typical auditory development, detection of sound begins in the third trimester of pregnancy and continues to develop during the first year of life. (Werner)

During a hearing screening, the technician plays a tone and the client responds by raising a hand. This is a simple detection task. During a more extensive evaluation, the volume of the tone could be decreased to the point at which the client no longer hears it. That is the point at which detection ceases. This point is called the threshold. When we read an audiogram, the thresholds for each frequency, or pitch, of sound are marked, often with Xs and Os, to designate hearing levels at the left (X) and right (O).

DETECTION AND STUDENTS WITH HEARING LOSS IN THE SCHOOL SETTING

Professionals working with students who have a hearing loss should not forget that the student may not be hearing a particular sound, due to device failure, hearing fluctuation or a variety of other reasons.  A change in ability to detect or identify a sound can often be discovered quickly during a Daily Listening Check. LINK

Assessment of Detection

A student’s audiologist should ensure that the device settings allow the student access to the full range of speech sounds accessible to the student; however, these settings can become less effective over time.

Professionals working with a student can determine if the student can indeed hear all or most of the phonemes. Erber describes a subset of the Glendonald Auditory Screening Procedure! (GASP!) to evaluate the student’s ability to detect speech sounds. Download the Modified Glendonald Auditory Screening Procedure (GASP). The GASP presents ten vowel sounds and 12 consonant sounds, representing the full spectrum of the 44 phonemes of English. These sounds and procedures appear in the downloadable test above. Erber says the steps can be completed in 10 minutes. The remaining 22 phonemes could presumably be added, increasing the time needed to 20 minutes, for a complete assessment of phoneme detection.

Developing Phoneme Detection Skills

A new device recipient may need practice with detecting the full range of speech sounds. This training may or may not be provided by the student’s audiologist.  First, determine whether the student can distinguish between speech and non-speech sounds. Instruct the student to listen raise a hand when your voice is heard – not other sounds, just your voice.  Let the student know immediately whether the response is correct.

1.  Stand behind the student and wad up a piece of paper. Wait for a response.

2. Say, “bu-bu-bu”.

3. Knock 3 times on a table, door or wall.

4. Rub the wad of paper across the table.

5. Say, “sssshhhhhh”.

6. If the student is having difficulty responding correctly, move to a place where you can be seen. Repeat the steps several times so the student can learn the differences between the sounds. If the student continues to struggle, the family and audiologist should be notified.

The CID Speech Perception Instruction Curriculum and Evaluation (CID SPICE) Manual offers other guidelines to help a student build speech detection skills.

Start with extended sounds like repeated syllables (e.g. bu-bu-bu) or a continuous vowel (e.g., oooooooo, eeeeeeee).

Once you find a sound that is detectable, practice with that sound until it is detected with at least 80% accuracy, then add other sounds.

When moving to detecting words, which may be briefer than the extended sounds referred to above, consider choosing the student’s name as the first word to practice detecting.

A student with a profound high frequency hearing loss may not have the ability to detect quieter unvoiced sounds (e.g. /s/, /f/, /th/).

A more challenging task is to identify when a voice starts and ends. This can be practiced with the repeated syllables or a vowel. The student should signal when the voice begins to be heard and when it stops.

When the student can identify the beginning and ending of a continuous voice, move on to signaling the beginning and ending of a spoken phrase or sentence.

Older students can indicate that a sound was heard, by raising a hand or giving a verbal response. Younger students may respond better to a fun activity such as stacking blocks or rings or pulling popbeads when a sound is heard. To signal the beginning and ending of voicing, drawing a line, coloring a picture, or turning a light on and off or moving a puppet’s mouth while the adult is voicing can be fun.

Recognizing Detection Errors and Improving Detection Skills

The context in which spoken language occurs contributes greatly to understanding the message. A student who doesn’t hear the plural /s/ in a sentence that begins with, “Scientists investigated ….” will still probably understand the key content of the message. Difficulty hearing a specific sound has few serious consequences in school. Some exceptions are missing a final consonant on a spelling test (i.e. writing track for tract) or misunderstanding a name (Maria vs. Maryann). Detection errors can also lead to speech errors such as omitting /s/, /f/, /th/, /t/ and other soft sounds in a student’s speech production.

