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Aural Rehab Chapters 5 and 6

Terms in this set (53)

Components of Speechreading
Natural gestures and body language, facial expressions, situational cues, linguistic factors
Situational cues
Location of conversation, roles of the communication participants; helps predict what people might say
Linguistics factors
Redundancy of language, helps fill-in what might have been missed
Variable related to speechreading: speaker
Familiarity of the speaker, facial expressions, gestures/articulation/lip movements, rate of speech, distractors, gender, visibility of speaker
Variable related to speechreading: visibility
Viseme, homophenes, predictability allows the speechreader to fill in what they may have missed or revise what they might have misread
Viseme
A group of phonemes that look alike but sound different
Homophenes
Sounds/words/phrases that share the same place of articulation and look alike but sound different
Variable related to speechreading: Environment
Distance between the speaker and speechreader, viewing angle, competition, lighting, situational cues
Variable related to speechreading: speechreader
Residual hearing, language skills, personality traits, age, gender, intelligence, eye sight, visual perception
What makes a good speechreader?
Natural talent, perceptual proficiency, synthetic ability, flexibility, knowledge of the language, motivation, self confidence
Perceptual proficiency
The ability to see and identify speech movements quickly and accurately
Synthetic ability
The ability to take to limited information available and fill in the gaps using available information
Assessment of speechreading abilities
Presented visual-only or visual- auditory; presented live, face-to-face video, CD, or DVD;CID Everyday Sentence Test, Denver Quick Test of Lipreading Ability, Craig Lipreading Inventory- for children
Analytic Approach to Speechreading
Before the whole can be identified, the individual parts must be perceived; phoneme-> words-> phrases-> sentences-> whole meaning
Synthetic Approaches
Focus on understanding the general meaning rather than on identifying each component; Use situational cues and predict and synthesize the message from fragmented visual information
Speechreading Instruction
Improvement in hearing aids, cochlear implants, and ALDs allow clients to integrate speechreading skills in communication;Less emphasis on formal speechreading training and more on attending visually while communicating; Speechreading is trained separately to increase the client's knowledge but then incorporated into general rehabilitation
Speechreading sessions
4-6 week individual or group working on: understanding hearing loss, effective use of hearing loss, using assistive listening devices, using communication strategies and speechreading
Communication strategies
Be close to person speaking, watch mouth, facial expression, and gestures, be aware of topic of conversations, use hearing aids and/or assistive listening devices, minimize background noise, tell speaker you have hearing loss
Self-instructional program: CD/DVD
Conversation Made Easy, CasperSent, Seeing and Hearing Speech, Read My Quips
Advantages of self-instruction CD/DVD
Clients responses are recorded, client determines pace and time of instruction, lots of stimuli
Assertiveness training
Willing to admit hearing loss and willing to explain hearing loss and the problems it causes to others, able to suggest ways to improve communication
Anticipatory strategies
Predicting possible problems and solutions that may arise in communication situations, Predicting what might be said in communication situations, planning how environment can be modified, seating choice, may have to develop pragmatic language skills so as to not appear as rude or aggressive, identify problems and role play situations, discuss possible message in various communication situation relevant to the clients
Repair strategies/ clarification strategies
Solutions to use while in difficult situations- repetition, confirmation, rephrasing, key words, spelling and code words, digits, counting, writing, signing or fingerspelling
Cued Speech
The use of specific hand cues to reduce the visual confusion produced by speech reading homophenous phonemes, considered manual communication system, originally developed to improve literacy skills in deaf children
Manually Coded English
Artificial sign systems invented for educational purposes after it was realized that Deaf children of Deaf parents who sign do better on every measure when compared to Deaf children of hearing parents who do not sign, Represent English grammar visually using signs that aren't based in meaning, includes morphological inflections which deaf people consider "visual noise"
ASL
Independent language with its own grammar, meaning based signs, and non-verbal features
Prerequisites for Normal Speech and Hearing
Hearing within normal limits, exposure to and interactions with fluent speaker of the language, cognition within normal limits
Factors of hearing that affect speech and language
Degree of hearing loss, age on onset, type of hearing loss
Primary difference between the development of children with hearing loss and hearing children
The ability to access language around them
Essential factors for speech and language development
Early identification of hearing loss, early and appropriate application, early and appropriate intervention
