Auditory Development

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Auditory Development

• In Children with Hearing Loss and Additional
  Disabilities

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Purpose of Presentation

• Discuss strategies for working with children who
  are learning to listen, and who have special
  circumstances
• Multiple Disabilities
• Motor Structural
• Visual
• Cognitive
• Language
• English as a Second Language
• Auditory Neuropathy
• ADHD

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Outline

• Review
• How we hear
• Hearing Instrument Technology
• Or They CAN hear you now
• Audiograms and what they tell us
• Or Audiograms and what they dont tell us
• Auditory Development
• Re-Evaluating our Definition of Success
• Realistic Expectations
• Techniques
• Or Changing I talk! into the Nitty Gritty of
  everyday every moment learning to listen

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Electrode array inserted into Scala Tympany
(MedEL) (Cochlear array occupies less than ½ of
ST crossection
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Amplification

• Access to sound
• What sounds
• speech spectrum all some none
• Environmental
• Expect child to hear
• A word on technology
• Digital hearing aids
• Cochlear implants

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• Hearing Aid Technology FM

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Advanced Bionics Processors
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FM Advances in Technology
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Aided Audiogram
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Aided Audiogram, CI
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Primary motor cortex (M1)
Motor homunculus
Hip
Trunk
Arm
Hand
Foot
Face
Tongue
Larynx
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Audiogram with Ling Sounds

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Auditory Development Within the Brain Nervous
System

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Auditory Brain Development - Birth to 5 years

• What demonstrated?
• Receptive
• Expressive
• How is it developed?
• Internal External Forces
• Motivation
• Expectation

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Auditory Brain Development Birth to 5 cont.

• NOT AUTOMATIC
• LEARNED BEHAVIOR
• HEARING, HARD OF HEARING, OR DEAF, with special
  needs...IS THERE A DIFFERENCE?

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Factors that Affect Progress in Comprehensive
Auditory Development

• Amplification
• Environment
• Teaching
• Child

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Amplification What to Do

• Wear hearing instrument every day, all day
• Communicate with audiologist
• May need a Map (CI) or Program (HA) change
• Know what child can perceive through device and
  be aware of changes
• Report changes to audiologist

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Environment

• Room Acoustics Poor Signal to Noise Ratio
• Audiotechnotalk for sound is bouncing off the
  walls.
• 2001 ANSI Standards for Classroom Acoustics
• In the mean timequiet classroom

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Child

• Cognitive deficit
• Language learning problem
• Attention cant stay on task
• Oral-motor
• Poor short-term memory
• Syndromes Genetics

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Teaching

• BUT I TALK!!!
• Expectation for listening, you must create it,
  throughout the day
• Take the training out of auditory training
• Ten Auditory Processes by L. Daniel.

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Auditory development as it is related to speech
language development
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Ten Auditory Processes
Linda Daniel 1998
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Ten Auditory Processes
Linda Daniel 1998
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Ten Auditory Processes
Linda Daniel 1998
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Music can (and is only a small part of auditory
integration!)

• Reinforce active listening skills
• Stimulate verbal responses
• Stimulate motor responses
• Be easily adapted to any age, ability, or culture
• Release and nurture creativity
• Be a non-verbal/pre-verbal means of communication
• Motivate
• Build a sense of community

By permission Christine Barton, MM, MT-BC
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Audition, Speech and MusicConnections and
Differences

• SPEECH
• Intonation
• Rate
• Stress
• Rhythm
• Duration
• Produced by voice
• Speech decoding (temporal) on left auditory
  cortical regions

• MUSIC
• Intonation
• Tempo
• Accent
• Rhythm
• Duration
• Produced by voice and instruments
• Pitch discrimination (frequency) on right
  cortical regions

By permission Christine Barton, MM, MT-BC
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Musical Development
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Musical Activities

• Steady Beat
• Sing/Stop
• Sing/Hum
• Pitch Imitation
• Pitch Discrimination

Music hath charms to sooth the savage beast -
unknown
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Building Blocks for Success

• Expectations
• Programming
• Equipment Management

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Establishing Expectations

• Uncertainty
• Short and long term goals should be discussed
  early and often
• Consensus across team
• May need to use a different measuring stick
• Rate of Progress
• Augmentative Communication

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The Cement

• 90/10 Concept
• Experience
• Teamwork
• Thinking

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Equipment Management Considerations for Children
with Multiple Disabilities

• Creativity may be called for in device
  positioning
• Traditional options
• Earmold
• Otoclip
• Huggie or Mic Lock Tubing
• Non Traditional options
• Hats
• Huggie Head
• Contralateral microphone placement
• Velcro
• Pin processor to collar

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Summary

• Special children have unique needs.
• With flexibility, creativity, and teamwork,
  guided by experience
• 1,000,0001 chance need not be the odds of
  achieving rewarding use of hearing in challenging
  cases.

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Association Method

• Mildred McGinnis, 1963, Aphasic Children
  published by A.G. Bell
• Association/integration of attention, retention
  and recall
• Principles such as Preceptive follows expressive,
  mastery of material, no prompting.
• Rote memory builds auditory memory

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Differences in Learners10 vocabulary words

• Fast learner
• Day 1 Introduce all 10 words in conversational
  setting
• Day 2 Check comprehension child gets all but
  one or two
• Day 3 Child knows all words pretty well
• Continued practice for mastery

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Differences in Learners10 vocabulary words

• Average Learner
• Introduce 5 words individually and child says
  each
• Add other words gradually next two days
• Third day child comprehends all words and can
  name at least half
• Can name all easily and quickly by end of the week

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Differences in Learners10 vocabulary words

• Slow Learner
• Introduce 3 or 4 words
• Practice in sets with know words
• Pull out and practice those child is forgetting
• Add a new word each day
• Continue to practice ones already introduced