If a detection error is suspected, asking the student to repeat what she heard can be a quick check. If the student omits sound(s) in her response, cue her to the error by saying, “Oh, you missed a sound. Listen again.” Then repeat the word, sentence or phrase naturally. If she still can’t repeat correctly, then tell her the exact error, repeat the phrase and have her produce the word correctly. In this way, the student can become more aware of the sounds that are difficult for her to hear and may improve her speech perception and production abilities.

More Resources

Free PD webinar from CID – Central Institute for the Deaf

LOCALIZATION

Localization, the ability to locate the source of a sound, begins to develop within the first seven months of life and continues to improve as the child has more experience with hearing and listening. When localizing a sound, the brain compares the relative loudness of the sound at each ear. Sounds that originate from the right or left side of a person are easier to locate than sounds originating from in front or behind. Individuals with unilateral or imbalanced hearing loss (including imbalanced hearing levels with hearing devices) may have more difficulty locating the source of a sound.

LOCALIZATION AND STUDENTS WITH HEARING LOSS

Localization is important during class discussions and conversations with multiple people. Difficulty localizing can have academic consequences, as time and effort spent locating the talker reduces attention to the message and delays the support received from visual cues such as speechreading. Localization of environmental sounds can also be a safety issue in sports, traffic and other environments.

Assessment of Localization Skills

A discussion with the student with hearing loss can reveal the student’s perceptions of challenges with class discussions. Use open-ended questions, not yes/no questions. For example: Tell me about understanding class discussions. What is helpful? What is the hardest? When are you most successful?

Observe the student during small group or whole class discussions.  Note the number of people in the group.

a) Make a hash mark each time a different person begins talking.

b) Make a checkmark each time the student tries to find the talker.

c) Circle the checkmark if he was successful in finding the talker.

d) Put an x through the checkmark if he if he gave up before the talker finished.

e) Note any students who try to help the student with hearing loss follow the discussion

Turn your observations into data by calculating percentages.

— Rate of Attempts to Locate the Talker = c ÷ b (“c” is number of checkmarks)

— Rate of Successfully Locating the Talker = d ÷ b (“d” is number of circled checkmarks)

— Rate of Abandoned Attempts = e ÷ b (“e”  is the number of checkmarks with an x)

Observe the teacher during class discussions.

— Note any strategies the teacher uses to help students know who is speaking (see suggestions in the next paragraph)?

— Note any relevant rules posted in the room to guide class discussions. Note how many times those rules are followed or broken. Note number of times the students were reminded to follow the rules.

Addressing Localization Challenges

There is evidence that training can improve localization skills in adults with typical hearing, but there are few studies of localization training in individuals with hearing loss. Explain to students with hearing loss that turning the head can help localize a sound. Use the alarm on a phone to demonstrate and practice. Make sure the alarm tone and volume are audible to the student.

There are some simple steps that the classroom teacher can take that will benefit students during class discussions.

— When calling on a student to speak, use the student’s name and gesture toward them (with a nod or sweep of the hand).

— Establish the expectation that anyone who is speaking to the class will stand and use an appropriate volume.

— Use a pass-around microphone or the teacher’s FM microphone for anyone speaking to the class.

— Repeat or summarize each question or comment.

Using information and data from your observation, make a plan with the student, or with the student and teacher together to improve the student’s ability to follow class discussions.

More Resources for Localization

Curricula: Central Institute for the Deaf – CID SPICE for Life

AUDITORY ATTENTION

Auditory Attention is often discussed as a  figure-ground task –  the ability to attend to a spoken message in the presence of competing background noise. The Where’s Waldo challenges are a visual figure-ground task. Focusing on a specific voice in a sea of other human voices can be compared to searching for Waldo in a scene of similarly clad people.

When an individual is in a room full of people chatting in small groups, she filters out the conversations around her in order to focus on her own small group. The irrelevant speech become a low rumble as if it were distant thunder. Although this focused listening seems to happen without effort, it does require cognitive resources and listening effort to attend to a single stream of speech in a sea of spoken language.

Auditory Attention and Students with Hearing Loss

Students with reduced hearing levels are not the only ones who can struggle with auditory attention. Students with attention deficit disorder, auditory processing disorder, autism spectrum disorder and others may find it difficult to attend to a spoken message in the presence of background noise. Ability to attend can be affected by multiple factors, such as amount of sleep, nutrition, bodily comfort, emotional state, motivation, and interest in the topic, to name a few.