Communication with hearing mother/deaf child
Less likely to use verbal praise, ask for opinions and suggestions, use questions, and have more tension in the relationship; don't have shared method of communication
Communication options for families
Professional must provide parents non biased information, BEGINNINGS for parents who are D/HOH
Communication options: Auditory-Oral Approach- Aural-Oral Approach
Full-time use of hearing aids or cochlear implants, auditory and visual skills are emphasized, child is educated with other children using the same approach, discourage use of natural hand gestures
Communication options: Auditory-Verbal Approach
Full-time use of hearing aids or cochlear implants, auditory skills are emphasized, no visual cues
Communication options: ASL- bilingual/bicultural approach
Established as the first language and used for instruction and socialization, used to develop language, english is later developed as a second language
Communication options: visual approach
Use of hearing aids or cochlear implants is not critical but an option, essential that the child have access to adults who are fluent in ASL, parents may choose to speech training in addition
Communication options: total communication
More of a philosophy than an approach, also called sign supported English (sign while voicing), Advocates the use of sign language, fingerspelling, speechreading, residual hearing, and speech; spoken language is combined with sign
Language characteristics of children with hearing loss
Language delay due to limited access to sound
Language characteristics: Form
Short, simple sentences - reduced MLU, Overuse of simple sentence patterns - SVO, Infrequent use of adverbs, auxiliaries, and conjunctions, Decreased use of grammatical morphemes, incorrect word order, incorrect use of irregular past tense
Language characteristics: Content
Reduced expressive and receptive vocabulary, reduced category labels, reduced understanding of object function, limited understanding of figurative language, difficulty with multiple meanings
Language Characteristics: Use
Restricted range of communicative intent, lack of knowledge of conversational conventions, limited understanding and use of conversational repair strategies, pragmatics are strong if sign language skills are strong
Assessment conditions
Must be functioning, quiet environment with no visual distractions, tests must be administered in child's mode of communication, evaluators must be fluent in whatever mode, allow child time to look at clinician, look at test materials, and look at clinician again to ensure full reception of spoken and/or signed message
Preliteracy and Literacy issues
Delays in language lead to delays in literacy, phonological awareness is a precursor to reading and spelling abilities
Facilitating literacy skills
Exposure to reading and writing, environmental print, book reading
Formal Language Assessment
Tests standardized on hearing children may be given by must be interpreted with caution
Checklist/ criterion-referenced assessment
Checklist to compare the child's language, can be completed by teachers and parents, useful for evaluation and measuring progress, criterion-references assessment can be developed by the teacher and/or SLP to assess child on language that has been address in the classroom and/or intervention
Language Sample and Narrative Analysis
Used to supplement testing, use the sample to evaluate content, form, and use and conversation ability
Speech characteristics of children with hearing loss
Infants with hearing loss vocalize, even with amplification babbling and speech sound acquisition is different from hearing children
Speech characteristics for mild-moderate hearing loss
Expect intelligible speech with misarticulating of individual consonants and/or consonant blends, common errors with affricates, fricatives, and blends, error types are usually substituted with few distortions, errors appear developmental and resemble those made by younger hearing children, demonstrate typical phonological processes and normal sequence of phoneme acquisition, vowels and suprasegmentals usually normal
Speech characteristics for pre lingual severe to profound hearing loss
Difficulties with consonants, vowels, and voice quality, respiration and phonation may be effected, resonation may be used as feedback, suprasegmentals may be effected
Speech characteristics for post lingual profound hearing loss
Gradual deterioration in speech intelligibility, changes in voice quality, vowel neutralizations, changes in /s/ and /sh/, voiced/voiceless substitutions /r/ for /w/ substitutions, final consonant omission
Speech intervention
Amplifications must be word and functioning, targets are selected according to the normal development sequence, intervention should be meaningful and functional, develop the child's feedback loop with visual, tactile, and kinesthetic cues, sit at eye level with the child, sit across from the child or to the side of the child's better ear at a 90 degree angle, 10 minutes of speech training several times a day is better than 1 hour daily, carryover throughout the day
Speech intervention resources
Ling- speech and the hearing-impaired child, Ling- foundation of spoken language for hearing impaired children, The Ling Thing, Calvery and Silverman- speech and deafness, Walling and Harrison- A speech guide for teachers and clinicians of hearing impaired children
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