What are the 3 factors that account for differences in language acquisition among children with hearing impairment?
1) Degree of loss
2) Age of onset
3) Other co-occuring disabilities
What are the predictors of early expressive language development in children who are deaf or hard of hearing?
1) child's age
2) age of identification of child's hearing loss
3) age of implantation
4) child's cognitive status
5) presence or absence of disabilities
The greater the hearing loss, the greater the expected _____ ______
What are 3 key factors that have greatly impacted the speech and language outcomes for children with hearing loss?
1) increased client diversity
2) early intervention (before 6 months)
3) availability of cochlear implants
Children with hearing loss are not a ______ group
Better speech intelligibility is predicted by 4 factors, what are they?
1) more advanced language development
2) lesser degree of hearing loss
3) oral mode of communication
4) increased age
study of sound systems used in language
study of the minimal units of language that are meaningful, such as "s" for bugs or "ing" for progressive verb tense or "ed" for past tense
functional use of language
study of word meanings and relations
the rules that govern how words are arranged in sentences
T/F the use of cochlear implants results in spoken language development that surpasses those with hearing aids
True if implantation is before age 5
What are some common characteristics of language usage by children who are hearing impaired?
1) Syntax (shorter sentences, simpler sentences
2) Semantics (reduced expressive/receptive vocab, limited understanding of metaphores, idioms, difficulty with multiple meanings of words)
3) Pragmatics (requests, topic changes, turn-taking, lack of comm. repairs)
Children with hearing loss miss out on incidental learning. What does this mean?
normal hearing children learn through hearing their parents and siblings talk, routines and all the talking around them. HI children do not have this, so the parent has to place extra effort.
T/F There is a direct correlation between identifying hearing loss before 6 months and cognitive status.
Reduced _____ is common among children with hearing loss.
With regard to syntactic-morphologic skills of school aged children, what have studies shown?
1) overuse of nouns and verbs and omission of function words
2) overuse of SVO sentence structure
3) delay with subsequent plateau in regard to syntactic abilities
4) misuse of morphological markers, omission of major sentence
At what age is there a plateau in semantic and syntactic skills of children with severe hearing loss?
What is metacognition?
child's knowledge and awareness of the thinking process
tied to symbolic language for reasoning and problem solving
What is an important precursor to reading which HI children do not have?
What is phonological awareness?
ability to recognize words consist of individual syllables, onsets, and rimes
How is language assessed in children with hearing impairment?
1) comm. checklists
2) formal lang. tests
3) comm./lang. sample analysis
Name 3 formal tests that measure language?
1) PPVT (Peabody Picture Vocabulary Test)
2) Expressive One Word Picture Vocabulary Test Revised (EOWPVT-R)
3) Test of Language Development (TOLD)
What are some limitations and cautions in using formal language measures?
1) Can't rely on oral receptive, bc child cannot hear
2) can't have child read bc it's too much emphasis on reading ability
What should be considered when testing HI children?
1) Check functionality of HA and CI
2) Reduce background noise or distractions
3) Allow access to speechreading cues
What are 2 traditional intervention formats in language intervention with children?
1) syntactic mastery- drills
2) natural or experiential approach in play
What is contingent responding?
what parents say to or do for their children is predicated on their child's preceding utterance
What are some strategies used for developing conversational skills?
2) set-up pretend schemas
3) set-up sabatoging scenarios
4) semantic mapping
What is recasting?
Adults communicate with child target syntactic-semantic structures
When child uses improper syntax, adult rephrases it.
Child: "Daddy eated cookie."
Adult: "yes, daddy at the cookie."
What is set-up pretend schemas?
Talk about or set up imaginative play of routines, such as going to the doctor. Talk about it and act it out
What is sabatoging scenarios?
To elicit protesting, requesting, commenting, and encourage child's use of language in a meaningful way, adult presents an obstacle such as setting the table with utensils, placemats and glasses on the chairs instead of the table. This encourages the child to question it
At what age does a fetus hear speech?
28 weeks gestation
By what age can a child discriminate sounds of his/her language?
What is the sequence of sound productions?
1) Crying and Vegetative sounds
Coughs - reflexive
2) Cooing and Laughing
3) Reduplicated babbling (canonical- baba)
4) Alternating babbling - babies with normal hearing will move to this (badadaba)
What are vocables?
speech sound combinations
starts at 11-14 months
i.e. saying bee for blanket
What age do HI children produce canonical babbling?
What are the 2 main factors that affect intelligibility?
1) experience of the listener with deaf speech
2) difficulty level of vocabulary and sentence structure for the speaker
There is more variability in speech intelligibility for children who hearing losses exceed ___
Children who use ________ communication have greater intelligibility.
What are the potential causes for improved intelligibility in children that use oral communication?
1) more intensive speech training
2) teachers in total comm. programs don't have expertise in speech training
3) higher expectations by teachers and parents
4) peer use of speech
Speech training should include six guidelines, what are they?
1) integrate auditory and speech goals
2) follow a dialogue, instead of tutorial
3) use bridging activities to promote real-world carryover
4) practice communication sabotage
5) use contrasts in perception and production
6) select speech goals that enhance communicative competence
What are the speech characteristics of mild to moderately severe prelingual hearing loss?