Gomes, et al describe four types of auditory attention: arousal, orientation, selective attention and sustained attention. Each of these are important for academic success. When students are working in small groups and the teacher begins talking to the whole class, each student needs to rouse to the teacher’s voice (arousal), shift attention from the conversation in the small group and focus on what the teacher is saying (orientation). Often, other students or groups of students do not cease talking in order to listen to the teacher. When this happens, the amount of background noise adds to the difficulty of focusing on the teacher’s message (selective attention). In addition to being alerted by the teacher’s voice and shifting attention, the student needs to be able to sustain attention for the duration of the teacher’s discourse or group conversation.

Assessing Auditory Attention

Auditory attention is just one way of attending to an activity – but it may be the most important part of attention at school. Consider the amount of information shared in the classroom by students and teachers using spoken language. Any student with poor auditory attention will be at a great disadvantage.

While there are formal tests of auditory attention, such as the Test of Variable Attention, observation may be the most convenient and informative assessment tool for a teacher. The Children’s Auditory Performance Scale can provide information about the student’s attention in a variety of listening conditions.

Another method is Momentary Time Sampling. Before beginning the observation, define the listening behavior you are measuring. Auditory attention is not a visible behavior. A student who is doodling may be listening carefully. A student rummaging through his desk is probably not. Set a timer to vibrate every 10 seconds.  When the timer vibrates, record whether the student was attending to the activity at that moment.  It can be helpful to also collect data on a classmate with typical hearing and compare the two data sets.

The Screening Instrument for Targeting Educational Risk (SIFTER) for preschool, elementary and middle through high school has three items that compare attention of a student with hearing loss to that of his or her classmates. The Children’s Auditory Performance Scale (CHAPS) for children 7 years and older has 8 items to compare auditory attention to that of other children of similar age and background in a variety of circumstances.

Developing Auditory Attention

Attention requires ongoing cognitive effort. Almost any error a student makes could be due to wavering attention. A mistake in the Ling Sound Check, an incorrect response in group discussion, a misheard spelling word. Whether the auditory task required detection, identification, discrimination or comprehension, a momentary lack of attention can have an impact on the student’s success with the task.

According to the International Listening Association, 45% of a student’s day is spent listening, and students are expected to acquire 85% of their knowledge through listening.

Students who haven’t been expected to listen in class (“She’s deaf, after all!”) may not have developed the stamina needed for sustained attention. A student may not recognize when their attention drifts from the teacher or even be aware that it’s possible for them to notice this. They may not know that simply hearing the teacher isn’t going to lead to learning.

Many students feel helpless when told they need to “pay attention”.  It can be helpful to explain a few principles of hearing and attention.

— Listening is different than hearing. Listening requires effort. Listening = hearing + attention. Younger students may understand the statement that “Listening uses your eyes, ears and”

— Each person has a degree of control over their attention, and exercising the attention ‘muscle’ can improve our sustained attention.

— No one can pay attention 100% of the time. Everyone’s attention drifts for a moment or even longer. Teachers may benefit from accepting this fact too! If a student is allowed to admit, without negative consequences, that they weren’t paying attention, the student might do so and ask for a repetition of what was said. This would increase engagement in the lesson.  Self-awareness of one’s own attention might also increase.

— For students still developing spoken language, they may need to learn how to ask for something to be repeated. This is also common in adults with hearing loss. Provide a variety of choices, such as, “I’m sorry, I missed that. Could you repeat it please?” “Could you repeat that, please?” or “Please say that again.”

Auditory Attention Resources:

Intervention Central  has suggestions,  activities and tools for building attention in the classroom

On Task Self- Monitoring Sheet

References

Erber, N. 1982 Auditory Training. A.G. Bell Association for the Deaf. Washington D.C.

Gomes, A. Christodoulou, C. Mollholm,. Cowan, N. The Development of Auditory Attention in Children. Frontiers in Bioscience. 2000.5:108-120.

Werner, LA. 2007 Issues in Human Auditory Development. Journal of Communication Disorders. 2007;40(4): 275-283.

CURRICULA

Learning to Listen Sounds Kit

CAST – Contrasts for Auditory and Speech Training

SPICE – Speech Perception Instructional Curriculum & Evaluation

Posted August 2019. This information was authored by Julia West, teacher of the deaf/hard of hearing who has taught students with hearing loss in private and public schools for over 20 years. She is co-author of the CID SPICE for Life Auditory Learning Curriculum and authors the Listening and Self-Advocacy sections of the Teacher Tools e-Magazine.

The post Auditory Skills – Awareness first appeared on Supporting Success For Children With Hearing Loss.