1) intelligible speech
2) speech errors are misarticulation of single consonants and consonant blends
What are the most common articulation errors for prelingual mild-to-moderately severe hearing loss?
low intensity, high frequency, and/or short duration speech sounds
Affricates, fricatives, and blends
What are the most common phonological error types for prelingual mild-to-moderately severe hearing loss?
What should be used to assess or prelingual mild-to-moderately severe hearing loss?
same as what is used for normal hearing child.
be careful with vocabulary level of the stimulus
What should a clinician be aware of when assessing a prelingual mild-to-moderately severe hearing loss?
- child's aided hearing thresholds to determine child's residual hearing range
- be familiar with impact of coarticulation
How should a clinician approach assessment with a prelingual mild-to-moderately severe hearing loss?
1) select and sequence child's speech targets based on normal development
2) Maximize and ensure optimal residual hearing
3) have parents and clinician's target spoken language goals during normal everyday activities
What is the average intelligibility of children with severe to profound hearing loss?
What do children with severe to profound hearing loss have trouble with?
1) consonant production
2) vowel and dipthong production
3) voice quality
Children with severe to profound hearing loss experience suprasegmental issues, what are they?
1) respiration - speak only a few syllables on a single exhalation of air
2) Resonance- both hyponasal and hypernasal
3) Phonation- incomplete vocal fold adduction
4) Articulation and phonology- variability,
What are some vowel error patterns noticed in severe to profound hearing loss?
1) vowel neutralization
2) dipthong and vowel confusion
3) nasalization of vowels
What are some consonant errors in severe to profound hearing loss?
1) voicing errors (/b/ for /p/)
2) Omission and distortion of consonants
3) Omission of consonants in blends
4) nasalization of consonants
What is palatometry?
placement of a thin custom-fit psuedoplate over child's hard palate and maxillary teeth shows contact points on screen when child speaks.
What would a goal be for severe to profound hearing loss?
What is an acoustic physiologic display that can be used with severe to profound hearing loss?
Visi-Pitch- fundamental frequency and intensity
IBM Speech Viewer-mean frequency
What are 7 suprasegmental errors?
1) slow speaking rate
2) within phrase pauses
3) excessive fundamental frequency variation(Stress)
5) Breath control
6) Voice quality
What are the typical language delays in HI school age children?
HI children and young adults (ages 4 to 20 yrs old) averaged scores similar to 6-8 yrs old
HI children and young adults (ages 4 to 20 yrs old) averaged scores similar to 5-7 yrs old
3) Reduced pragmatics
Language skills plateau around 12-13 yrs for the severely HI
What is the speech intelligibility for gold users at 500, 1000, 2000 Hz?
72% at 90-100dB
What is the speech intelligibility for silver users at 500, 1000, 2000 Hz?
101-110dB at two of three freq
What is the speech intelligibility for bronze users at 500, 1000, 2000 Hz?
110+ dB at two of three freq
When doing an assessment, what are the 7 items assessed?
1) History and background information
2) Sensory Functioning (HAVV)
- Hearing Sensitivity
- Auditory Perception
- Visual acuity
- Visual motor perception
4) Language and academic achievement
5) Psycho-motor functioning (sensory-motor integration)
6) Social maturity and adaptive behavior
7) Emotional adjustment
What are the problems with child assessment?
1) Fewer tools available that are appropriate
2) Few individuals have all the knowledge and skills necessary
What are the 4 levels of auditory processing?
What is detection?
the ability to perceive the presence or absence of sound
What is discrimination?
the ability to perceive similarities or differences between stimuli (same/different)
What is identification?
the ability to associate an auditory stimuli with its representation
i.e. recognize the sound of a doorbell or a cat meow
What is comprehension?
the ability to produce a response that reflects understanding of a stimulus
What are the auditory skill levels from easy to hard?
What are 4 design priniciples for auditory training?
1) Auditory Skills
Sound Awareness, Sound Discrimination, Identification, Comprehension
Phonetic level; Phonologic level
3) Activity Type
Elicited vs. spontaneous speech
4) Difficulty Level
What 6 ways can you change the difficulty level?
1) Response Set: closed, limited, open
2) Stimulus Unit: words phrases sentences
3) Stimulus Similarity/Contrast: auditory similarities, #syllables
4) Presentation context: Linguistic, acoustic highlight, visual assist, # of repetitions
5) Task—highly structured, spontaneous
6) Listening conditions: Signal-to-Noise Ratio
How can you change the stimulus units?
Synthetic- using clues within syntax or context of situation
Continuum of Activities- going back and forth
What is an example of analytic auditory training?
break speech into smaller components (phoneme, syllable)
present /ba/ and /la/ and ask to discriminate first initial
What is an example of synthetic auditory training?
Present a short paragraph and ask to answer 3-4 questions based on the content of the paragraph
What is a formal activity?
highly structured - drills
What is an informal activity?
What are 5 tests that can be used for developing curricula for auditory skills and spoken language?
1) Word Associations for Syllable Perception (WASP)
2) Developmental Approach to Successful Listening (DASL)
3) Speech Perception Instructional Curriculum and Evaluation (SPICE)
4) Cottage Acquisition Scales for Listening, Language, and Speech (CASLLS)
5) Foreworks Auditory Skills Instructional Planning System.
What is auditory imprint?
to discover the connection between what is perceived and what can be produced.
imprinting not imitation
How many phonemes are in English?
What is a language assessment designed for children with hearing impairments?
TSA - Test of Syntactic Ability - has a screener
SKI-HI-Parent Observation and questionnaire